Effects of Experimentally Induced Lower Limb Muscle Fatigue on Healthy Adults' Gait: A Systematic Review

Lower limb fatigue reduces muscle strength, alters joint biomechanics, affects gait, and increases injury risk. In addition, it is of great clinical significance to explore local muscle fatigue or weakness caused by fatigue to understand its compensatory effect on the ipsilateral or contralateral joints. We systematically searched multiple databases, including five databases, using key terms such as "Muscle Fatigue" and "Gait". Only studies that experimentally induced fatigue through sustained muscle activities in healthy adults were included. This review examined 11 studies exploring the effects of lower limb muscle fatigue on gait and lower limb biomechanics. The findings indicated that muscle fatigue significantly influenced spatiotemporal parameters, joint angles, and moments. Most studies that were reviewed reported an increase in step width and a decrease in knee joint moments following fatigue. Additionally, muscle activation levels tended to decline. In summary, compensatory mechanisms can lead to new walking strategies, such as increasing step width or enhancing the strength of muscles in adjacent joints. These adjustments impact dynamic balance differently: wider steps may enhance medial-lateral stability, while reduced muscle strength could lead to higher heel contact velocity and longer slip distances. Although these changes might influence dynamic balance, compensatory strategies may help mitigate the overall effect of fall risk. Future studies should use appropriate protocols, such as moderate or severe fatigue interventions with isokinetic dynamometry.