Effects of Quadriceps Fatigue on the Outcomes of Slips and Falls

Identifying potential risk factors that affect slip-induced falls is key to developing effective interventions for reduction of injuries caused by these accidents. Existing epidemiological evidence suggests that localized muscle fatigue might be considered as an intrinsic risk factor that causes lack of balance control leading to falls. The literature on the relationship between localized muscular fatigue of the lower extremity and the gait parameters affecting slip severity is scarce. The purpose of the present study was to examine how lower extremity fatigue (quadriceps) alters gait parameters and increases slip severity. Sixteen healthy young participants were recruited to walk across an unexpected slippery floor in two different sessions (Fatigue and No fatigue). Kinematic and kinetic data were collected using a three-dimensional video analysis system and force plates during both sessions. The gait parameters important in assessing slip severity were compared for the two different sessions to evaluate the effects of fatigue. A repeated measure one-way analysis of variance (ANOVA) and multivariate analysis was employed to predict statistical significance. The results indicated a substantial increase in the heel contact velocity (HCV), required coefficient of friction (RCOF), slip distance II (SDII), peak average knee joint moment during slip recovery (kneemompeak), fall frequency and, a decrease in the transitional acceleration of the whole body COM (TA) in the fatigue session further indicating higher slip severity due to fatigue. In addition, a strong positive correlation was observed between RCOF and HCV, HCV and SDII, and, SDII and kneemompeak. These findings provide new insights into the relationship between localized muscular fatigue and slip initiation/recovery process. The present study concluded that localized muscular fatigue affects the gait parameters and increases slip severity and hence can be considered as a potential risk factor for slip-induced falls.