Wed, Aug 19, 2026
Volume 16, Issue 3 (Summer 2026)
PTJ 2026, 16(3): 243-254 |
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Hamzeh L, Jafarnejadgero A, Piri H, Tabatabai Ghomsheh F. Impact of Fatigue on Lower-limb Biomechanics in Individuals With Dynamic Knee Valgus: A Meta-analysis. PTJ 2026; 16 (3) :243-254
URL: http://ptj.uswr.ac.ir/article-1-737-en.html
URL: http://ptj.uswr.ac.ir/article-1-737-en.html
1- Department of Sports Biomechanics, CT.C., Islamic Azad University, Tehran, Iran.
2- Department of Sport Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
3- Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran.
4- Department of Ergonomics, Neurorehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Sport Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
3- Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran.
4- Department of Ergonomics, Neurorehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract: (2199 Views)
Purpose: This structured review aimed to examine the effects of fatigue on lower-limb biomechanics in individuals with dynamic knee valgus (DKV).
Methods: A comprehensive review was conducted using Scopus, Web of Science, and PubMed, spanning from the launch of these databases until January 5, 2025. To measure the effect of fatigue, we employed Hedges’ g as the effect size and calculated 95% confidence intervals (CIs) through either random-effects or fixed-effects models. A random-effects model was used when I² values exceeded 50%. Both reviewers assessed the risk of bias using the Newcastle-Ottawa scale (NOS).
Results: Following the screening phase, six studies involving 171 participants were incorporated into the review. The findings from the meta-analysis revealed that the fatigue intervention resulted in an amplified knee valgus angle in the dominant limb (effect size: -0.78, 95% CI, -1.56%, -0.01%, P=0.001), alongside a notable increase in the knee valgus angle of the non-dominant limb (effect size: -0.56, 95% CI=-0.78%, -0.21%, P=0.001).
Conclusion: The results indicated that fatigue-inducing protocols substantially increased the DKV angle in both the dominant and non-dominant lower limbs of the participants. The increase in knee valgus angles due to fatigue highlights a critical area for intervention and monitoring. By addressing these changes, professionals can enhance injury prevention strategies, optimize athletic performance, and improve rehabilitation outcomes for individuals with DKV. Nonetheless, the results of this study must be viewed with caution due to the diversity of fatigue protocols, differences in biomechanical assessment methods, and the challenges posed by small sample sizes.
Methods: A comprehensive review was conducted using Scopus, Web of Science, and PubMed, spanning from the launch of these databases until January 5, 2025. To measure the effect of fatigue, we employed Hedges’ g as the effect size and calculated 95% confidence intervals (CIs) through either random-effects or fixed-effects models. A random-effects model was used when I² values exceeded 50%. Both reviewers assessed the risk of bias using the Newcastle-Ottawa scale (NOS).
Results: Following the screening phase, six studies involving 171 participants were incorporated into the review. The findings from the meta-analysis revealed that the fatigue intervention resulted in an amplified knee valgus angle in the dominant limb (effect size: -0.78, 95% CI, -1.56%, -0.01%, P=0.001), alongside a notable increase in the knee valgus angle of the non-dominant limb (effect size: -0.56, 95% CI=-0.78%, -0.21%, P=0.001).
Conclusion: The results indicated that fatigue-inducing protocols substantially increased the DKV angle in both the dominant and non-dominant lower limbs of the participants. The increase in knee valgus angles due to fatigue highlights a critical area for intervention and monitoring. By addressing these changes, professionals can enhance injury prevention strategies, optimize athletic performance, and improve rehabilitation outcomes for individuals with DKV. Nonetheless, the results of this study must be viewed with caution due to the diversity of fatigue protocols, differences in biomechanical assessment methods, and the challenges posed by small sample sizes.
Type of Study: Systematic Review |
Subject:
General
Received: 2025/02/18 | Accepted: 2025/05/31 | Published: 2026/07/1
Received: 2025/02/18 | Accepted: 2025/05/31 | Published: 2026/07/1
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