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Impact of Exercise-Induced Fatigue on the Strength, Postural Control, and Gait of Children with a Neuromuscular Disease

Hart, Raphael MSc; Ballaz, Laurent PhD; Robert, Maxime MSc; Pouliot, Annie MSc; D’Arcy, Sylvie BSc, PT; Raison, Maxime PhD; Lemay, Martin PhD

American Journal of Physical Medicine & Rehabilitation: August 2014 - Volume 93 - Issue 8 - p 649–655
doi: 10.1097/PHM.0000000000000091
Original Research Articles

Objective Children with a neuromuscular disease are prone to early muscular fatigue. The objective of the present study was to evaluate the effects of fatigue induced by a walking exercise on the strength, postural control, and gait of children with a neuromuscular disease.

Design Maximal isometric knee strength (extension and flexion), quiet standing postural control, and gait were evaluated in 12 children (8.8 [1.4] yrs) with a neuromuscular disease before and after a walking exercise. The participants were asked to stop walking when they considered themselves “very fatigued.”

Results After the exercise-induced fatigue, a significant increase in range of motion in pelvis obliquity, hip abduction and adduction, and ankle flexion and extension during gait was reported along with an increase in stride length variability. Fatigue also reduced the knee flexor strength and had a detrimental effect on postural control.

Conclusions Fatigue affects the strength, postural control, and gait of children with a neuromuscular disease and could notably increase the risks of falling and the occurrence of serious injuries.

From the Centre de réadaptation Marie Enfant, CHU Sainte-Justine, Montreal, Quebec, Canada (RH, LB, MR, AP, SD, MR, ML); Département de kinanthropologie, Université du Québec à Montréal, Montreal, Quebec, Canada (RH, LB, MR, AP, ML); Groupe de recherche en activité physique adaptée (GRAPA), Montreal, Quebec, Canada (LB, ML); and Département de génie mécanique, École Polytechnique de Montréal, Montreal, Quebec, Canada (MR).

All correspondence and requests for reprints should be addressed to: Martin Lemay, PhD, Centre de réadaptation Marie Enfant, 5200 Bélanger, Montreal, Quebec, Canada, H1T 1C9.

Supported by a research grant from the CHU Sainte-Justine Research Center. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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