Effects of knee muscle fatigue on gait and proprioception in multiple sclerosis
5 affiliations
- 1Trakya University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Edirne, Türkiye.
- 2Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Ankara, Türkiye.
- 3Sivas Cumhuriyet University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Sivas, Türkiye.
- 4Aydın Adnan Menderes University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Aydın, Türkiye.
- 5Lokman Hekim University, Department of Neurology – Ankara, Türkiye.
Abstract
SUMMARY: OBJECTIVE:: People with multiple sclerosis often experience muscle weakness and fatigue, which impair proprioception and gait. The effects of knee muscle fatigue on these outcomes remain unclear. This study investigated the effects of a knee muscle fatigue protocol on knee position sense and gait in people with multiple sclerosis.
METHODS:: A total of 36 mildly affected people with multiple sclerosis and nine healthy controls participated in this case-control study with repeated pre- and post-fatigue assessments. Gait was assessed using a G-Walk sensor, and knee position sense with an active repositioning test on an isokinetic dynamometer. Muscle strength and fatigue indexes were determined isokinetically for the knee flexors and extensors.
RESULTS:: During the fatigue protocol, people with multiple sclerosis produced lower total workloads than healthy control, although fatigue indexes were similar. After fatigue, both groups showed increased cadence and reduced gait cycle duration, while gait speed increased only in people with multiple sclerosis. Knee position sense deteriorated bilaterally in people with multiple sclerosis and on the non-dominant side in healthy control.
CONCLUSION:: Localized knee muscle fatigue altered knee position sense and gait in both groups, with no significant group×time interaction, though the small control group warrants caution. Similar fatigue indices despite lower total work warrant cautious interpretation of the Cybex fatigue index, given its dependence on baseline torque. As proprioceptive acuity declined transiently after localized knee muscle fatigue, clinicians may consider performing balance- or coordination-demanding tasks beforehand in people with multiple sclerosis.
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BibTeX
@article{yıldırım2026effects,
title = {{Effects of knee muscle fatigue on gait and proprioception in multiple sclerosis}},
author = {Muhammed Şeref Yıldırım and Cagla Ozkul and Gamze Cobanoglu and Kader Eldemir and Sefa Eldemir and Fettah Saygili and Nevin Atalay Guzel and Ceyla Irkec and Arzu Guclu-Gunduz},
journal = {Revista da Associacao Medica Brasileira (1992)},
year = {2026},
month = oct,
doi = {10.1590/1806-9282.20260933},
url = {https://europepmc.org/article/PMC/PMC13722091},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of knee muscle fatigue on gait and proprioception in multiple sclerosis
AU - Muhammed Şeref Yıldırım
AU - Cagla Ozkul
AU - Gamze Cobanoglu
AU - Kader Eldemir
AU - Sefa Eldemir
AU - Fettah Saygili
AU - Nevin Atalay Guzel
AU - Ceyla Irkec
AU - Arzu Guclu-Gunduz
PY - 2026
DA - 2026/10/30
JO - Revista da Associacao Medica Brasileira (1992)
DO - 10.1590/1806-9282.20260933
UR - https://europepmc.org/article/PMC/PMC13722091
AB - SUMMARY: OBJECTIVE:: People with multiple sclerosis often experience muscle weakness and fatigue, which impair proprioception and gait. The effects of knee muscle fatigue on these outcomes remain unclear. This study investigated the effects of a knee muscle fatigue protocol on knee position sense and gait in people with multiple sclerosis. METHODS:: A total of 36 mildly affected people with multiple sclerosis and nine healthy controls participated in this case-control study with repeated pre- and post-fatigue assessments. Gait was assessed using a G-Walk sensor, and knee position sense with an active repositioning test on an isokinetic dynamometer. Muscle strength and fatigue indexes were determined isokinetically for the knee flexors and extensors. RESULTS:: During the fatigue protocol, people with multiple sclerosis produced lower total workloads than healthy control, although fatigue indexes were similar. After fatigue, both groups showed increased cadence and reduced gait cycle duration, while gait speed increased only in people with multiple sclerosis. Knee position sense deteriorated bilaterally in people with multiple sclerosis and on the non-dominant side in healthy control. CONCLUSION:: Localized knee muscle fatigue altered knee position sense and gait in both groups, with no significant group×time interaction, though the small control group warrants caution. Similar fatigue indices despite lower total work warrant cautious interpretation of the Cybex fatigue index, given its dependence on baseline torque. As proprioceptive acuity declined transiently after localized knee muscle fatigue, clinicians may consider performing balance- or coordination-demanding tasks beforehand in people with multiple sclerosis.
SN - 0104-4230
SN - 1806-9282
ER -