The effect of fatigue on asymmetry between lower limbs in functional performances in elite child taekwondo athletes

J Orthop Surg Res. 2021 Jan 9;16(1):33. doi: 10.1186/s13018-020-02175-7.

Abstract

Background: Inter-limb asymmetry above a certain threshold in functional performance indicates increased injury risk in sports. Fatigue has been found to increase bilateral asymmetry in lower-limb jumping performance among high-school and adult athletes, whereas this impact has not been examined in child athletes. This study aimed to examine the effect of fatigue on inter-limb asymmetry in functional performances in elite Taekwondo athletes aged between 9 and 11 years.

Methods: Performance of single-leg jumps, Star Excursion Balance Test (SEBT), and muscle (hamstring and gastrocnemius) flexibility were measured for 13 elite male child Taekwondo athletes (aged 9.85 ± 0.80 years) at both the rested and fatigued states to examine the inter-limb asymmetry. A two-way repeated measures ANOVA was conducted to examine for difference and the interaction between limb (dominant, non-dominant leg) and state (rested, fatigued state) for each test. Paired t test or Wilcoxon signed-rank test was used to compare the asymmetry magnitude at the rested vs. fatigued state for each test, and the variation of performance post fatigue in the dominant vs. non-dominant leg when appropriate.

Results: The inter-limb asymmetry in triple-hop distance significantly (p = 0.046) increased with fatigue, whereas the asymmetry significantly (p = 0.004) decreased with fatigue in anterior (ANT) reach distance in SEBT. A significant (p = 0.027) limb by state interaction was shown for posterolateral (PL) reach distance in SEBT, wherein a significant (p = 0.005) bilateral difference was only shown at the rested state. The PL reach distance showed a significantly greater decrease (p = 0.028) post fatigue when using the dominant leg for support compared to using the non-dominant leg.

Conclusions: Fatigue significantly impacts inter-limb asymmetry in jump performances and dynamic balance for child athletes, while the variation of inter-limb asymmetry post fatigue may be different across tests. For the purpose of injury prevention, practitioners should consider assessing the inter-limb asymmetry for children at both the rested and fatigued state and be mindful of the fatigue response of each leg in functional tests.

Keywords: Bilateral asymmetry; Dynamic balance; Fatigue; Injury; Lower-limb power; Muscle flexibility.

MeSH terms

  • Age Factors
  • Athletes*
  • Athletic Injuries / etiology
  • Athletic Injuries / prevention & control
  • Child
  • Fatigue / physiopathology*
  • Humans
  • Lower Extremity / physiopathology*
  • Male
  • Muscle, Skeletal / physiopathology*
  • Physical Functional Performance*
  • Pliability
  • Postural Balance
  • Risk
  • Sports*