• Sarit SUWANMANA Mahidol university
  • Metta PINTHONG
Keywords: Postural control / Muscle fatigue / Older adults / Center of pressure / Center of mass.


            The aim of this study was to investigate the effect of unilateral ankle fatigue on postural control in older adults. Fourteen older adults (male = 7, female = 7) volunteered to participate in this study. Subjects (aged 65 ± 4 years) were asked to perform perturbation tests; bipedal standing followed by 15 repetitions of rapid arm raising, during pre-fatigue and post-fatigue conditions. Ankle fatigue was induced in dominant leg by preforming repetitive dorsi-and plantar-flexion exercise (120°/s) and terminated when maximum voluntary isometric contraction (MVIC) decreased to 50%. To evaluate postural control, center pressure (COP) excursion and center of mass (COM) displacement were recorded during the perturbation using 10 cameras motion capture (BTS DX 5000, BTS Bioengineering, Italy) and force platform (Kistler Instrument AG, Switzerland). Results showed that COP excursion and COM displacement in anterior posterior direction were significantly increased (p<0.05) after ankle fatigue (COP: Pre- vs. Post fatigue = 20.0 ± 6.4 vs. 22.2 ± 6.6); (COM: Pre- vs. Post fatigue = 7.8 ± 1.6 vs. 8.8 ± 1.5). However, no significant changes of COP and COM was observed in medial-lateral direction. It can be concluded that postural control capability during perturbation in older adults was compromised by acute unilateral ankle muscle fatigue.
(Journal of Sports Science and Technology 2019; 19(1): 49-57)
(Received: 1 May 2019, Revised: 12 June 2019, Accepted: 13 June 2019)
Keywords: Postural control / Muscle fatigue / Older adults / Center of pressure / Center of mass.
*Corresponding author: Metta PINTHONG, PhD
College of Sports Science and Technology, Mahidol University,
Salaya campus, Phuttamonton, Nakhonpathom, Thailand, 73170


1. Kim MJ, Kim TY, Choi YA, et al. A study on the characteristics of standing posture of elderly women with sarcopenia in Korea. J Exerc Rehabil. 2018;14(3):481.
2. Onambele GL, Narici MV, Maganaris CN. Calf muscle-tendon properties and postural balance in old age. J Appl Physiol. 2006;100(6):2048-56.
3. Granacher U, Zahner L, Gollhofer A. Strength, power, and postural control in seniors: Considerations for functional adaptations and for fall prevention. Eur J Sport Sci. 2008;8(6):325-40.
4. Nagy E, Feher-Kiss A, Barnai M, et al. Postural control in elderly subjects participating in balance training. Eur J Appl Physiol. 2007;100(1):97-104.
5. Lephart SM, Buz Swanik C, Boonriong T. Anatomy and physiology of proprioception and neuromuscular control. Athl Ther Today. 1998;3(5):6-9.
6. Hiemstra LA, Lo IK, Fowler PJ. Effect of fatigue on knee proprioception: implications for dynamic stabilization. J Orthop Sports Phys Ther. 2001;31(10):598-605.
7. Horak FB, Henry SM, Shumway-Cook A. Postural perturbations: new insights for treatment of balance disorders. Phys Ther. 1997;77(5):517-33.
8. Lemay JF, Gagnon DH, Nadeau S, et al. Center-of-pressure total trajectory length is a complementary measure to maximum excursion to better differentiate multidirectional standing limits of stability between individuals with ncomplete spinal cord injury and able-bodied individuals. J Neuroeng Rehabil 2014;11(1):8.
9. Kanekar N, Aruin AS. The effect of aging on anticipatory postural control. Exp Brain Res.2014;232(4):1127-36.
10. Tanaka T, Takeda H, Izumi T, Ino S, Ifukube T. Age-Related Changes in Postural Control Associated with Location of the Center of Gravity and Foot Pressure. Phys Occup Ther Geriatr.1997;15(2):1-14.
11. Yu E, Abe M, Masani K, Kawashima N, Eto F, Haga N, et al. Evaluation of postural control in quiet standing using center of mass acceleration: comparison among the young, the elderly, and people with stroke. Arch Phys Med Rehabil. 2008;89(6):1133-9.
12. Stackhouse SK, Stevens JE, Lee SC, et al. Maximum voluntary activation in nonfatigued and fatigued muscle of young and elderly individuals. Phys Ther. 2001;81(5):1102-9.
13. Gimmon Y, Riemer R, Oddsson L, Melzer I. The effect of plantar flexor muscle fatigue on postural control. J Electromyogr Kinesiol. 2011;21(6):922-8.
14. Bellew JW, Fenter PC. Control of balance differs after knee or ankle fatigue in older women. Arch Phys Med Rehabil. 2006;87(11):1486-9.
15. Forestier N, Teasdale N, Nougier V. Alteration of the position sense at the ankle induced by muscular fatigue in humans. Med Sci Sports Exerc. 2002;34(1):117-22.
16. Gribble PA, Hertel J. Effect of lower-extremity muscle fatigue on postural control. Arch Phys Med Rehabil. 2004;85(4):589-92.
17. Nam HS, Park DS, Kim DH, et al. The relationship between muscle fatigue and balance in the elderly. Ann Rehabil Med. 2013;37(3):389.
18. Kennedy A, Guevel A, Sveistrup H. Impact of ankle muscle fatigue and recovery on the anticipatory postural adjustments to externally initiated perturbations in dynamic postural control. Exp Brain Res. 2012;223(4):553-62.
19. Skelton DA, Kennedy J, Rutherford OM. Explosive power and asymmetry in leg muscle function in frequent fallers and non‐fallers aged over 65. Age Ageing. 2002;31(2):119-25.
20. Maki BE. Gait changes in older adults: predictors of falls or indicators of fear? J Am Geriatr Soc.1997;45(3):313-20.
21. Washburn RA, McAuley E, Katula J, Mihalko SL, et al. The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol. 1999;52(7):643-51.
22. Lajoie Y, Gallagher SP. Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Confidence (ABC) scale for comparing fallers and non-fallers. Arch Gerontol Geriatr. 2004;38(1):11-26.
23. Laohaprasitiporn P, Jarusriwanna A, Unnanuntana A. Validity and reliability of the Thai version of the Barthel Index for elderly patients with femoral neck fracture. J Med Assoc Thai. 2017;100(5):539-48.
24. Rab G, Petuskey K, Bagley A. A method for determination of upper extremity kinematics. Gait Posture. 2002;15(2):113–9.
25. Davis RB, Õunpuu S, Tyburski D, et al. A gait analysis data collection and reduction technique.Hum Mov Sci. 1991;10(5):575-87.
26. Bisson EJ, McEwen D, Lajoie Y, et al. Effects of ankle and hip muscle fatigue on postural sway and attentional demands during unipedal stance. Gait Posture. 2011;33(1):83-7.
27. Heit EJ, Lephart SM, Rozzi SL. The effect of ankle bracing and taping on joint position sense in the stable ankle. J Sport Rehabil. 1996;5(3):206-13.
28. Winter DA, Prince F, Frank JS, et al. Unified theory regarding A/P and M/L balance in quiet stance.J Neurophysiol. 1996;75(6):2334-43.
29. Winter DA. Human balance and posture control during standing and walking. Gait Posture.1995;3(4):193–214.
30. Brenière, Y. Why we walk the way we do. J Mot Behav. 1996;28(4):291-8.
31. Madigan ML, Davidson BS, Nussbaum MA. Postural sway and joint kinematics during quiet standing are affected by lumbar extensor fatigue. Hum Mov Sci. 2006;25(6):788-99.
32. Boyas S, Remaud A, Bisson EJ, Cadieux S, Morel B, Bilodeau M. Impairment in postural control is greater when ankle plantarflexors and dorsiflexors are fatigued simultaneously than when fatigued separately. Gait Posture. 2011;34(2): 254-9.
33. Lundin TM, Feuerbach JW, Grabiner MD. Effect of plantar flexor and dorsiflexor fatigue on unilateral postural control. J Appl Biomech.1993;9(3):191- 201.
Research Article