The Influence of General and Local Muscle Fatigue on Kinematics and Plantar Pressure Distribution during Running: A Systematic Review and Meta-Analysis

Fatigue has the potential to alter how impact forces are absorbed during running, heightening the risk of injury. Conflicting findings exist regarding alterations in both kinematics and plantar pressure. Thus, this systematic review and subsequent meta-analysis were conducted to investigate the impact of general and localized muscle fatigue on kinematics and plantar pressure distribution during running. Initial searches were executed on 30 November 2021 and updated on 29 April 2023, encompassing PubMed, The Cochrane Library, SPORTDiscus, and Web of Science without imposing any restrictions on publication dates or employing additional filters. Our PECOS criteria included cross-sectional studies on healthy adults during their treadmill running to mainly evaluate local muscle fatigue, plantar pressure distribution, biomechanics of running (kinematics, kinetics, and EMG results), and temporospatial parameters. The literature search identified 6626 records, with 4626 studies removed for titles and abstract screening. Two hundred and one articles were selected for full-text screening, and 20 studies were included in qualitative data synthesis. The pooled analysis showed a non-significant decrease in maximum pressure under the right forefoot's metatarsus, which was more than the left rearfoot after local muscle fatigue at a velocity of 15 km/h (p-values = 0.48 and 0.62). The results were homogeneous and showed that local muscle fatigue did not significantly affect the right forefoot's stride frequency and length (p-values = 0.75 and 0.38). Strength training for the foot muscles, mainly focusing on the dorsiflexors, is recommended to prevent running-related injuries. Utilizing a standardized knee and ankle joint muscle fatigue assessment protocol is advised. Future experiments should focus on various shoes for running and varying foot strike patterns for injury prevention.