Background and aims The core plays a crucial role in providing stability, facilitating efficient force transmission, and reducing the risk of injury in athletes. Core muscle fatigue can disrupt neuromuscular function, potentially impairing knee joint control and postural stability. This study examined the effects of trunk muscle and neuromuscular fatigue on knee muscle feedforward activation and postural control in elite athletes. Methods Thirty-two elite female athletes participated in the study. In the first session, baseline assessments were conducted under non-fatigue conditions. In the second session, participants were randomly assigned to either a neuromuscular fatigue group (n = 16) or a trunk muscle fatigue group (n = 16), followed by immediate post-fatigue testing. After a 72 h washout period, participants completed the alternate fatigue protocol in a crossover design during the third session. Feedforward activity of the vastus medialis (VM), vastus lateralis (VL), and gluteus medius (GM) muscles, and postural control were evaluated as outcomes. Results Significant differences in feedforward activity were found among the three fatigue conditions for the VM during double-leg landing (p = 0.006) and the GM during single-leg landing (p = 0.03), but not during lateral hopping (p > 0.05). The center of pressure sway area also differed significantly across fatigue conditions in both eyes-open (p = 0.002) and eyes-closed (p = 0.04) postural tests. Conclusion The feedforward activity of the VM in the double-leg landing and the GM in the single-leg landing tasks significantly differed among the fatigue conditions. Control of posture was also affected by the fatigue conditions.
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