Fakhraei Rad, Niloofar, Singh, Utkarsh, and Doma, Kenji (2025) Impact of Exercise-Induced Muscle Damage on Balance: A Systematic Review and Meta-Analysis. Journal of Science in Sport and Exercise. (In Press)

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Abstract

Purpose: This systematic review and meta-analysis examined the impacts of exercise-induced muscle damage (EIMD) on balance performance.

Methods: Meta-analyses were conducted to report on standardized mean differences (SMD) and associated p-values for overall balance performance and across four separate conditions, including anterior–posterior direction, mediolateral direction, stable and unstable conditions at 24 and 48 h after the muscle-damaging protocols. Indirect muscle damage markers were also analysed, including creatine kinase (CK) and delayed onset of muscle soreness (DOMS). Meta-analyses were not conducted for outcome measures with fewer than five effect points, and rather, reported qualitatively.

Results: Seven studies, with effect points ranging between 6-11 groups, were included for the forest plots. Overall balance and balance in both stable and unstable conditions were impaired at 24-h and 48-h post-exercise (P < 0.001, respectively), with a larger attenuation observed in the unstable condition according to the SMD value. Qualitative data indicated mixed results for balance performance, with differences between anterior–posterior and mediolateral directions. Some studies reported impairment in both directions, whilst other studies showed no differences. The EIMD markers, including CK and DOMS, increased significantly, whilst muscle performance was impaired at 24-h and 48-h post-exercise in all conditions (P < 0.001, respectively).

Conclusion: Balance performance was impaired when EIMD markers were elevated, with greater attenuation in the unstable condition. Although further research is necessary to confirm the effects of EIMD on balance performance in the anterior–posterior and mediolateral directions, caution should be taken to minimize the risk of falls during periods of EIMD, particularly in unstable conditions.

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