Hopkins J T, Ingersoll C D, Edwards J E, Cordova M L
Athletic Training Department, Indiana State University, Terre Haute 47809, USA.
Arch Phys Med Rehabil. 2000 Sep;81(9):1199-203. doi: 10.1053/apmr.2000.6298.
To compare changes in the magnitude of soleus motoneuron excitability before and over a 4-hour period following artificial knee effusion.
Before-after trial.
All measurements were collected in the Sports Injury Research Laboratory, Indiana State University.
Eleven healthy and neurologically sound volunteers (mean age +/- SD, 24 +/- 3yr; height, 173.2 +/- 9.6cm; weight, 72.9 +/- 8.7kg) with no history of lower-extremity surgery and no lower extremity pathology in the last year.
An area superolateral to the patella was cleaned and injected subcutaneously with 2mL of lidocaine for anesthetic purposes. With a second disposable syringe, 25mL of sterile saline was injected through the superolateral knee joint capsule into the joint space to mimic mechanical joint effusion.
Hoffmann's reflex (H-reflex) was elicited by applying a percutaneous stimulus to the tibial nerve in the popliteal fossa. Seven to 12 stimuli were delivered at 20-second intervals with varying intensities to find the maximal H-reflex. The maximal H-reflex was measured five times at the same stimulus intensity with 20-second rest intervals. This measurement was recorded before injection and at 1-hour intervals following the injection for 4 hours.
An overall difference between groups was found. Measurements from hours 3 and 4 were significantly higher than the preinjection measurements (p < or = .05).
The soleus motoneuron pool was not inhibited as expected. The soleus was facilitated beyond the preinjection level, showing that the quadriceps and soleus do not respond in the same way to artificial knee effusion. Because the quadriceps are normally inhibited during knee effusion, this facilitation could be the result of a compensatory reaction by the soleus in response to inhibited quadriceps. Further studies must be performed to determine the extent and duration of soleus motoneuron pool excitability in relation to quadriceps inhibition elicited by artificial knee effusion.
比较人工膝关节积液前后4小时比目鱼肌运动神经元兴奋性的变化幅度。
前后对照试验。
所有测量均在印第安纳州立大学运动损伤研究实验室进行。
11名健康且神经系统健全的志愿者（平均年龄±标准差，24±3岁；身高，173.2±9.6厘米；体重，72.9±8.7千克），无下肢手术史且过去一年无下肢病变。
清洁髌骨上方外侧区域，皮下注射2毫升利多卡因用于麻醉。用第二个一次性注射器，通过膝关节囊上方外侧将25毫升无菌生理盐水注入关节腔以模拟机械性关节积液。
通过对腘窝处的胫神经施加经皮刺激来引出霍夫曼反射（H反射）。每隔20秒以不同强度给予7至12次刺激以找到最大H反射。在相同刺激强度下，每隔20秒休息一次，测量最大H反射5次。在注射前以及注射后每隔1小时记录一次该测量值，共记录4小时。
发现组间存在总体差异。第3小时和第4小时的测量值显著高于注射前测量值（p≤0.05）。
比目鱼肌运动神经元池未如预期受到抑制。比目鱼肌的兴奋性超过注射前水平，表明股四头肌和比目鱼肌对人工膝关节积液的反应方式不同。由于在膝关节积液期间股四头肌通常会受到抑制，这种易化可能是比目鱼肌对受抑制的股四头肌做出的代偿反应的结果。必须进行进一步研究以确定比目鱼肌运动神经元池兴奋性相对于人工膝关节积液引起的股四头肌抑制的程度和持续时间。
