Miura Kazutomo, Ishibashi Yasuyuki, Tsuda Eiichi, Okamura Yoshihisa, Otsuka Hironori, Toh Satoshi
Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Hirosaki, Japan.
Arthroscopy. 2004 Apr;20(4):414-8. doi: 10.1016/j.arthro.2004.01.007.
The purpose of this study was to compare the effects of local and general fatigue loads on knee proprioception.
Experimental controlled study.
Proprioception of the knee joint was evaluated by measuring absolute angular error (AAE) at matching defined index angles before and after 2 different types of fatigue protocols (local load and general load) in 27 healthy male volunteers. Local load was provided with maximum isokinetic knee flexion-extension on the isokinetic dynamometer, and general load was 5 minutes running on a treadmill.
After local load, a significant decrease in peak torque of knee flexors and extensors was found, but no significant change in AAE was seen. In contrast, after general load, a significant increase of AAE was noted without significant muscle weakness.
The different results in previous studies evaluating the effect of fatigue on knee proprioception may have been affected by the difference of fatigue protocols, whether local or general load. Although local load was intended to produce local fatigue of the knee, which may cause dysfunction of muscle mechanoreceptors, general load may have produced general fatigue and affected other mechanisms in the proprioceptional pathway. The results of the present study suggest that decreased reproduction ability after general load is not due to the loss of peripheral afferent signals, but to other factors, especially deficiency of central processing of proprioceptive signals.
To prevent knee injury caused by fatigue-induced proprioceptional decline, muscle endurance training alone is not enough, and neuromuscular training, including central motor programming, is essential.
本研究旨在比较局部和全身疲劳负荷对膝关节本体感觉的影响。
实验对照研究。
在27名健康男性志愿者中，通过测量两种不同类型疲劳方案（局部负荷和全身负荷）前后在匹配的定义指标角度下的绝对角度误差（AAE），评估膝关节的本体感觉。局部负荷通过在等速测力计上进行最大等速膝关节屈伸来提供，全身负荷是在跑步机上跑步5分钟。
局部负荷后，发现膝关节屈伸肌的峰值扭矩显著下降，但AAE未见显著变化。相比之下，全身负荷后，AAE显著增加，而肌肉无明显无力。
先前评估疲劳对膝关节本体感觉影响的研究结果不同，可能受到疲劳方案差异的影响，无论是局部负荷还是全身负荷。尽管局部负荷旨在产生膝关节局部疲劳，这可能导致肌肉机械感受器功能障碍，但全身负荷可能产生全身疲劳并影响本体感觉通路中的其他机制。本研究结果表明，全身负荷后再现能力下降并非由于外周传入信号丧失，而是由于其他因素，尤其是本体感觉信号中枢处理不足。
为预防因疲劳导致的本体感觉下降引起的膝关节损伤，仅进行肌肉耐力训练是不够的，包括中枢运动编程在内的神经肌肉训练至关重要。
