Urbach Dietmar, Berth Alexander, Awiszus Friedemann
Neuromuscular Research Group, Department of Orthopedics, Otto-von-Guericke University, Leipziger Strasse 44, D-39120 Magdeburg, Germany.
Muscle Nerve. 2005 Aug;32(2):164-9. doi: 10.1002/mus.20353.
Joint disease causes weakness and wasting of adjacent muscles, in part because of inability to fully activate these muscles voluntarily. Previous findings suggest that transcranial magnetic stimulation (TMS) paired with muscle contractions enhances maximal voluntary contraction force (MVC) in healthy subjects by improving voluntary activation (VA). The aim of the present study was to evaluate whether such an effect is also present in subjects suffering from diminished muscle force due to decreased VA. Three single TMS over resting motor threshold were applied in 10 patients with a mean age of 62 years after total-knee arthroplasty either during MVC or during muscle relaxation (control experiment) in a blinded randomized crossover study. MVC and VA were determined using a twitch-interpolation technique at 1, 15, 30, and 60 min after stimulation. There was a significant effect of TMS on MVC if applied in synchrony with muscle contraction, and this persisted for at least 60 min beyond stimulation. In patients suffering from joint disease, TMS might make physiotherapy more effective.
关节疾病会导致邻近肌肉无力和萎缩，部分原因是无法完全自主激活这些肌肉。先前的研究结果表明，经颅磁刺激（TMS）与肌肉收缩相结合，可通过改善自主激活（VA）来增强健康受试者的最大自主收缩力（MVC）。本研究的目的是评估在因VA降低而导致肌肉力量减弱的受试者中是否也存在这种效应。在一项双盲随机交叉研究中，对10名平均年龄为62岁的全膝关节置换术后患者，在MVC期间或肌肉放松期间（对照实验），施加三次超过静息运动阈值的单次TMS。在刺激后1、15、30和60分钟，使用抽搐插值技术测定MVC和VA。如果TMS与肌肉收缩同步应用，则对MVC有显著影响，并且这种影响在刺激后至少持续60分钟。对于患有关节疾病的患者，TMS可能会使物理治疗更有效。
