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慢性踝关节不稳时股四头肌和腘绳肌的关节源性肌肉反应

Arthrogenic muscle response of the quadriceps and hamstrings with chronic ankle instability.

作者信息

Sedory Edward J, McVey Eric D, Cross Kevin M, Ingersoll Christopher D, Hertel Jay

机构信息

University of Virginia, Charlottesville, VA, USA.

出版信息

J Athl Train. 2007 Jul-Sep;42(3):355-60.

Abstract

CONTEXT

An arthrogenic muscle response (AMR) of the soleus and peroneal muscles has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of AMR in muscles acting on joints proximal to unstable ankles has not been previously explored.

OBJECTIVE

To determine if AMR is present in the quadriceps and hamstrings muscles of those with and without unilateral CAI.

DESIGN

Case control.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twenty subjects with unilateral CAI (12 males, 8 females: age = 19.9 +/- 3.7 years; height = 170.3 +/- 15.6 cm; mass = 78.0 +/- 23.1 kg) and 21 controls (16 males, 5 females: age = 23.2 +/- 5.4 years; height = 173.9 +/- 12.7 cm; mass = 87.2 +/- 24.6 kg) with no previous ankle injuries.

MAIN OUTCOME MEASURE(S): The central activation ratio (CAR), a measure of motoneuron pool excitability during maximal voluntary isometric contraction, for the hamstrings and quadriceps muscles was measured in both limbs using the superimposed burst technique.

RESULTS

The CAI group demonstrated quadriceps CARs that were significantly larger in their involved limbs (.87 +/- .09), as compared with their uninvolved limbs (.84 +/- .08), whereas no significant side-to-side difference was seen in the control group (sham involved = .80 +/- .11, sham uninvolved = .81 +/- .11). When values from both the involved and uninvolved limbs were averaged, the hamstrings CAR was significantly lower for the CAI group (.94 +/- .03) than for the control group (.96 +/- .03).

CONCLUSIONS

Arthrogenic inhibition of the hamstrings muscles bilaterally and facilitation of the quadriceps muscle ipsilateral to the involved limb were noted in subjects with unilateral CAI. Motoneuron pool excitability appears to be altered in muscles that act on joints proximal to the ankle in those with unilateral CAI.

摘要

背景

先前已在慢性踝关节不稳(CAI)患者中证实比目鱼肌和腓骨肌存在关节源性肌肉反应(AMR),但此前未探讨不稳定踝关节近端关节作用肌中AMR的存在情况。

目的

确定单侧CAI患者和非CAI患者的股四头肌和腘绳肌中是否存在AMR。

设计

病例对照研究。

地点

大学研究实验室。

患者或其他参与者

20名单侧CAI患者(12名男性,8名女性;年龄=19.9±3.7岁;身高=170.3±15.6厘米;体重=78.0±23.1千克)和21名对照者(16名男性,5名女性;年龄=23.2±5.4岁;身高=173.9±12.7厘米;体重=87.2±24.6千克),均无既往踝关节损伤史。

主要观察指标

使用叠加脉冲技术测量双下肢腘绳肌和股四头肌在最大自主等长收缩期间运动神经元池兴奋性的指标——中枢激活率(CAR)。

结果

CAI组患侧肢体股四头肌的CAR(.87±.09)显著大于健侧肢体(.84±.08),而对照组未观察到显著的双侧差异(假患侧=.80±.11,假健侧=.81±.11)。当将患侧和健侧肢体的值进行平均时,CAI组腘绳肌的CAR(.94±.03)显著低于对照组(.96±.03)。

结论

在单侧CAI患者中,观察到双侧腘绳肌的关节源性抑制以及患侧肢体同侧股四头肌的易化。在单侧CAI患者中,作用于踝关节近端关节的肌肉的运动神经元池兴奋性似乎发生了改变。

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