Collins Amber T, Blackburn J Troy, Olcott Chris W, Dirschl Douglas R, Weinhold Paul S
Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA.
J Orthop Surg Res. 2009 Feb 2;4:3. doi: 10.1186/1749-799X-4-3.
A variety of knee injuries and pathologies may cause a deficit in knee proprioception which may increase the risk of reinjury or the progression of disease. Stochastic resonance stimulation is a new therapy which has potential benefits for improving proprioceptive function. The objective of this study was to determine if stochastic resonance (SR) stimulation applied with a neoprene sleeve could improve knee proprioception relative to a no-stimulation/no-sleeve condition (control) or a sleeve alone condition in the normal, healthy knee. We hypothesized that SR stimulation when applied with a sleeve would enhance proprioception relative to the control and sleeve alone conditions.
Using a cross-over within subject design, twenty-four healthy subjects were tested under four combinations of conditions: electrical stimulation/sleeve, no stimulation/sleeve, no stimulation/no sleeve, and stimulation/no sleeve. Joint position sense (proprioception) was measured as the absolute mean difference between a target knee joint angle and the knee angle reproduced by the subject. Testing was conducted during both partial-weight bearing (PWB) and non-weight bearing (NWB) tasks. Differences in joint position sense between the conditions were evaluated by repeated-measures analysis of variance testing.
Joint position sense error during the stimulation/sleeve condition (2.48 degrees +/- 1.32 degrees ) was found to be more accurate (P < 0.05) relative to the control condition (3.35 degrees +/- 1.63 degrees ) in the PWB task. No difference in joint position sense error was found between stimulation/sleeve and sleeve alone conditions for the PWB task. Joint position sense error was not found to differ between any of the conditions for the NWB task.
These results suggest that SR electrical stimulation when combined with a neoprene sleeve is an effective modality for enhancement of joint proprioception in the PWB knee. We believe these results suggest the need for further study of the potential of SR stimulation to correct proprioceptive deficits in a clinical population with knee injury/pathology or in subjects at risk of injury because of a proprioceptive deficit.
多种膝关节损伤和病变可能导致膝关节本体感觉功能障碍,这可能会增加再次受伤或疾病进展的风险。随机共振刺激是一种新的治疗方法,对改善本体感觉功能具有潜在益处。本研究的目的是确定与无刺激/无袖套情况(对照)或仅使用袖套情况相比,使用氯丁橡胶袖套进行随机共振(SR)刺激是否能改善正常健康膝关节的本体感觉。我们假设与对照和仅使用袖套情况相比,使用袖套进行SR刺激会增强本体感觉。
采用受试者内交叉设计,对24名健康受试者在四种条件组合下进行测试:电刺激/袖套、无刺激/袖套、无刺激/无袖套和刺激/无袖套。关节位置觉(本体感觉)通过目标膝关节角度与受试者重现的膝关节角度之间的绝对平均差值来测量。测试在部分负重(PWB)和非负重(NWB)任务期间进行。通过重复测量方差分析测试评估不同条件之间关节位置觉的差异。
在PWB任务中,刺激/袖套条件下的关节位置觉误差(2.48度±1.32度)相对于对照条件(3.35度±1.63度)更准确(P<0.05)。在PWB任务中,刺激/袖套和仅使用袖套条件之间未发现关节位置觉误差有差异。在NWB任务中,任何条件之间均未发现关节位置觉误差有差异。
这些结果表明,SR电刺激与氯丁橡胶袖套结合是增强PWB膝关节关节本体感觉的有效方式。我们认为这些结果表明需要进一步研究SR刺激在纠正膝关节损伤/病变临床人群或因本体感觉功能障碍而有受伤风险的受试者中本体感觉缺陷的潜力。