内侧副韧带断裂及离心康复方案后的神经肌肉恢复。

Neuromuscular recovery after medial collateral ligament disruption and eccentric rehabilitation program.

机构信息

UMR CNRS 6233, Institut des Sciences du Mouvement, Etienne-Jules Marey, Equipe Plasticité des Systèmes Nerveux et Musculaire, Université de la Méditerranée, Aix-Marseille II - Aix-Marseille Université, Faculté des Sciences du Sport, Parc Scientifique et Technologique de Luminy, Marseille, FRANCE.

出版信息

Med Sci Sports Exerc. 2011 Jun;43(6):1032-41. doi: 10.1249/MSS.0b013e3182042956.

DOI:10.1249/MSS.0b013e3182042956

PMID:21085041

Abstract

PURPOSE

Medial collateral ligament (MCL) rupture of the knee joint frequently occurs during sport activities. However, the optimal rehabilitation strategy after such lesion is unknown. The aim of this study was to assess the effects of progressive eccentric rehabilitation program on neuromuscular deficits induced by MCL transection.

METHODS

Rats were randomized as follows: (i) control group (C, n = 10) without any surgery; (ii) lesion groups in which neuromuscular measurements were made 1 (L1, n = 10) and 3 wk (L3, n = 9) after MCL transection by a 15- to 20-min surgery (this group was designed to determine changes induced by the MCL transection); and (iii) eccentric group (ECC, n = 7) in which rats performed a progressive 2-wk eccentric rehabilitation program beginning 1 wk after MCL transection surgery. Dynamic functional assessments were performed at weeks 1 and 3 after the MCL transection by measuring the maximal and minimal knee angles during the stance phase of the gait cycle. Neuromuscular measurements included 1) modulation of H-reflex in response to a 10-mM KCl injection, 2) analysis of the twitch relaxation properties of the quadriceps muscle, and 3) recording of metabosensitive and mechanosensitive afferents activity in response to chemical injections and to tendon patellar vibrations, respectively.

RESULTS

Our results indicated that H-reflex modulation induced by metabosensitive afferents was disturbed by MCL transection without any recovery despite rehabilitation program. Responses of both metabosensitive and mechanosensitive muscle afferents, as well as the muscle relaxation properties, were fully recovered after the eccentric rehabilitation program.

CONCLUSIONS

Our results directly indicated an influence of progressive eccentric program on muscle afferents response after MCL section but apparently not for spinal reflex modulation.

摘要

目的

膝关节内侧副韧带（MCL）撕裂在运动中经常发生。然而，这种损伤后的最佳康复策略尚不清楚。本研究旨在评估渐进性离心康复方案对 MCL 切断引起的神经肌肉缺陷的影响。

方法

将大鼠随机分为以下三组：（i）对照组（C，n = 10），不进行任何手术；（ii）实验组，在 MCL 切断后 1 周（L1，n = 10）和 3 周（L3，n = 9）进行神经肌肉测量，通过 15-20 分钟的手术进行（该组旨在确定 MCL 切断引起的变化）；（iii）离心组（ECC，n = 7），在 MCL 切断手术后 1 周开始进行为期 2 周的渐进性离心康复方案。在 MCL 切断后 1 周和 3 周，通过测量步态周期支撑阶段的最大和最小膝关节角度，进行动态功能评估。神经肌肉测量包括：1）10mM KCl 注射引起的 H 反射调制，2）股四头肌的牵张反射松弛特性分析，3）代谢敏感和机械敏感传入纤维对化学注射和髌腱振动的反应记录。