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急性外踝扭伤后小腿肌肉运动神经元池兴奋性。

Motor-neuron pool excitability of the lower leg muscles after acute lateral ankle sprain.

机构信息

Physical Therapy at Atlantic Coast Athletic Club, Charlottesville, VA, USA.

出版信息

J Athl Train. 2011 May-Jun;46(3):263-9. doi: 10.4085/1062-6050-46.3.263.

Abstract

CONTEXT

Neuromuscular deficits in leg muscles that are associated with arthrogenic muscle inhibition have been reported in people with chronic ankle instability, yet whether these neuromuscular alterations are present in individuals with acute sprains is unknown.

OBJECTIVE

To compare the effect of acute lateral ankle sprain on the motor-neuron pool excitability (MNPE) of injured leg muscles with that of uninjured contralateral leg muscles and the leg muscles of healthy controls.

DESIGN

Case-control study.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

Ten individuals with acute ankle sprains (6 females, 4 males; age= 19.2 ± 3.8 years, height= 169.4 ± 8.5 cm, mass= 66.3 ± 11.6 kg) and 10 healthy individuals(6 females,4 males; age= 20.6 ± 4.0 years, height = 169.9 ± 10.6 cm, mass= 66.3 ± 10.2 kg) participated.

INTERVENTION(S): The independent variables were group (acute ankle sprain, healthy) and limb (injured, uninjured). Separate dependent t tests were used to determine differences in MNPE between legs.

MAIN OUTCOME MEASURE(S): The MNPE of the soleus, fibularis longus, and tibialis anterior was measured by the maximal Hoffmann reflex (H(max)) and maximal muscle response (M(max)) and was then normalized using the H(max):M(max) ratio.

RESULTS

The soleus MNPE in the ankle-sprain group was higher in the injured limb (H(max):M(max) = 0.63; 95% confidence interval [Cl],0.46, 0.80) than the uninjured limb (H(max):M(max) = 0.47; 95%Cl, 0.08, 0.93)(t(6) = 3.62,P =.01).In the acute ankle-sprain group, tibialis anterior MNPE tended to be lower in the injured ankle (H(max):M(max) =0.06; 95% Cl, 0.01, 0.10) than in the uninjured ankle (H(max):M(max) =0.22; 95%Cl, 0.09, 0.35),but this finding was not different (t(9) =-2.01, P =.07). No differences were detected between injured (0.22; 95% Cl, 0.14, 0.29) and uninjured (0.25; 95%Cl, 0.12, 0.38) ankles for the fibularis longus in the ankle-sprain group (t(9) =-0.739, P =.48). We found no side-to-side differences in any muscle among the healthy group.

CONCLUSIONS

Facilitated MNPE was present in the involved soleus muscle of patients with acute ankle sprains, but no differences were found in the fibularis longus or tibialis anterior muscles.

摘要

背景

患有慢性踝关节不稳定的人群,其腿部肌肉存在与关节源性肌肉抑制相关的神经肌肉功能障碍,然而急性踝关节扭伤患者是否存在这些神经肌肉改变尚不清楚。

目的

比较急性外侧踝关节扭伤对受伤侧腿部肌肉运动神经元池兴奋性(MNPE)的影响与对未受伤对侧腿部肌肉和健康对照组腿部肌肉的影响。

设计

病例对照研究。

地点

实验室。

患者或其他参与者

10 名急性踝关节扭伤患者(6 名女性,4 名男性;年龄=19.2±3.8 岁,身高=169.4±8.5cm,体重=66.3±11.6kg)和 10 名健康个体(6 名女性,4 名男性;年龄=20.6±4.0 岁,身高=169.9±10.6cm,体重=66.3±10.2kg)参与了这项研究。

干预措施

自变量为组(急性踝关节扭伤、健康)和肢体(受伤、未受伤)。使用独立样本 t 检验来确定腿部之间 MNPE 的差异。

主要观察指标

比目鱼肌、腓骨长肌和胫骨前肌的 MNPE 通过最大 Hoffmann 反射(H(max))和最大肌肉反应(M(max))进行测量,并通过 H(max):M(max) 比值进行归一化。

结果

与未受伤侧相比,踝关节扭伤组受伤侧的比目鱼肌 MNPE 更高(H(max):M(max)=0.63;95%置信区间[Cl],0.46,0.80)(t(6)=3.62,P=.01)。在急性踝关节扭伤组中,受伤踝关节的胫骨前肌 MNPE 倾向于低于未受伤踝关节(H(max):M(max)=0.06;95%Cl,0.01,0.10),但这一发现无显著差异(t(9)=-2.01,P=.07)。在踝关节扭伤组中,受伤侧(0.22;95%Cl,0.14,0.29)和未受伤侧(0.25;95%Cl,0.12,0.38)的腓骨长肌之间未检测到差异(t(9)=-0.739,P=.48)。在健康组中,我们没有发现任何肌肉在任何一侧存在差异。

结论

急性踝关节扭伤患者受累的比目鱼肌存在 MNPE 易化,但腓骨长肌和胫骨前肌无差异。

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