School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taiwan, Republic of China.
J Orthop Sports Phys Ther. 2011 Oct;41(10):785-94. doi: 10.2519/jospt.2011.3564. Epub 2011 Sep 4.
Controlled laboratory study.
To compare the neuromuscular function of the triceps surae muscle bilaterally in elite athletes with unilateral chronic Achilles tendinopathy.
Previous studies suggest that tendinopathies or chronic pain may lead to a spinal/supraspinal level modulation of the excitability or voluntary activation of ipsilateral motor units. However, this has not been studied in Achilles tendinopathy.
Fourteen college athletes (mean ± SD age, 24.2 ± 1.7 years) who had unilateral chronic middle-portion tendinopathy in their Achilles tendons were recruited. Bilateral measurements of soleus reflex tests, including H-reflex and V wave, and rate of force development (RFD), as well as corresponding electromyography of the tibialis anterior and triceps surae muscles, were performed. Statistical within-subject and between-leg comparisons were made.
In the leg with tendinopathy, the V wave of the soleus muscle was significantly increased (P<.001). The side with tendinopathy also had a reduced normalized RFD (0-30, 0-50, and 0-100 ms) in plantar flexion, and concomitant higher electromyography ratios between the tibialis anterior and soleus (0-30 and 0-50 milliseconds) during the early stage of explosive contractions (P<.05). No significant differences were found for H-reflex, maximal plantar flexion and dorsiflexion torque, and absolute RFD.
Higher volitional supraspinal reflexes and lower maximal-strength independent force development occur in the triceps surae of elite athletes with unilateral middle-portion Achilles tendinopathy. These changes potentially indicate an acquired compensatory mechanism for maximal force production and deficits in explosive strength. The RFD is also suggested as a sensitive parameter to depict neuromuscular changes during treatment of chronic tendinopathies.
对照实验室研究。
比较双侧慢性跟腱腱病的精英运动员的比目鱼肌的神经肌肉功能。
先前的研究表明，腱病或慢性疼痛可能导致兴奋性或同侧运动单位的自主激活的脊髓/脊髓上水平调节。然而，这在跟腱腱病中尚未得到研究。
招募了 14 名患有单侧慢性中段跟腱腱病的大学生运动员（平均±标准差年龄，24.2±1.7 岁）。对跟腱进行双侧测量，包括比目鱼肌反射测试，包括 H 反射和 V 波，以及力发展率（RFD），以及相应的胫骨前肌和比目鱼肌肌电图。进行了统计的受试者内和腿间比较。
在患腱病的腿中，比目鱼肌的 V 波明显增加（P<.001）。患腱病的腿还表现出跖屈时正常化 RFD（0-30、0-50 和 0-100ms）的降低，并且在爆发性收缩的早期阶段，胫骨前肌和比目鱼肌之间的肌电图比（0-30 和 0-50 毫秒）更高（P<.05）。H 反射、最大跖屈和背屈扭矩以及绝对 RFD 没有差异。
单侧中段跟腱腱病的精英运动员的比目鱼肌中存在更高的意志超脊髓反射和更低的最大强度独立力发展。这些变化可能表明存在一种用于最大力量产生的获得性补偿机制，以及爆发力不足。RFD 也被认为是描绘慢性腱病治疗过程中神经肌肉变化的敏感参数。
