Musculoskeletal Health and Movement Science Laboratory, University of Toledo, MS 119, 2801 West Bancroft Street, Toledo, OH 43606-3390, USA.
J Athl Train. 2012 Nov-Dec;47(6):621-6. doi: 10.4085/1062-6050-47.6.11.
CONTEXT: Neuromuscular deficits are common in people with chronic ankle instability (CAI). Corticomotor pathways are very influential in the production of voluntary muscle function, yet these pathways have not been evaluated in people with CAI. OBJECTIVE: To determine if corticomotor excitability of the fibularis longus (FL) differs between individuals with unilateral CAI and matched control participants without CAI. DESIGN: Case-control study. SETTING: Laboratory. Patients or Other Participants: Ten people with CAI (4 men, 6 women; age = 21.2 ± 1.23 years, height = 175.13 ± 9.7 cm, mass = 77.1 ± 13.58 kg) and 10 people without CAI (4 men, ± women; age = 21.2 ± 2.3 years; height = 172.34 ± 8.86 cm, mass = 73.4 ± 7.15 kg) volunteered for this study. MAIN OUTCOME MEASURE(S): Transcranial magnetic stimulation was performed over the motor cortex on neurons corresponding with the FL. All testing was performed with the participant in a seated position with a slightly flexed knee joint and the ankle secured in 10 8 of plantar flexion. The resting motor threshold (RMT), which was expressed as a percentage of 2 T, was considered the lowest amount of magnetic energy that would induce an FL motor evoked potential equal to or greater than 20 l V, as measured with surface electromyography, on 7 consecutive stimuli. In addition, the Functional Ankle Disability Index (FADI) and FADI Sport were used to assess self-reported function. RESULTS: Higher RMTs were found in the injured and uninjured FL of the CAI group (60.8% ± 8.4% and 59.1% ± 8.99%, respectively) than the healthy group (52.8% ± 8.56% and 52% ± 7.0%, respectively; F(1,18) = 4.92, P = .04). No leg x group interactions (F(1,18) = 0.1, P = .76) or between-legs differences (F(1,18) = 0.74, P = .40) were found. A moderate negative correlation was found between RMT and FADI (r = 0.4, P = .04) and FADI Sport (r = 0.44, P = .03), suggesting that higher RMT is related to lower self-reported function. CONCLUSIONS: Higher bilateral RMTs may indicate deficits in FL corticomotor excitability in people with CAI. In addition, a moderate correlation between RMT and FADI suggests that cortical excitability deficits may be influential in altering function.
背景：慢性踝关节不稳（CAI）患者常存在神经肌肉功能障碍。皮质运动通路对随意肌功能的产生有很大的影响，但这些通路在 CAI 患者中尚未得到评估。
目的：确定单侧 CAI 患者腓骨长肌（FL）的皮质运动兴奋性是否与无 CAI 的匹配对照组参与者不同。
设计：病例对照研究。
地点：实验室。
患者或其他参与者：10 名 CAI 患者（4 名男性，6 名女性；年龄=21.2±1.23 岁，身高=175.13±9.7cm，体重=77.1±13.58kg）和 10 名无 CAI 患者（4 名男性，±女性；年龄=21.2±2.3 岁；身高=172.34±8.86cm，体重=73.4±7.15kg）自愿参加了这项研究。
主要观察指标：经颅磁刺激在与 FL 相对应的运动皮质上进行。所有测试均在参与者坐姿下进行，膝关节轻微弯曲，踝关节固定在跖屈 10°。静息运动阈值（RMT）以 2 T 的百分比表示，被认为是在 7 次连续刺激下，通过表面肌电图测量，能够引起 FL 运动诱发电位等于或大于 20 l V 的最低磁能。此外，使用功能性踝关节残疾指数（FADI）和 FADI 运动评估自我报告的功能。
结果：CAI 组受伤和未受伤的 FL 的 RMT 较高（分别为 60.8%±8.4%和 59.1%±8.99%），高于健康组（分别为 52.8%±8.56%和 52%±7.0%；F(1,18)=4.92，P=.04）。未发现腿×组交互作用（F(1,18)=0.1，P=.76）或腿间差异（F(1,18)=0.74，P=.40）。RMT 与 FADI（r=0.4，P=.04）和 FADI 运动（r=0.44，P=.03）呈中度负相关，表明 RMT 越高，自我报告的功能越低。
结论：CAI 患者双侧 RMT 升高可能表明 FL 皮质运动兴奋性存在缺陷。此外，RMT 与 FADI 之间的中度相关性表明皮质兴奋性缺陷可能会影响功能。
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