Gabel C P, Osborne J, Burkett B
Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Australia.
Educational and Counselling Psychology, University of Louisville, USA.
J Sci Med Sport. 2015 Jan;18(1):62-6. doi: 10.1016/j.jsams.2013.11.007. Epub 2013 Nov 28.
To determine and compare the level of quadriceps activation for knee injured participants during kinetic open-chain, closed-chain and composite-chain (Slackline) clinical exercises. Quadriceps activation is a critical component of lower limb movement and subsequently, rehabilitation. However, selective activation can be difficult due to pain, loss of function and impaired neuro-motor activation.
Repeated measures (within-subjects) ANOVA.
Consecutive physiotherapy outpatients (n=49, 41.8±16.8 years, range 13-72 years, 57% female) with an acute (<2 weeks) knee injury were recruited. Participants were assessed for quadriceps activation using skin mounted electromyography during five separate clinical quadriceps activation exercises: two open-chain, inner range quads and straight leg raise; two closed-chain, step down and step up; and a composite-chain, slacklining step-up. Outcome measures were: median score on electromyography as measured in microvolts (μV); and perceived exertion on an 11-point numerical rating scale.
Median scores of the open- and closed-chain exercises showed no statistical difference, while composite-chain Slackline exercise showed significantly (p<0.0001) higher quadriceps activation (F(2.52, 121.00)=21.53, p<0.0001) at significantly lower exertion (F(1.62, 77.70)=26.88, p<0.0001).
The use of Slackline rehabilitation training can provide significant increases in activation and recruitment of the quadriceps for composite-chain exercises in the clinical setting. This activation occurs spontaneously at significantly lower levels of perceived exertion. This spontaneous quadriceps activation in a selective and simple manner is a valuable adjunct exercise for lower limb rehabilitation programmes. This is of particular relevance for the outpatient setting and circumstances where the quadriceps is inhibited and activation is required.
确定并比较膝关节受伤参与者在动力性开链、闭链及复合链(扁带)临床练习期间股四头肌的激活水平。股四头肌激活是下肢运动及后续康复的关键组成部分。然而,由于疼痛、功能丧失及神经运动激活受损,选择性激活可能会很困难。
重复测量(受试者内)方差分析。
招募连续的急性(<2周)膝关节损伤的物理治疗门诊患者(n = 49,41.8±16.8岁,年龄范围13 - 72岁,57%为女性)。在五项单独的临床股四头肌激活练习期间,使用皮肤表面肌电图评估参与者的股四头肌激活情况:两项开链练习,即内范围股四头肌练习和直腿抬高;两项闭链练习,即下台阶和上台阶;以及一项复合链练习,即扁带登阶。结果指标为:以微伏(μV)测量的肌电图中位数得分;以及11点数字评分量表上的主观用力感觉。
开链和闭链练习的中位数得分无统计学差异,而复合链扁带练习显示股四头肌激活显著更高(p<0.0001)(F(2.52, 121.00)=21.53,p<0.0001),且主观用力显著更低(F(1.62, 77.70)=26.88,p<0.0001)。
在临床环境中,使用扁带康复训练可显著提高复合链练习中股四头肌的激活和募集。这种激活在主观用力感觉显著更低的水平上自发发生。这种以选择性且简单的方式自发激活股四头肌,对于下肢康复计划而言是一项有价值的辅助练习。这对于门诊环境以及股四头肌受抑制且需要激活的情况尤为重要。