Harkey Matthew, McLeod Michelle M, Terada Masafumi, Gribble Phillip A, Pietrosimone Brian G
Dept of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
J Sport Rehabil. 2016 May;25(2):137-45. doi: 10.1123/jsr.2014-0282. Epub 2015 Mar 11.
Spinal-reflexive and corticomotor excitability may have a critical role in altering muscle function needed to stabilize the ankle in people with chronic ankle instability (CAI).
To determine the association between self-reported disability and both spinal-reflexive and corticomotor excitability in people with CAI.
Descriptive laboratory study.
Research laboratory.
30 participants with CAI.
Soleus spinal-reflexive excitability was measured with normalized Hoffmann reflexes (H:M ratio), and corticomotor excitability was measured with transcranial magnetic stimulation and quantified by normalized motor-evoked-potential (MEP) amplitudes at 120% of active motor threshold (120%MEP). Self-reported disability was quantified with the activities-of-daily-living and sport subscales of the Foot and Ankle Ability Measure (FAAM-ADL and FAAM-S). Separate linear Pearson product-moment correlations and nonlinear quadratic correlations were used to determine associations between the neural-excitability and disability variables.
Thirty participants were included in the spinal-reflexive-excitability analysis, while only 19 were included in the corticomotor analysis. There was a significant, weak linear association between H:M ratio and FAAM-ADL (R = .39, P = .03) and a nonsignificant, weak linear association between H:M ratio and FAAM-S (R = .36, P = .06). There were significant, moderate quadratic associations between H:M ratio and both FAAM-ADL (R = .48, P = .03) and FAAM-S (R = .50, P = .02). There was a significant, moderate linear association between 120%MEP and FAAM-ADL (R = -.48, P = .04) and a nonsignificant, moderate negative linear association between FAAM-S (R = -.42, P = .07). There was a significant, moderate quadratic association between 120%MEP and FAAM-ADL (R = .57, P = .046) and a significant, strong quadratic correlation between 120%MEP and FAAM-S (R = .71, P = .004).
There are significant quadratic associations between self-reported disability and both spinal-reflexive and corticomotor excitability of the soleus. CAI participants with low or high neural excitability present with lower function.
脊髓反射性和皮质运动兴奋性可能在改变慢性踝关节不稳（CAI）患者稳定踝关节所需的肌肉功能方面起关键作用。
确定CAI患者自我报告的功能障碍与脊髓反射性和皮质运动兴奋性之间的关联。
描述性实验室研究。
研究实验室。
30名CAI患者。
用标准化霍夫曼反射（H:M比值）测量比目鱼肌脊髓反射兴奋性，用经颅磁刺激测量皮质运动兴奋性，并通过在主动运动阈值的120%时的标准化运动诱发电位（MEP）幅度进行量化（120%MEP）。用足踝能力测量的日常生活活动和运动分量表（FAAM-ADL和FAAM-S）对自我报告的功能障碍进行量化。分别使用线性皮尔逊积矩相关和非线性二次相关来确定神经兴奋性和功能障碍变量之间的关联。
30名参与者纳入脊髓反射兴奋性分析，而只有19名纳入皮质运动分析。H:M比值与FAAM-ADL之间存在显著的弱线性关联（R = 0.39，P = 0.03），H:M比值与FAAM-S之间存在不显著的弱线性关联（R = 0.36，P = 0.06）。H:M比值与FAAM-ADL（R = 0.48，P = 0.03）和FAAM-S（R = 0.50，P = 0.02）之间均存在显著的中度二次关联。120%MEP与FAAM-ADL之间存在显著的中度线性关联（R = -0.48，P = 0.04），与FAAM-S之间存在不显著的中度负线性关联（R = -0.42，P = 0.07）。120%MEP与FAAM-ADL之间存在显著的中度二次关联（R = 0.57，P = 0.046），120%MEP与FAAM-S之间存在显著的强二次相关（R = 0.71，P = 0.004）。
自我报告的功能障碍与比目鱼肌的脊髓反射性和皮质运动兴奋性之间均存在显著的二次关联。神经兴奋性低或高的CAI参与者功能较低。
