Junge Tina, Wedderkopp Niels, Thorlund Jonas Bloch, Søgaard Karen, Juul-Kristensen Birgit
Institute of Regional Health Services, University of Southern Denmark, Odense, Denmark; Department of Physiotherapy, University College Lillebaelt, Odense, Denmark; Health Sciences Research Centre, University College Lillebaelt, Odense, Denmark.
Institute of Regional Health Services, University of Southern Denmark, Odense, Denmark; Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark.
J Electromyogr Kinesiol. 2015 Jun;25(3):501-7. doi: 10.1016/j.jelekin.2015.02.011. Epub 2015 Mar 6.
Generalised Joint Hypermobility (GJH) is considered an intrinsic risk factor for knee injuries. Knee neuromuscular control during landing may be altered in GJH due to reduced passive stability. The aim was to identify differences in knee neuromuscular control during landing of the Single-Leg-Hop-for-Distance test (SLHD) in 25 children with GJH compared to 29 children without GJH (controls), all 10-15years. Inclusion criteria for GJH: Beighton score⩾5/9 and minimum one hypermobile knee. EMG was recorded from the quadriceps, the hamstring and the calf muscles, presented relative to Maximum Voluntary Electrical activity (MVE). There was no difference in jump length between groups. Before landing, GJH had 33% lower Semitendinosus, but 32% higher Gastrocnemius Medialis activity and 39% higher co contraction of the lateral knee muscles, than controls. After landing, GJH had 36% lower Semitendinosus activity than controls, all significant findings. Although the groups performed equally in SLHD, GJH had a Gastrocnemius Medialis dominated neuromuscular strategy before landing, plausibly caused by reduced Semitendinosus activity. Reduced Semitendinosus activity was seen in GJH after landing, but with no compensatory Gastrocnemius Medialis activity. Reduced pre and post-activation of the Semitendinosus may present a risk factor for traumatic knee injuries as ACL ruptures in GJH with knee hypermobility.
全身关节过度活动(GJH)被认为是膝关节损伤的一个内在风险因素。由于被动稳定性降低,GJH患者在着陆过程中的膝关节神经肌肉控制可能会发生改变。本研究旨在确定25名GJH儿童与29名非GJH儿童(对照组)在单腿跳远测试(SLHD)着陆过程中膝关节神经肌肉控制的差异,所有儿童年龄均在10 - 15岁。GJH的纳入标准:Beighton评分⩾5/9且至少有一个膝关节活动过度。记录股四头肌、腘绳肌和小腿肌肉的肌电图,以最大自主电活动(MVE)为参照呈现。两组之间的跳跃长度没有差异。着陆前,GJH组的半腱肌活动比对照组低33%,但内侧腓肠肌活动高32%,膝关节外侧肌肉的共同收缩高39%。着陆后,GJH组的半腱肌活动比对照组低36%,所有这些都是显著的发现。尽管两组在SLHD测试中的表现相同,但GJH组在着陆前以内侧腓肠肌为主导的神经肌肉策略,可能是由于半腱肌活动减少所致。着陆后在GJH组中观察到半腱肌活动减少,但内侧腓肠肌没有代偿性活动。半腱肌激活前和激活后的减少可能是GJH合并膝关节活动过度患者发生创伤性膝关节损伤(如前交叉韧带断裂)的一个风险因素。