Centre for Health, Exercise and Sports Medicine, University of Melbourne, Victoria, Australia.
Dr Ward is now with the Insight Centre for Data Analytics, University College Dublin, Ireland.
J Athl Train. 2019 May;54(5):505-512. doi: 10.4085/1062-6050-414-17. Epub 2019 Apr 22.
Poor quadriceps force control has been observed after anterior cruciate ligament (ACL) reconstruction but has not been examined after ACL injury. Whether adaptations within the central nervous system are contributing to these impairments is unknown.
To examine quadriceps force control in individuals who had sustained a recent ACL injury and determine the associations between cortical excitability and quadriceps force control in these individuals.
Cross-sectional study.
Research laboratory.
Eighteen individuals with a recent unilateral ACL injury (6 women, 12 men; age = 29.6 ± 8.4 years, height = 1.74 ± 0.07 m, mass = 76.0 ± 10.4 kg, time postinjury = 69.5 ± 42.5 days) and 18 uninjured individuals (6 women, 12 men; age = 29.2 ± 6.8 years, height = 1.79 ± 0.07 m, mass = 79.0 ± 8.4 kg) serving as controls participated.
MAIN OUTCOME MEASURE(S): Quadriceps force control was quantified as the root mean square error between the quadriceps force and target force during a cyclical force-matching task. Cortical excitability was measured as the active motor threshold and cortical silent period. Outcome measures were determined bilaterally in a single testing session. Group and limb differences in quadriceps force control were assessed using mixed analyses of variance (2 × 2). Pearson product moment correlations were performed between quadriceps force control and cortical excitability in individuals with an ACL injury.
Individuals with an ACL injury exhibited greater total force-matching error with their involved (standardized mean difference [SMD] = 0.8) and uninvolved (SMD = 0.9) limbs than did controls ( = 11.347, = .03). During the period of descending force, individuals with an ACL injury demonstrated greater error using their involved (SMD = 0.8) and uninvolved (SMD = 0.8) limbs than uninjured individuals ( = 4.941, = .04). Greater force-matching error was not associated with any cortical excitability measures ( > .05).
Quadriceps force control was impaired bilaterally after recent ACL injury but was not associated with selected measures of cortical excitability. The findings highlight a need to incorporate submaximal-force control tasks into rehabilitation and "prehabilitation," as the deficits were present before surgery.
前交叉韧带（ACL）重建后观察到股四头肌力量控制不佳，但 ACL 损伤后并未进行检查。中枢神经系统内的适应性是否导致这些损伤尚不清楚。
检查最近 ACL 损伤患者的股四头肌力量控制，并确定这些患者的皮质兴奋性与股四头肌力量控制之间的关系。
横断面研究。
研究实验室。
18 名单侧 ACL 损伤患者（6 名女性，12 名男性；年龄=29.6±8.4 岁，身高=1.74±0.07 m，体重=76.0±10.4 kg，受伤后时间=69.5±42.5 天）和 18 名未受伤的个体（6 名女性，12 名男性；年龄=29.2±6.8 岁，身高=1.79±0.07 m，体重=79.0±8.4 kg）作为对照组参加。
在周期性力量匹配任务中，通过股四头肌力量与目标力量之间的均方根误差来量化股四头肌力量控制。皮质兴奋性被测量为主动运动阈值和皮质静息期。在单次测试过程中双侧确定了结果测量值。使用混合方差分析（2×2）评估 ACL 损伤患者的股四头肌力量控制的组间和肢体差异。在 ACL 损伤患者中进行了股四头肌力量控制与皮质兴奋性之间的 Pearson 乘积矩相关性分析。
与对照组相比，ACL 损伤患者的受累（标准化均数差[SMD] = 0.8）和未受累（SMD = 0.9）肢体的总力量匹配误差更大（ = 11.347， =.03）。在下降力期间，ACL 损伤患者的受累（SMD = 0.8）和未受累（SMD = 0.8）肢体的误差大于未受伤个体（ = 4.941， =.04）。较大的力量匹配误差与任何皮质兴奋性测量值均无关（ >.05）。
最近 ACL 损伤后双侧股四头肌力量控制受损，但与皮质兴奋性的某些测量值无关。研究结果强调需要将亚最大力量控制任务纳入康复和“预康复”中，因为这些缺陷在手术前就已经存在。
