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慢性踝关节不稳运动员踝关节的中枢神经控制和神经肌肉功能下降。

Decreased supraspinal control and neuromuscular function controlling the ankle joint in athletes with chronic ankle instability.

机构信息

Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, 73170, Nakhon Pathom, Thailand.

College of Sport Science and Technology, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, 73170, Nakhon Pathom, Thailand.

出版信息

Eur J Appl Physiol. 2019 Sep;119(9):2041-2052. doi: 10.1007/s00421-019-04191-w. Epub 2019 Jul 18.

Abstract

PURPOSE

Chronic ankle instability (CAI) alters lower extremity neuromuscular function, associated with a change in corticomotor excitability. The aim of this study was to compare corticomotor excitability and neuromuscular function of the muscles around the ankle between athletes with CAI and without CAI (non-CAI).

METHODS

Nineteen CAI athletes (15 men and 4 women) and 19 non-CAI athletes (15 men and 4 women) participated (age- and sex-matched). Corticomotor excitability was measured by transcranial magnetic stimulation for the following muscles: the tibialis anterior (TA), peroneus longus (PL) and gastrocnemius medialis (GM). The resting motor threshold (rMT), motor evoked potential (MEP), and latency (Lat) were subsequently measured. Neuromuscular function was assessed with a jump test, using the EMG activity before foot contact, peak torque, and joint position sense.

RESULTS

The corticomotor excitability in CAI showed a lower normalized MEP in the TA (p = 0.026) and PL (p = 0.003), and longer latency in the TA (p = 0.049) and GM (p = 0.027) compared with non-CAI. The neuromuscular assessment showed CAI had less EMG activity of the PL (p < 0.001), less peak torque of the dorsiflexor (p = 0.019) muscle compared with non-CAI.

CONCLUSION

Athletes with CAI had lower corticomotor excitability in the TA and PL and a longer latency in the TA and GM muscles. Additionally, CAI demonstrated functional neuromuscular deficits by decreasing EMG activity of the PL muscle and strength of the dorsiflexor muscle. Our findings indicated maladaptation at both cortical and peripheral levels among athletes with CAI.

摘要

目的

慢性踝关节不稳定(CAI)改变下肢神经肌肉功能,与皮质运动兴奋性变化相关。本研究旨在比较 CAI 运动员和非 CAI(非 CAI)运动员踝关节周围肌肉的皮质运动兴奋性和神经肌肉功能。

方法

19 名 CAI 运动员(15 名男性和 4 名女性)和 19 名非 CAI 运动员(15 名男性和 4 名女性)参加(年龄和性别匹配)。使用经颅磁刺激测量以下肌肉的皮质运动兴奋性:胫骨前肌(TA)、腓骨长肌(PL)和比目鱼肌内侧(GM)。随后测量静息运动阈值(rMT)、运动诱发电位(MEP)和潜伏期(Lat)。使用肌电图(EMG)活动在足触地前、峰值扭矩和关节位置感觉来评估神经肌肉功能。

结果

CAI 的皮质运动兴奋性显示 TA(p=0.026)和 PL(p=0.003)的归一化 MEP 较低,TA(p=0.049)和 GM(p=0.027)的潜伏期较长。神经肌肉评估显示 CAI 的 PL 肌 EMG 活动较少(p<0.001),背屈肌(p=0.019)峰值扭矩较低。

结论

CAI 运动员 TA 和 PL 的皮质运动兴奋性较低,TA 和 GM 肌肉的潜伏期较长。此外,CAI 还通过降低 PL 肌肉的 EMG 活动和背屈肌的力量来表现出功能性神经肌肉缺陷。我们的研究结果表明 CAI 运动员在皮质和外周水平均存在适应不良。

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