J Sport Rehabil. 2021 Dec 1;31(6):667-675. doi: 10.1123/jsr.2021-0162. Print 2022 Aug 1.
Arthrogenic muscle inhibition (AMI) is a common neurophysiological response to joint injury. While athletic trainers (ATs) are constantly treating patients with AMI, it is unclear how clinicians are using the available evidence to treat the condition.
To investigate ATs' general knowledge, clinical practice, and barriers for treating AMI.
A cross-sectional web-based survey was utilized. The survey was distributed to a random sample of 3000 ATs from the National Athletic Trainers' Association and through social media. 143 board certified ATs (age: 34.6 [10.3] y; experience: 11.7 [9.8] y) from various clinical settings and educational backgrounds were included in the analysis.
One hundred one respondents were able to correctly identify the definition of AMI. The majority of these respondents correctly reported that joint effusion (n = 95, 94.1%) and abnormal activity from joint receptors (n = 91, 90.1%) resulted in AMI. Of the 101 respondents, only 58 (57.4%) reported using disinhibitory interventions to treat AMI. The most frequently used evidence supported interventions were transcutaneous electrical nerve stimulation (n = 38, 65.5%), neuromuscular electrical stimulation (n = 33, 56.9%), and focal joint cooling (n = 25, 43.1%). The interventions used correctly most often based on current evidence were neuromuscular electrical stimulation (n = 29/33, 87.9%) and transcutaneous electrical nerve stimulation (n = 26/38, 68.4%). Overall, difficulty quantifying AMI (n = 62, 61.24%) and lack of education (n = 71, 76.2%) were most frequently perceived as barriers. Respondents that did not use disinhibitory interventions perceived lack of experience treating AMI, understanding the terminology, and access to therapeutic modalities more often than the respondents that reported using disinhibitory interventions.
Further education about concepts and treatment about AMI is warranted for ATs. Continued understanding of ATs' clinical practice in regard to AMI may help identify gaps in athletic training clinical education.
关节源性肌肉抑制（AMI）是一种常见的关节损伤后神经生理反应。虽然运动训练师（ATs）一直在治疗患有 AMI 的患者，但目前尚不清楚临床医生如何利用现有证据来治疗这种疾病。
调查 ATs 对 AMI 的一般知识、临床实践和治疗障碍。
采用横断面网络调查。该调查分发给美国国家运动训练协会的 3000 名随机样本的 ATs，并通过社交媒体进行分发。共纳入来自不同临床环境和教育背景的 143 名持有董事会认证的 ATs（年龄：34.6[10.3]岁；经验：11.7[9.8]年）。
有 101 名应答者能够正确识别 AMI 的定义。其中大多数应答者正确报告关节积液（n=95，94.1%）和关节感受器的异常活动（n=91，90.1%）导致 AMI。在 101 名应答者中，只有 58 名（57.4%）报告使用抑制解除干预来治疗 AMI。最常使用的有证据支持的干预措施是经皮神经电刺激（n=38，65.5%）、神经肌肉电刺激（n=33，56.9%）和局部关节冷却（n=25，43.1%）。根据现有证据，最常正确使用的干预措施是神经肌肉电刺激（n=29/33，87.9%）和经皮神经电刺激（n=26/38，68.4%）。总体而言，最常被认为是障碍的是难以量化 AMI（n=62，61.24%）和缺乏教育（n=71，76.2%）。未使用抑制解除干预的应答者比报告使用抑制解除干预的应答者更常认为缺乏治疗 AMI 的经验、理解术语和获得治疗方式。
需要对 ATs 进行更多关于 AMI 概念和治疗的教育。持续了解 ATs 在 AMI 方面的临床实践，可能有助于发现运动训练临床教育中的差距。
