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前交叉韧带损伤后的致肌抑制。

Arthrogenic Muscle Inhibition Following Anterior Cruciate Ligament Injury.

出版信息

J Sport Rehabil. 2022 Feb 14;31(6):694-706. doi: 10.1123/jsr.2021-0128. Print 2022 Aug 1.

Abstract

Arthrogenic muscle inhibition (AMI) is a common impairment in individuals who sustain an anterior cruciate ligament (ACL) injury. The AMI causes decreased muscle activation, which impairs muscle strength, leading to aberrant movement biomechanics. The AMI is often resistant to traditional rehabilitation techniques, which leads to persistent neuromuscular deficits following ACL reconstruction. To better treat AMI following ACL injury and ACL reconstruction, it is important to understand the specific neural pathways involved in AMI pathogenesis, as well as the changes in muscle function that may impact movement biomechanics and long-term structural alterations to joint tissue. Overall, AMI is a critical factor that limits optimal rehabilitation outcomes following ACL injury and ACL reconstruction. This review discusses the current understanding of the: (1) neural pathways involved in the AMI pathogenesis following ACL injury; (2) consequence of AMI on muscle function, joint biomechanics, and patient function; and (3) development of posttraumatic osteoarthritis. Finally, the authors review the evidence for interventions specifically used to target AMI following ACL injury.

摘要

关节源性肌肉抑制(AMI)是前交叉韧带(ACL)损伤患者常见的一种功能障碍。AMI 导致肌肉激活减少,从而削弱肌肉力量,导致异常的运动生物力学。AMI 通常对传统的康复技术有抵抗力,这导致 ACL 重建后持续存在神经肌肉缺陷。为了更好地治疗 ACL 损伤和 ACL 重建后的 AMI,了解 AMI 发病机制中涉及的特定神经通路以及可能影响运动生物力学和关节组织长期结构改变的肌肉功能变化非常重要。总的来说,AMI 是限制 ACL 损伤和 ACL 重建后最佳康复效果的关键因素。这篇综述讨论了目前对以下方面的理解:(1)ACL 损伤后 AMI 发病机制中涉及的神经通路;(2)AMI 对肌肉功能、关节生物力学和患者功能的影响;以及(3)创伤后骨关节炎的发展。最后,作者回顾了专门用于针对 ACL 损伤后 AMI 的干预措施的证据。

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