Kim Joo-Sung, Kim Kyung-Min, Chang Eunwook, Jung Hyun Chul, Lee Jung-Min, Needle Alan R
Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA.
Department of Sport Science, Sungkyunkwan University, Suwon-si 16419, Korea.
Healthcare (Basel). 2022 Jun 23;10(7):1171. doi: 10.3390/healthcare10071171.
Neural changes in the ankle stabilizing muscles following ankle sprains are thought to be one contributing factor to persistent ankle dysfunction. However, empirical evidence is limited. Therefore, we aimed to examine spinal reflex excitability of lower leg muscles following acute ankle sprains (AAS). We performed a case-control study with 2 groups consisting of 30 young adults with AAS and 30 aged-matched uninjured controls. Hoffmann reflex (H-reflex) testing was performed to estimate spinal reflex excitability of lower leg muscles: soleus, fibularis longus (FL), tibialis anterior (TA). Maximal H-reflex (H) and motor responses (M) were determined by delivering a series of electrical stimuli at the sciatic nerve. H/M ratios were calculated to represent normalized spinal reflex excitability. Separate group-by-limb analyses of variance (ANOVA) with repeated measures found there were no significant interactions for any of the muscles (SL: = 0.95, = 0.33, FL: = 0.65, = 0.42, TA: = 1.87, = 0.18), but there was a significant main effect of group in the soleus ( = 6.56, = 0.013), indicating the H/M ratio of soleus in the AAS group was significantly lower bilaterally (AAS = 0.56 ± 0.19, control = 0.68 ± 0.17, = 0.013), with no significant group differences in the other muscles (FL: = 0.26, = 0.61, TA: = 0.93, = 0.34). The bilateral inhibition of the soleus spinal reflex excitability following AAS may be significant in that it may explain bilateral sensorimotor deficits (postural control deficits) following unilateral injury, and provide insights into additional therapies aimed at the neural change.
踝关节扭伤后踝关节稳定肌的神经变化被认为是导致持续性踝关节功能障碍的一个因素。然而，实证证据有限。因此，我们旨在研究急性踝关节扭伤（AAS）后小腿肌肉的脊髓反射兴奋性。我们进行了一项病例对照研究，两组分别由30名患有AAS的年轻成年人和30名年龄匹配的未受伤对照组成。通过霍夫曼反射（H反射）测试来评估小腿肌肉的脊髓反射兴奋性：比目鱼肌、腓骨长肌（FL）、胫骨前肌（TA）。通过在坐骨神经上施加一系列电刺激来确定最大H反射（H）和运动反应（M）。计算H/M比值以代表标准化的脊髓反射兴奋性。采用重复测量的分组肢体方差分析（ANOVA）发现，任何肌肉均无显著交互作用（比目鱼肌：F = 0.95，P = 0.33；腓骨长肌：F = 0.65，P = 0.42；胫骨前肌：F = 1.87，P = 0.18），但比目鱼肌存在显著的组间主效应（F = 6.56，P = 0.013），表明AAS组双侧比目鱼肌的H/M比值显著降低（AAS = 0.56±0.19，对照组 = 0.68±0.17，P = 0.013），其他肌肉无显著组间差异（腓骨长肌：F = 0.26，P = 0.61；胫骨前肌：F = 0.93，P = 0.34）。AAS后比目鱼肌脊髓反射兴奋性的双侧抑制可能具有重要意义，因为它可能解释单侧损伤后的双侧感觉运动缺陷（姿势控制缺陷），并为针对神经变化的额外治疗提供见解。
