Rodriguez Kazandra M, Palmieri-Smith Riann M, Krishnan Chandramouli
School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.
School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor, MI, USA.
J Electromyogr Kinesiol. 2022 Dec;67:102700. doi: 10.1016/j.jelekin.2022.102700. Epub 2022 Aug 30.
This study comprehensively evaluated the test-retest reliability of raw and normalized quadriceps motor evoked responses elicited by transcranial magnetic stimulation (TMS) in individuals with anterior cruciate ligament (ACL) reconstruction. Fifteen participants were tested on three different days that were separated at least by 24 h. Motor evoked responses were collected during a small background contraction on the reconstructed leg across a range of TMS intensities using torque (MEP) and electromyographic (MEP) responses. MEP and MEP were evaluated using different normalization procedures (raw, normalized to maximum voluntary isometric contraction [MVIC], peak MEP, and background contraction). MEP was also normalized to the magnetically-evoked peripheral resting twitch torque. The area under the recruitment curve was computed for both raw and normalized MEPs. Intraclass correlation coefficients (ICCs) were determined to assess test-retest reliability. Results indicated that MEP generally showed greater reliability than MEP for all normalization procedures. Vastus medialis MEP generally showed greater reliability than rectus femoris MEP. Finally, both MEP and MEP exhibited good reliability, even when not normalized. These findings indicate that MEP and MEP offer reliable measures of corticospinal function and suggest that MEP is a suitable alternative to MEP for measuring quadriceps corticospinal excitability in individuals with ACL reconstruction.
本研究全面评估了经颅磁刺激（TMS）诱发的股四头肌原始和标准化运动诱发电位在接受前交叉韧带（ACL）重建的个体中的重测可靠性。15名参与者在至少间隔24小时的三个不同日期接受测试。在重建腿上进行小幅度背景收缩期间，使用扭矩（MEP）和肌电图（MEP）反应，在一系列TMS强度下收集运动诱发电位。MEP和MEP使用不同的标准化程序进行评估（原始数据、标准化至最大自主等长收缩[MVIC]、MEP峰值和背景收缩）。MEP也被标准化至磁诱发的外周静息抽搐扭矩。计算原始和标准化MEP的募集曲线下面积。确定组内相关系数（ICC）以评估重测可靠性。结果表明，在所有标准化程序中，MEP通常比MEP表现出更高的可靠性。股内侧肌MEP通常比股直肌MEP表现出更高的可靠性。最后，即使未进行标准化，MEP和MEP均表现出良好的可靠性。这些发现表明，MEP和MEP为皮质脊髓功能提供了可靠的测量指标，并表明在测量ACL重建个体的股四头肌皮质脊髓兴奋性方面，MEP是MEP的合适替代指标。
