Murphy Myles Calder, Rio Ebonie Kendra, Whife Casey, Latella Christopher
Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
School of Health Sciences, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
BMJ Open Sport Exerc Med. 2024 May 7;10(2):e001935. doi: 10.1136/bmjsem-2024-001935. eCollection 2024.
Rehabilitative practice is often criticised for being non-individualised, monotonous and not well aligned with foundational principles that drive continued physiological adaptation(s). However, our understanding of neuromuscular physiology is rapidly increasing and the way we programme rehabilitation is improving. This viewpoint highlights some of the potential considerations around why the adaptations achieved during rehabilitation programmes may be suboptimal. We provide basic, clinician-focused discussion about potential confounding physiological factors, and put forward several exercise-based programming recommendations and novel approaches to consider in contemporary rehabilitative practice. Specifically, we outline several potential mechanisms contributing to poor muscle activation and function that might be present following musculoskeletal injury. However, clinicians require strategies capable of attenuating these impairments to restore proper function. Therefore, we also provide an overview of recommended strength and conditioning guidelines, and novel strategies (such as external pacing and electrical stimulation techniques) that clinicians can consider to potentially improve the efficacy of musculoskeletal rehabilitation.
康复训练常常因缺乏个性化、单调乏味且与驱动持续生理适应的基本原则不一致而受到批评。然而，我们对神经肌肉生理学的理解正在迅速增加，我们制定康复训练计划的方式也在不断改进。这一观点强调了一些关于为何康复训练计划所实现的适应可能并非最优的潜在考量因素。我们提供了以临床医生为重点的关于潜在混杂生理因素的基础讨论，并提出了一些基于运动的训练计划建议以及当代康复训练实践中可考虑的新方法。具体而言，我们概述了一些可能导致肌肉激活和功能不佳的潜在机制，这些机制可能在肌肉骨骼损伤后出现。然而，临床医生需要能够减轻这些损伤以恢复正常功能的策略。因此，我们还概述了推荐的力量和体能训练指南，以及临床医生可考虑采用的新策略（如外部起搏和电刺激技术），以潜在地提高肌肉骨骼康复的效果。
