监测皮质和神经肌肉活动：前交叉韧带重建术后膝关节位置觉的六个月观察
Monitoring Cortical and Neuromuscular Activity: Six-month Insights into Knee Joint Position Sense Following ACL Reconstruction.
作者信息
Busch Aglaja, Gianotti Lorena R R, Mayer Frank, Baur Heiner
机构信息
School of Health Professions Bern University of Applied Sciences.
Sports Medicine & Sports Orthopeadics University of Potsdam.
出版信息
Int J Sports Phys Ther. 2024 Nov 2;19(11):1290-1303. doi: 10.26603/001c.124840. eCollection 2024.
BACKGROUND
Changes in cortical activation patterns after rupture of the anterior cruciate ligament (ACL) have been described. However, evidence of these consequences in the early stages following the incident and through longitudinal monitoring is scarce. Further insights could prove valuable in informing evidence-based rehabilitation practices.
PURPOSE
To analyze the angular accuracy, neuromuscular, and cortical activity during a knee joint position sense (JPS) test over the initial six months following ACL reconstruction. Study design: Cohort Study.
METHODS
Twenty participants with ACL reconstruction performed a JPS test with both limbs. The measurement time points were approximately 1.5, 3-4 and 6 months after surgery, while 20 healthy controls were examined on a single occasion. The active JPS test was performed seated with a target angle of 50° for two blocks of continuous angular reproduction (three minutes per block). The reproduced angles were recorded simultaneously by an electrogoniometer. Neuromuscular activity of the quadriceps muscles during extension to the target angle was measured with surface electromyography. Spectral power for theta, alpha-2, beta-1 and beta-2 frequency bands were determined from electroencephalographic recordings. Linear mixed models were performed with group (ACL or controls), the measurement time point, and respective limb as fixed effect and each grouping per subject combination as random effect with random intercept.
RESULTS
Significantly higher beta-2 power over the frontal region of interest was observed at the first measurement time point in the non-involved limb of the ACL group in comparison to the control group (p = 0.03). Despite individual variation, no other statistically significant differences were identified for JPS error, neuromuscular, or other cortical activity.
CONCLUSION
Variation in cortical activity between the ACL and control group were present, which is consistent with published results in later stages of rehabilitation. Both indicate the importance of a neuromuscular and neurocognitive focus in the rehabilitation.
LEVEL OF EVIDENCE
背景
已有研究描述了前交叉韧带（ACL）断裂后皮质激活模式的变化。然而，关于这些后果在事件发生后的早期阶段以及通过纵向监测的证据却很少。进一步的见解可能对基于证据的康复实践具有重要价值。
目的
分析ACL重建术后最初六个月内膝关节位置觉（JPS）测试中的角度准确性、神经肌肉和皮质活动。研究设计：队列研究。
方法
20名接受ACL重建的参与者对双下肢进行JPS测试。测量时间点分别为术后约1.5个月、3 - 4个月和6个月，同时对20名健康对照者进行单次检查。主动JPS测试在坐位进行，目标角度为50°，连续进行两个角度重现块（每个块三分钟）。角度重现由电子测角仪同时记录。在伸展至目标角度过程中，用表面肌电图测量股四头肌的神经肌肉活动。从脑电图记录中确定θ、α-2、β-1和β-2频段的频谱功率。采用线性混合模型，将组（ACL组或对照组）、测量时间点和相应肢体作为固定效应，将每个受试者组合的每组作为具有随机截距的随机效应。
结果
与对照组相比，ACL组未受累肢体在第一个测量时间点时，在感兴趣的额叶区域观察到显著更高的β-2功率（p = 0.03）。尽管存在个体差异，但在JPS误差、神经肌肉或其他皮质活动方面未发现其他统计学显著差异。
结论
ACL组和对照组之间存在皮质活动差异，这与康复后期已发表的结果一致。两者均表明在康复中关注神经肌肉和神经认知的重要性。
证据水平
3级。
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