影响大学生男性运动员踝关节扭伤后复发的神经生理抑制因素:前瞻性队列研究。

Neurophysiologic inhibitory factors influencing subsequent ankle sprain in collegiate male athletes: a prospective cohort study.

机构信息

Faculty of Health and Sports Sciences, Toyo University, 1-7-11 Akabanedai, Kita-ku, Tokyo, 151-8650, Japan.

Faculty of Business and Information Sciences, Jobu University, Gunma, Japan.

出版信息

Exp Brain Res. 2024 Dec;242(12):2839-2851. doi: 10.1007/s00221-024-06930-8. Epub 2024 Nov 7.

Abstract

Many athletes with recurrent ankle sprains complain of neurophysiological deficits related to chronic ankle instability (CAI). However, it remains unclear how changes in the corticospinal pathway affect the potential risk of subsequent ankle sprains. The purpose of this study was to investigate whether the corticospinal excitability (input-output properties) and silent period (SP) could be related to the risk of subsequent ankle sprains among athletes. Forty-three male collegiate basketball athletes were enrolled, and 82 ankles were finally sorted into four ankle groups based on symptoms (CAI, sub-CAI, copers, and normal). The neurophysiological data was recorded in both ankles using transcranial magnetic stimulation (TMS) as baseline assessments. Subsequently, we prospectively followed the occurrence of subsequent ankle sprain injuries for 24 months (SG, subsequent ankle sprain group; NSG, non-sprain group). In the baseline assessment, we confirmed that the threshold of the input-output properties in the CAI group was higher than those in the normal group. After the follow-up, 22 ankles sustained subsequent ankle sprains (SGs). We also found that SGs exhibited a significantly longer SP at the middle and high stimulus intensities of TMS compared to NSGs (60 ankles) (middle: p = 0.012, Cohen's d = 0.644, and high: p = 0.020, Cohen's d = 0.590). These findings suggest that a prolonged SP could be a crucial factor affecting subsequent ankle sprains in athletes. To prevent further recurrent sports injuries, neurophysiologic probes, particularly a longer SP, might be a potential assessment tool to return to the field.

摘要

许多反复踝关节扭伤的运动员抱怨与慢性踝关节不稳定(CAI)相关的神经生理缺陷。然而,皮质脊髓通路的变化如何影响随后踝关节扭伤的潜在风险尚不清楚。本研究旨在探讨皮质脊髓兴奋性(输入-输出特性)和静息期(SP)是否与运动员随后踝关节扭伤的风险有关。共纳入 43 名男性大学生篮球运动员,根据症状(CAI、亚 CAI、代偿者和正常)最终将 82 只踝关节分为四组。使用经颅磁刺激(TMS)记录双侧踝关节的神经生理数据作为基线评估。随后,我们前瞻性地随访了 24 个月(SG,随后踝关节扭伤组;NSG,非扭伤组)的后续踝关节扭伤损伤的发生情况。在基线评估中,我们确认 CAI 组的输入-输出特性的阈值高于正常组。随访后,22 只踝关节发生了随后的踝关节扭伤(SGs)。我们还发现 SGs 在 TMS 的中、高强度刺激时的 SP 明显长于 NSGs(60 只踝关节)(中:p=0.012,Cohen's d=0.644,高:p=0.020,Cohen's d=0.590)。这些发现表明,较长的 SP 可能是影响运动员随后踝关节扭伤的关键因素。为了防止进一步的复发性运动损伤,神经生理探针,特别是较长的 SP,可能是恢复运动的潜在评估工具。

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