确定阳极经颅直流电刺激对前交叉韧带重建术后皮质脊髓兴奋性和股四头肌功能的安全性、可行性及影响：一项随机交叉设计。

Determining the safety, feasibility, and effects of anodal transcranial direct current stimulation on corticospinal excitability and quadriceps performance after anterior cruciate ligament reconstruction: a randomized crossover design.

作者信息

Zarzycki Ryan, Leung Anne, Abraham Rebekah, Hammoud Sommer, Perrone Mattia, Kantak Shailesh

机构信息

Department of Physical Therapy, Arcadia University, Glenside, PA, USA.

Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

出版信息

Ann Jt. 2025 Jan 21;10:3. doi: 10.21037/aoj-24-15. eCollection 2025.

DOI:10.21037/aoj-24-15

PMID:39981427

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11836737/

Abstract

BACKGROUND

Alterations in corticospinal excitability (CSE) to the quadriceps persist after anterior cruciate ligament reconstruction (ACLR). Centrally targeted interventions, such as transcranial direct current stimulation (tDCS), may be necessary to increase CSE and quadriceps muscle strength. The purpose of this study was to determine (I) the feasibility and safety of a single session of tDCS and (II) the effects of a single session of tDCS on CSE and quadriceps muscle performance in participants after ACLR.

METHODS

This was a randomized crossover design of a single session of active sham tDCS, including 20 participants (nine male) 4-6 months post-ACLR. Surgical limb quadriceps performance [peak torque normalized to body mass, rate of torque development from onset to 100 ms (RTD100), and RTD from 100 to 200 ms (RTD200)] and CSE [active motor threshold (AMT) and slope of a stimulus-response curve (SLOPE)] were measured using an isokinetic dynamometer and transcranial magnetic stimulation (TMS), respectively. Anodal tDCS (a-tDCS) was delivered over the primary motor cortex while the participant rode a stationary bike for 20 minutes. Adverse events were collected after each tDCS session. Repeated measures 2×2 analyses of variance (ANOVAs) were used to test the effect of condition and time on CSE and quadriceps performance.

RESULTS

There were no adverse events reported and no participant drop out. There was no significant condition by time interactions for CSE (P≥0.17) or quadriceps performance (P≥0.53). There was a significant main effect of time for RTD200 (P=0.02) with decreased RTD200 post-intervention regardless of condition.

CONCLUSIONS

TDCS is safe and feasible for participants recovering from ACLR. There were no acute effects of a single session of a-tDCS on CSE and quadriceps performance measures. Multiple sessions of tDCS and/or tDCS during other tasks (e.g., during isolated quadriceps exercises) may lead to improved CSE and quadriceps performance.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT04504344.

摘要

背景

前交叉韧带重建（ACLR）后，股四头肌的皮质脊髓兴奋性（CSE）改变持续存在。可能需要进行以中枢为靶点的干预措施，如经颅直流电刺激（tDCS），以提高CSE和股四头肌力量。本研究的目的是确定（I）单次tDCS的可行性和安全性，以及（II）单次tDCS对ACLR术后参与者CSE和股四头肌功能的影响。

方法

这是一项关于单次主动/假tDCS的随机交叉设计，纳入20名参与者（9名男性），均为ACLR术后4 - 6个月。分别使用等速测力计和经颅磁刺激（TMS）测量手术侧肢体股四头肌功能[峰值扭矩除以体重、从开始到100毫秒的扭矩发展速率（RTD100）以及从100到200毫秒的RTD（RTD200）]和CSE[主动运动阈值（AMT）和刺激 - 反应曲线斜率（SLOPE）]。在参与者骑固定自行车20分钟时，将阳极tDCS（a - tDCS）施加于初级运动皮层。每次tDCS治疗后收集不良事件。采用重复测量2×2方差分析（ANOVA）来检验条件和时间对CSE和股四头肌功能的影响。