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本体感觉与中枢神经兴奋性:对韧带或半月板损伤运动员重返赛场的影响

Proprioception and Central Nervous Excitability: Implications for Return-to-Play in Athletes with Ligament or Meniscal Injuries.

作者信息

Okayama Yumi, Daikuya Shinichi

机构信息

Faculty of Health and Medical Sciences Hokuriku University.

出版信息

Int J Sports Phys Ther. 2025 Aug 1;20(8):1122-1130. doi: 10.26603/001c.142068. eCollection 2025.


DOI:10.26603/001c.142068
PMID:40756788
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12317791/
Abstract

BACKGROUND AND PURPOSE: While indicators such as joint stability, range of motion, and muscle strength are critical for assessing readiness to return to sports, athletes may still face challenges even when these benchmarks are met. Therefore, this study aimed to examine the relationship between sports injury history or return-to-play status and central nervous system excitability during muscle output adjustments, and to investigate the characteristics of evoked EMG during torque maintenance as a potential indicator for assessing readiness to return to sport. DESIGN: Case control, observational study. METHODS: Twenty-one female university basketball players participated, including athletes with and without a history of surgery. Participants were eligible if they had no current injuries. Those with a history of surgery had completed rehabilitation and were cleared for return to play. Subjects were instructed to maintain 25% of maximum effort of voluntary isometric contraction of knee extension and the torque, long-latency reflexes (LLR) were recorded. Torque maintenance was assessed under two conditions: visual feedback and verbal instructions. Frequency of LLR appearance, and an average of latency, duration, amplitude ratio, and number of phases were calculated. Comparisons were made using Wilcoxon signed-rank tests between the dominant and non-dominant legs, and in participants with a history of injury, comparisons were also made between the injured and non-injured legs. RESULTS: The visual feedback condition led to finer motor adjustments in uninjured knees compared to verbal feedback. For injured knees, the amplitude ratio of LLR was significantly higher with visual feedback, indicating increased central nervous system excitability. Athletes who had not returned to sports displayed greater torque fluctuation and lower LLR amplitudes, suggesting inadequate fine motor control. CONCLUSION: These findings suggest that visual feedback enhances motor adjustments in athletes with previous injuries, indicating heightened reliance on central nervous functions. LEVEL OF EVIDENCE: 3b.

摘要

背景与目的:虽然关节稳定性、活动范围和肌肉力量等指标对于评估恢复运动的准备情况至关重要,但即使达到这些标准,运动员仍可能面临挑战。因此,本研究旨在探讨运动损伤史或恢复比赛状态与肌肉输出调整过程中中枢神经系统兴奋性之间的关系,并研究在扭矩维持过程中诱发肌电图的特征,作为评估恢复运动准备情况的潜在指标。 设计:病例对照观察性研究。 方法:21名女大学生篮球运动员参与研究,包括有手术史和无手术史的运动员。参与者需无当前损伤才符合条件。有手术史的运动员已完成康复并获许恢复比赛。受试者被要求保持膝关节伸展自主等长收缩最大努力的25%,并记录扭矩和长潜伏期反射(LLR)。在视觉反馈和口头指令两种条件下评估扭矩维持情况。计算LLR出现的频率以及潜伏期、持续时间、振幅比和相位数量的平均值。使用Wilcoxon符号秩检验对优势腿和非优势腿进行比较,对于有损伤史的参与者,还对受伤腿和未受伤腿进行比较。 结果:与口头反馈相比,视觉反馈条件下未受伤膝关节的运动调整更精细。对于受伤膝关节,视觉反馈时LLR的振幅比显著更高,表明中枢神经系统兴奋性增加。未恢复运动的运动员表现出更大的扭矩波动和更低的LLR振幅,表明精细运动控制不足。 结论:这些发现表明,视觉反馈可增强既往受伤运动员的运动调整,表明对中枢神经功能的依赖增强。 证据水平:3b。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ab/12317791/ef39414afa60/ijspt_2025_20_8_142068_293741.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ab/12317791/cb3805ffd579/ijspt_2025_20_8_142068_293737.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ab/12317791/ef39414afa60/ijspt_2025_20_8_142068_293741.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ab/12317791/cb3805ffd579/ijspt_2025_20_8_142068_293737.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ab/12317791/ef39414afa60/ijspt_2025_20_8_142068_293741.jpg

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本文引用的文献

[1]
Hamstrings and Quadriceps Weaknesses Following Anterior Cruciate Ligament Reconstruction Persist Up to 6 Months After Return-to-Sport: An Angle-specific Strength Analysis.

Int J Sports Phys Ther. 2025-2-1

[2]
Knee proprioception four months after anterior cruciate ligament reconstruction: Impact of limb dominance, anterolateral procedure, and association with readiness to return to sport.

Phys Ther Sport. 2025-1

[3]
Proprioceptive Reweighting and Postural Control are Impaired Among Elite Athletes Following Anterior Cruciate Ligament Reconstruction.

Int J Sports Phys Ther. 2024-11-1

[4]
Clinical practice and barriers among Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction: A survey of pre-operative rehabilitation to return to sport.

Phys Ther Sport. 2024-1

[5]
Long Latency Reflexes in Clinical Neurology: A Systematic Review.

Can J Neurol Sci. 2023-9

[6]
Predicting Anterior Cruciate Ligament Reinjury From Return-to-Activity Assessments at 6 Months Postsurgery: A Prospective Cohort Study.

J Athl Train. 2022-4-1

[7]
Does Evoked Electromyography Detect the Injured Facial Nerve Recovery Earlier Than Clinical Assessments?

J Oral Maxillofac Surg. 2022-5

[8]
Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return.

J Orthop Sports Phys Ther. 2020-2

[9]
Eccentric knee flexor weakness in elite female footballers 1-10 years following anterior cruciate ligament reconstruction.

Phys Ther Sport. 2019-3-29

[10]
Long Loop Reflex 2 in Patients with Cortical Dementias: A Pilot Study.

Indian J Psychol Med. 2017

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