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摆线振动疗法对前交叉韧带重建术后关节源性肌肉抑制的疗效:一项前瞻性随机对照试验的研究方案

Efficacy of cycloid vibration therapy for arthrogenic muscle inhibition after anterior cruciate ligament reconstruction: a study protocol for a prospective, randomised controlled trial.

作者信息

Cao Wei, Sun Cuiyun, Hu Ke, Han Xiaofeng, Jin Wei, Xu Rong

机构信息

Department of Sports Rehabilitation, Anqing Normal University, Anqing, Anhui, China.

Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China.

出版信息

BMJ Open. 2025 Nov 4;15(11):e105424. doi: 10.1136/bmjopen-2025-105424.

Abstract

INTRODUCTION

Arthrogenic muscle inhibition (AMI) is a neuromuscular control disorder that occurs following joint injuries such as ligament tears, joint inflammation or postoperative conditions. It is characterised primarily by reflexive inhibition of the muscles surrounding the affected joint, substantially impeding rehabilitation. After anterior cruciate ligament reconstruction (ACLR), effective rehabilitation is essential to restore joint function, facilitate a return to preinjury activity levels and reduce the risk of reinjury. Vibration therapy may mitigate AMI by modulating somatosensory input to joint and cutaneous mechanoreceptors, thereby activating neuromuscular pathways through stimulation of mechanoreceptors in the skin, articular structures and musculotendinous tissues. Accordingly, this study employs cycloid vibration therapy (CVT) to evaluate its efficacy and safety in the management of AMI post-ACLR. The findings aim to determine whether integrating CVT into postoperative rehabilitation can effectively mitigate AMI, thereby optimising recovery of neuromuscular control and functional outcomes in ACLR patients.

METHODS AND ANALYSIS

This prospective, single-centre, randomised controlled trial will enrol 44 patients with AMI who have undergone ACLR. Participants will be randomly allocated in a 1:1 ratio to either an experimental group, receiving CVT plus conventional rehabilitation or a control group, receiving conventional rehabilitation alone. All participants will complete an 8-week rehabilitation programme consisting of 24 sessions. Outcome measures will be assessed at baseline, at a 4-week interim evaluation and immediately postintervention at week 8. These assessments will include surface electromyography parameters, ultrasonographic muscle thickness, range of motion, knee joint proprioception, Visual Analog Scale pain scores, Lysholm Knee Scoring Scale, Holden Functional Classification and adverse event rates. A follow-up study will evaluate patient satisfaction and long-term outcomes, while all adverse events will be monitored and documented throughout the trial.

ETHICS AND DISSEMINATION

The Medical Ethics Committee of Drum Tower Hospital, affiliated with Nanjing University School of Medicine, approved this study (2024-1022-02). The results will be submitted for publication in a peer-reviewed medical journal.

TRIAL REGISTRATION NUMBER

ChiCTR2500096882.

摘要

引言

关节源性肌肉抑制(AMI)是一种神经肌肉控制障碍,发生在诸如韧带撕裂、关节炎症或术后情况等关节损伤之后。其主要特征是受影响关节周围肌肉的反射性抑制,严重阻碍康复进程。在前交叉韧带重建(ACLR)术后,有效的康复对于恢复关节功能、促进恢复到伤前活动水平以及降低再次受伤风险至关重要。振动疗法可通过调节对关节和皮肤机械感受器的体感输入来减轻AMI,从而通过刺激皮肤、关节结构和肌腱组织中的机械感受器激活神经肌肉通路。因此,本研究采用摆线振动疗法(CVT)来评估其在ACLR术后AMI管理中的疗效和安全性。研究结果旨在确定将CVT纳入术后康复是否能有效减轻AMI,从而优化ACLR患者神经肌肉控制和功能结果的恢复。

方法与分析

本前瞻性、单中心、随机对照试验将招募44例接受ACLR且患有AMI的患者。参与者将按1:1的比例随机分配到实验组,接受CVT加传统康复治疗,或对照组,仅接受传统康复治疗。所有参与者将完成一个为期8周、共24节课程的康复计划。在基线、4周中期评估以及第8周干预结束后立即评估结果指标。这些评估将包括表面肌电图参数、超声肌肉厚度、活动范围、膝关节本体感觉、视觉模拟评分疼痛评分、Lysholm膝关节评分量表、霍尔登功能分类以及不良事件发生率。一项随访研究将评估患者满意度和长期结果,同时在整个试验过程中监测并记录所有不良事件。

伦理与传播

南京大学医学院附属鼓楼医院医学伦理委员会批准了本研究(2024 - 1022 - 02)。研究结果将提交至同行评审的医学期刊发表。

试验注册号

ChiCTR2500096882。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a989/12588005/9bd31a65fc2d/bmjopen-15-11-g001.jpg

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