Kim A W, Rosen A M, Brander V A, Buchanan T S
Department of Physical Medicine & Rehabilitation, Northwestern University Medical School, Chicago, IL, USA.
Arch Phys Med Rehabil. 1995 Aug;76(8):750-7. doi: 10.1016/s0003-9993(95)80530-3.
The objective of this study was to establish the presence of a local neurosensory reflex are from mechanoreceptors in human collateral ligaments and joint capsule to knee muscles and to determine if these muscles could be selectively activated as varus or valgus stabilizers using randomized trials. All studies were performed in the research department laboratories. Eleven subjects were recruited from the university staff and students based on no prior history of knee ailments. Subjects laid supine on an experimentation table as a current-modulated electrical stimulation was provided through the medial (MCL) or lateral collateral (LCL) knee ligaments. Latency of activation was measured for seven muscles, four by surface electrodes (semitendinosus, biceps femoris long head, vastus medialis, and lateralis), and three by intramuscular electrodes (sartorius, gracilis, tensor fascia lata). In the protocol, selective activation was defined as the relative increase in the activity of four muscles with medial moment arms following MCL stimulation compared with corresponding activity following LCL stimulation. For lateral muscles, the opposite was assumed (ie, that more activity would follow LCL than MCL stimulation). Monte Carlo simulations were performed on the data to determine significant selective muscle activation (p < .05). Statistically significant increases in activation were observed, most consistently, in the vastus medialis following MCL stimulation and in the vastus lateralis following LCL stimulation. These results suggest that a neurosensory reflex are from ligament mechanoreceptors may provide varus and valgus stabilization and knee muscles may be selectively activated to counter varus or valgus loads.
本研究的目的是确定人体侧副韧带和关节囊中机械感受器至膝部肌肉的局部神经感觉反射弧是否存在，并通过随机试验确定这些肌肉是否可作为内翻或外翻稳定肌被选择性激活。所有研究均在研究部门实验室进行。从大学教职员工和学生中招募了11名受试者，他们均无膝关节疾病史。受试者仰卧在实验台上，通过内侧（MCL）或外侧副韧带（LCL）进行电流调制电刺激。测量七块肌肉的激活潜伏期，四块通过表面电极测量（半腱肌、股二头肌长头、股内侧肌和股外侧肌），三块通过肌内电极测量（缝匠肌、股薄肌、阔筋膜张肌）。在该方案中，选择性激活定义为与LCL刺激后的相应活动相比，MCL刺激后具有内侧力矩臂的四块肌肉活动的相对增加。对于外侧肌肉，假设情况相反（即LCL刺激后的活动比MCL刺激后的更多）。对数据进行蒙特卡罗模拟以确定显著的选择性肌肉激活（p < 0.05）。观察到激活有统计学显著增加，最一致的是，MCL刺激后股内侧肌，以及LCL刺激后股外侧肌。这些结果表明，来自韧带机械感受器的神经感觉反射弧可能提供内翻和外翻稳定，并且膝部肌肉可能被选择性激活以对抗内翻或外翻负荷。
