Karst G M, Willett G M
Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha 68198-4420, USA.
Phys Ther. 1995 Sep;75(9):813-23. doi: 10.1093/ptj/75.9.813.
Inappropriate neural control of the quadriceps femoris muscle group has been implicated in patellofemoral pain syndrome (PFPS). This study investigated the timing of initial electromyographic (EMG) activity of the vastus medialis oblique muscle (VMO) and the vastus lateralis muscle (VL) in asymptomatic subjects and subjects with PFPS during reflex and voluntary muscle activity.
Fifteen symptomatic subjects (SYMP group) (9 with bilateral symptoms) and 12 asymptomatic subjects (ASYMP group) participated. Both knees were tested in the ASYMP group and only the symptomatic knees were tested in the SYMP group, resulting in a total of 24 data sets from each group.
Electromyographic data were recorded from the VMO and VL under three conditions: reflex knee extension (RFLX) elicited by a patellar tendon tap, and active knee extension in non-weight-bearing (NWB) and weight-bearing (WB) situations. For each condition, EMG activity onset times for the VMO and VL were determined from ensemble averages of four trials.
There were no differences between the SYMP and ASYMP groups with respect to the relative timing of initial VMO and VL activity under any of the three conditions tested. Mean timing differences for both groups were less than 0.25 milliseconds under reflex conditions and less than 4 milliseconds for active knee extension under both WB and NWB conditions.
These findings contradict a previous report of differences in reflex timing related to PFPS. Differences in the relative timing of onset of EMG activity of the VMO and VL during voluntary knee extension were not significant between SYMP and ASYMP groups, and were not related to the relative timing differences observed during reflex testing.
股四头肌群的神经控制不当与髌股疼痛综合征(PFPS)有关。本研究调查了无症状受试者以及患有PFPS的受试者在反射和自主肌肉活动期间,股内侧斜肌(VMO)和股外侧肌(VL)初始肌电图(EMG)活动的时间。
15名有症状的受试者(SYMP组)(9名双侧有症状)和12名无症状受试者(ASYMP组)参与研究。ASYMP组双侧膝关节均进行测试,SYMP组仅测试有症状的膝关节,每组共获得24个数据集。
在三种情况下记录VMO和VL的肌电图数据:髌腱叩击引发的反射性膝关节伸展(RFLX),以及非负重(NWB)和负重(WB)情况下的主动膝关节伸展。对于每种情况,通过四次试验的总体平均值确定VMO和VL的EMG活动起始时间。
在测试的三种情况下的任何一种情况下,SYMP组和ASYMP组在VMO和VL初始活动的相对时间方面均无差异。两组在反射条件下的平均时间差异小于0.25毫秒,在WB和NWB条件下主动膝关节伸展时的平均时间差异小于4毫秒。
这些发现与之前关于与PFPS相关的反射时间差异的报告相矛盾。SYMP组和ASYMP组在主动膝关节伸展期间VMO和VL的EMG活动起始相对时间差异不显著,且与反射测试期间观察到的相对时间差异无关。