PDF(Pubmed)
Abstract：
BACKGROUND: Acute lateral ankle sprains (ALAS) are associated with long-term impairments and instability tied to altered neural excitability. Arthrogenic muscle inhibition (AMI) has been observed in this population; however, relationships with injury-related impairments are unclear, potentially due to the resting, prone position in which AMI is typically measured. Assessing AMI during bipedal stance may provide a better understanding of this relationship.
METHODS: AMI was assessed in 38 young adults (19 ALAS within 72 h of injury: 10 males, 21.4 ± 2.7 years; 19 healthy controls: 10 males, 21.9 ± 2.2 years; mean ± SD) using the Hoffmann reflex (H-reflex) during bipedal stance. Electrical stimulation was administered to identify the maximal H-reflex (Hmax) and maximal motor response (Mmax) from the soleus, fibularis longus, and tibialis anterior muscles. The primary outcome measure was the Hmax/Mmax ratio. Secondary outcomes included acute symptoms (pain and swelling), postural control during bipedal stance, and self-reported function.
RESULTS: No significant group-by-limb interactions were observed for any muscle. However, a significant group main effect was observed in the soleus muscle (F(1,35) = 6.82, p = 0.013), indicating significantly lower Hmax/Mmax ratios following ALAS (0.38 ± 0.20) compared to healthy controls (0.53 ± 0.16). Furthermore, lower Hmax/Mmax ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control.
CONCLUSIONS: This study supports previous evidence of AMI in patients with ALAS, providing insight into neurophysiologic impacts of musculoskeletal injury. Our results suggest that assessing AMI in a standing position following acute injury may provide valuable insight into how AMI develops and guide potential therapeutic options to curb and offset the formation of joint instability.
METHODS: AMI was assessed in 38 young adults (19 ALAS within 72 h of injury: 10 males, 21.4 ± 2.7 years; 19 healthy controls: 10 males, 21.9 ± 2.2 years; mean ± SD) using the Hoffmann reflex (H-reflex) during bipedal stance. Electrical stimulation was administered to identify the maximal H-reflex (Hmax) and maximal motor response (Mmax) from the soleus, fibularis longus, and tibialis anterior muscles. The primary outcome measure was the Hmax/Mmax ratio. Secondary outcomes included acute symptoms (pain and swelling), postural control during bipedal stance, and self-reported function.
RESULTS: No significant group-by-limb interactions were observed for any muscle. However, a significant group main effect was observed in the soleus muscle (F(1,35) = 6.82, p = 0.013), indicating significantly lower Hmax/Mmax ratios following ALAS (0.38 ± 0.20) compared to healthy controls (0.53 ± 0.16). Furthermore, lower Hmax/Mmax ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control.
CONCLUSIONS: This study supports previous evidence of AMI in patients with ALAS, providing insight into neurophysiologic impacts of musculoskeletal injury. Our results suggest that assessing AMI in a standing position following acute injury may provide valuable insight into how AMI develops and guide potential therapeutic options to curb and offset the formation of joint instability.
摘要：
背景：急性踝关节外侧扭伤（ALAS）与神经兴奋性改变导致的长期损伤和不稳定相关。在该人群中观察到关节肌肉抑制（AMI）；然而，与损伤相关损伤的关系尚不清楚，可能是由于休息，通常测量AMI的俯卧位。在双足站立期间评估AMI可能会更好地理解这种关系。
方法：在38名年轻人中评估了AMI（受伤72小时内19名ALAS：10名男性，21.4±2.7岁；19名健康对照：10名男性，21.9±2.2年；平均值±SD）在双足站立期间使用霍夫曼反射（H反射）。进行电刺激以识别比目鱼的最大反射（Hmax）和运动（Mmax）反应，长腓骨,和胫骨前肌.主要结果测量是Hmax/Mmax比值。次要结果包括急性症状（疼痛和肿胀），双足站立时的姿势控制，和自我报告功能。
结果：对于任何肌肉，均未观察到明显的群肢相互作用。然而,在比目鱼肌中观察到显著的组主要效应(F(1,35)=6.82,p=0.013),表明与健康对照组（0.53±0.16）相比，ALAS后的Hmax/Mmax比率（0.38±0.20）显着降低。此外，比目鱼较低的Hmax/Mmax比值与急性症状和自我报告的功能显著相关,但与姿势控制无关.
结论：本研究支持ALAS患者先前的AMI证据，提供对肌肉骨骼损伤的神经生理学影响的见解。我们的结果表明，评估急性损伤后站立姿势的AMI可能为AMI的发展提供有价值的见解，并指导潜在的治疗选择以遏制和抵消关节不稳定的形成。
方法：在38名年轻人中评估了AMI（受伤72小时内19名ALAS：10名男性，21.4±2.7岁；19名健康对照：10名男性，21.9±2.2年；平均值±SD）在双足站立期间使用霍夫曼反射（H反射）。进行电刺激以识别比目鱼的最大反射（Hmax）和运动（Mmax）反应，长腓骨,和胫骨前肌.主要结果测量是Hmax/Mmax比值。次要结果包括急性症状（疼痛和肿胀），双足站立时的姿势控制，和自我报告功能。
结果：对于任何肌肉，均未观察到明显的群肢相互作用。然而,在比目鱼肌中观察到显著的组主要效应(F(1,35)=6.82,p=0.013),表明与健康对照组（0.53±0.16）相比，ALAS后的Hmax/Mmax比率（0.38±0.20）显着降低。此外，比目鱼较低的Hmax/Mmax比值与急性症状和自我报告的功能显著相关,但与姿势控制无关.
结论：本研究支持ALAS患者先前的AMI证据，提供对肌肉骨骼损伤的神经生理学影响的见解。我们的结果表明，评估急性损伤后站立姿势的AMI可能为AMI的发展提供有价值的见解，并指导潜在的治疗选择以遏制和抵消关节不稳定的形成。
