{"title":"急性外踝扭伤后的足底关节肌肉抑制与症状和踝关节残疾有关，但与姿势控制无关。","authors":"Kyung-Min Kim, Joo-Sung Kim, Alan R Needle","doi":"10.1016/j.jshs.2024.02.005","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 (H<sub>max</sub>) and maximal motor response (M<sub>max</sub>) from the soleus, fibularis longus, and tibialis anterior muscles. The primary outcome measure was the H<sub>max</sub>/M<sub>max</sub> ratio. Secondary outcomes included acute symptoms (pain and swelling), postural control during bipedal stance, and self-reported function.</p><p><strong>Results: </strong>No significant group-by-limb interactions were observed for any muscle. However, a significant group main effect was observed in the soleus muscle (F<sub>(1,35)</sub> = 6.82, p = 0.013), indicating significantly lower H<sub>max</sub>/M<sub>max</sub> ratios following ALAS (0.38 ± 0.20) compared to healthy controls (0.53 ± 0.16). Furthermore, lower H<sub>max</sub>/M<sub>max</sub> ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":48897,"journal":{"name":"Journal of Sport and Health Science","volume":" ","pages":"559-568"},"PeriodicalIF":9.7000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184308/pdf/","citationCount":"0","resultStr":"{\"title\":\"Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control.\",\"authors\":\"Kyung-Min Kim, Joo-Sung Kim, Alan R Needle\",\"doi\":\"10.1016/j.jshs.2024.02.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 (H<sub>max</sub>) and maximal motor response (M<sub>max</sub>) from the soleus, fibularis longus, and tibialis anterior muscles. The primary outcome measure was the H<sub>max</sub>/M<sub>max</sub> ratio. Secondary outcomes included acute symptoms (pain and swelling), postural control during bipedal stance, and self-reported function.</p><p><strong>Results: </strong>No significant group-by-limb interactions were observed for any muscle. However, a significant group main effect was observed in the soleus muscle (F<sub>(1,35)</sub> = 6.82, p = 0.013), indicating significantly lower H<sub>max</sub>/M<sub>max</sub> ratios following ALAS (0.38 ± 0.20) compared to healthy controls (0.53 ± 0.16). Furthermore, lower H<sub>max</sub>/M<sub>max</sub> ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":48897,\"journal\":{\"name\":\"Journal of Sport and Health Science\",\"volume\":\" \",\"pages\":\"559-568\"},\"PeriodicalIF\":9.7000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184308/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Sport and Health Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jshs.2024.02.005\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"HOSPITALITY, LEISURE, SPORT & TOURISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Sport and Health Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jshs.2024.02.005","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"HOSPITALITY, LEISURE, SPORT & TOURISM","Score":null,"Total":0}
引用次数: 0
摘要
背景：急性外侧踝关节扭伤（ALAS）与神经兴奋性改变引起的长期损伤和不稳定性有关。在这类人群中已观察到关节源性肌肉抑制（AMI）；然而，与损伤相关损伤的关系尚不清楚，这可能是由于测量AMI时通常采用静息、俯卧姿势。评估双足站立时的 AMI 可以更好地了解这种关系：对 38 名年轻成年人（19 名在受伤后 72 小时内进行了 ALAS，10 名男性，21.4 ± 2.5 ± 1.5）的 AMI 进行了评估：10 名男性，21.4 ± 2.7 岁；19 名健康对照组：10 名男性，21.9 ± 2.2 岁；平均 ± SD）在双足站立时使用霍夫曼反射（H-反射）进行评估。通过电刺激来识别比目鱼肌、腓骨长肌和胫骨前肌的最大反射（Hmax）和运动（Mmax）反应。主要结果指标为 Hmax/Mmax 比率。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以及自我报告的功能：结果：在任何肌肉上都没有观察到明显的组间肢体交互作用。然而，在比目鱼肌上观察到了明显的组间主效应（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 比值（0.38 ± 0.20）明显较低。此外，比目鱼肌较低的Hmax/Mmax比率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：本研究支持了之前关于 ALAS 患者 AMI 的证据，为了解肌肉骨骼损伤对神经生理学的影响提供了见解。我们的研究结果表明，评估急性损伤后站立姿势下的 AMI 可为了解 AMI 的发展过程提供有价值的信息，并指导潜在的治疗方案，以遏制和抵消关节不稳定性的形成。
Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control.
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.
Conclusion: 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.
期刊介绍：
The Journal of Sport and Health Science (JSHS) is an international, multidisciplinary journal that aims to advance the fields of sport, exercise, physical activity, and health sciences. Published by Elsevier B.V. on behalf of Shanghai University of Sport, JSHS is dedicated to promoting original and impactful research, as well as topical reviews, editorials, opinions, and commentary papers.
With a focus on physical and mental health, injury and disease prevention, traditional Chinese exercise, and human performance, JSHS offers a platform for scholars and researchers to share their findings and contribute to the advancement of these fields. Our journal is peer-reviewed, ensuring that all published works meet the highest academic standards.
Supported by a carefully selected international editorial board, JSHS upholds impeccable integrity and provides an efficient publication platform. We invite submissions from scholars and researchers worldwide, and we are committed to disseminating insightful and influential research in the field of sport and health science.
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