膝关节病变和传出通路功能障碍:绘制从运动皮层到肌肉力量的肌肉抑制图谱

IF 2.2 3区 医学 Q1 REHABILITATION
David A. Sherman , Justin Rush , Neal R. Glaviano , Grant E. Norte
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引用次数: 0

摘要

背景膝关节病变后传出通路的功能障碍与股四头肌和腿肌表现、日常功能和健康相关生活质量的长期损害有关。了解其根本病因对于有效治疗和预防不良后果(如创伤后骨关节炎或关节置换)至关重要、方法我们总结了目前研究三种常见膝关节病变(前交叉韧带 (ACL) 损伤、前膝关节疼痛 (AKP) 和膝关节骨性关节炎 (OA))患者运动皮层、皮质脊髓束和运动神经元池的文献。为了提供一个完整的视角,我们借鉴了应用一系列神经影像学和神经生理学技术进行的研究。结果膝关节病变患者的运动皮层、皮质脊髓束和运动神经元池均存在适应性改变,并突出显示了股四头肌和腿肌功能的损伤。每种病症都有证据表明运动系统的兴奋性发生了改变,肌肉的自主激活和发力能力下降,但在前交叉韧带损伤、AKP 和 OA 的研究中,很少有共同的损伤。这些发现强调了运动皮层和运动单元行为在膝关节病变患者长期预后中的核心作用。结论传出通路的适应性是三种常见膝关节病变中肌肉功能持续障碍的原因。本综述概述了这些变化,并总结了神经生理学和神经影像学研究的主要发现,为关节损伤康复的未来研究和临床应用提供了方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Knee joint pathology and efferent pathway dysfunction: Mapping muscle inhibition from motor cortex to muscle force

Background

Dysfunction in efferent pathways after knee pathology is tied to long-term impairments in quadriceps and hamstrings muscle performance, daily function, and health-related quality of life. Understanding the underlying etiology is crucial for effective treatment and prevention of poor outcomes, such as post-traumatic osteoarthritis or joint replacement.

Objectives

To synthesize recent evidence of efferent pathway dysfunction (i.e., motor cortex, motor units) among individuals with knee pathology.

Design

Commentary.

Method

We summarize the current literature investigating the motor cortex, corticospinal tract, and motoneuron pool in individuals with three common knee pathologies: anterior cruciate ligament (ACL) injury, anterior knee pain (AKP), and knee osteoarthritis (OA). To offer a complete perspective, we draw from studies applying a range of neuroimaging and neurophysiologic techniques.

Results

Adaptations within the motor cortices, corticospinal tract, and motoneuron pool are present in those with knee pathology and underline impairments in quadriceps and hamstrings muscle function. Each pathology has evidence of altered motor system excitability and reduced volitional muscle activation and force-generating capacity, but few impairments were common across ACL injury, AKP, and OA studies. These findings underscore the central role of the motor cortex and motor unit behavior in the long-term outcomes of individuals with knee pathology.

Conclusions

Adaptations in the efferent pathways underlie persistent muscle dysfunction across three common knee pathologies. This review provides an overview of these changes and summarizes key findings from neurophysiology and neuroimaging studies, offering direction for future research and clinical application in the rehabilitation of joint injuries.
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来源期刊
Musculoskeletal Science and Practice
Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation
CiteScore
4.10
自引率
8.70%
发文量
152
审稿时长
48 days
期刊介绍: Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.
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