Myles Calder Murphy, Colin Sylvester, Casey Whife, Peter D'Alessandro, Ebonie Kendra Rio, Ann-Maree Vallence
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Anodal-tDCS or sham-tDCS was delivered to the primary motor cortex for 20 min, three times per week, for 6 weeks from week 2 post ACLR. Transcranial magnetic stimulation quantified quadriceps short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI) and short-interval intracortical facilitation (SICF). Significance at p<0.05.</p><p><strong>Results: </strong>Participants were randomised to anodal (n=11) or sham (n=10) tDCS. Participants were predominantly male (n=13) and had a mean (SD) age of 24.4 (4.7) years. For SICI, there was a group-by-time effect for anodal-tDCS (β=0.519, 95% CI 0.057 to 0.981, p=0.028) and an effect for time (β=-1.421, 95% CI -1.919 to -0.923, p<0.001). For LICI, there was no group-by-time (β=-0.217, 95% CI -0.916 to 0.482, p=0.543) or time effect (β=0.039, 95% CI -0.815 to -0.893, p=0.928). For SICF, there was a group-by-time effect for anodal-tDCS (β=-0.764, 95%CI -1.407 to -0.120, p=0.020) but not time (β=0.504, 95% CI -0.627 to 1.635, p=0.383).</p><p><strong>Conclusion: </strong>This study provided proof of the efficacy of anodal-tDCS post ACLR in reducing maladaptive quadriceps inhibition and facilitation. We demonstrated anodal-tDCS improved facilitation and inhibition post ACLR, which are drivers of arthrogenic muscle inhibition.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"10 4","pages":"e002080"},"PeriodicalIF":3.9000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629017/pdf/","citationCount":"0","resultStr":"{\"title\":\"Anodal transcranial direct current stimulation (tDCS) modulates quadriceps motor cortex inhibition and facilitation during rehabilitation following anterior cruciate ligament (ACL) reconstruction: a triple-blind, randomised controlled proof of concept trial.\",\"authors\":\"Myles Calder Murphy, Colin Sylvester, Casey Whife, Peter D'Alessandro, Ebonie Kendra Rio, Ann-Maree Vallence\",\"doi\":\"10.1136/bmjsem-2024-002080\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Following anterior cruciate ligament reconstruction (ACLR), maladaptive changes occur in the motor cortex representation of the quadriceps, evidenced by increases in intracortical inhibition and facilitation. The primary objective of this proof-of-concept study was to determine if anodal transcranial direct current stimulation (tDCS) can alter quadriceps intracortical inhibition and facilitation in an early-ACLR population after 6 weeks of application during exercise.</p><p><strong>Methods: </strong>We performed a randomised, triple-blind controlled trial for proof of concept comparing anodal-tDCS to sham-tDCS following ACLR. Anodal-tDCS or sham-tDCS was delivered to the primary motor cortex for 20 min, three times per week, for 6 weeks from week 2 post ACLR. Transcranial magnetic stimulation quantified quadriceps short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI) and short-interval intracortical facilitation (SICF). Significance at p<0.05.</p><p><strong>Results: </strong>Participants were randomised to anodal (n=11) or sham (n=10) tDCS. Participants were predominantly male (n=13) and had a mean (SD) age of 24.4 (4.7) years. For SICI, there was a group-by-time effect for anodal-tDCS (β=0.519, 95% CI 0.057 to 0.981, p=0.028) and an effect for time (β=-1.421, 95% CI -1.919 to -0.923, p<0.001). For LICI, there was no group-by-time (β=-0.217, 95% CI -0.916 to 0.482, p=0.543) or time effect (β=0.039, 95% CI -0.815 to -0.893, p=0.928). For SICF, there was a group-by-time effect for anodal-tDCS (β=-0.764, 95%CI -1.407 to -0.120, p=0.020) but not time (β=0.504, 95% CI -0.627 to 1.635, p=0.383).</p><p><strong>Conclusion: </strong>This study provided proof of the efficacy of anodal-tDCS post ACLR in reducing maladaptive quadriceps inhibition and facilitation. We demonstrated anodal-tDCS improved facilitation and inhibition post ACLR, which are drivers of arthrogenic muscle inhibition.</p>\",\"PeriodicalId\":47417,\"journal\":{\"name\":\"BMJ Open Sport & Exercise Medicine\",\"volume\":\"10 4\",\"pages\":\"e002080\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-12-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629017/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open Sport & Exercise Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjsem-2024-002080\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"SPORT SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open Sport & Exercise Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjsem-2024-002080","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
目的：在前交叉韧带重建（ACLR）后，股四头肌运动皮层发生不适应变化，表现为皮质内抑制和促进的增加。这项概念验证研究的主要目的是确定在运动期间应用6周后，淋巴结经颅直流电刺激（tDCS）是否可以改变早期aclr人群的股四头肌皮质内抑制和促进。方法：我们进行了一项随机，三盲对照试验，以证明ACLR后anodal-tDCS和sham-tDCS的概念。从ACLR后第2周开始，将Anodal-tDCS或sham-tDCS送入初级运动皮层20分钟，每周3次，持续6周。经颅磁刺激量化股四头肌短间隔皮质内抑制（SICI）、长间隔皮质内抑制（LICI）和短间隔皮质内促进（SICF）。结果的意义：参与者被随机分配到正常（n=11）或假（n=10） tDCS。参与者主要为男性（n=13），平均（SD）年龄为24.4（4.7）岁。对于SICI，阳极- tdcs存在按时间分组效应（β=0.519, 95% CI 0.057 ~ 0.981, p=0.028）和按时间分组效应（β=-1.421, 95% CI -1.919 ~ -0.923, p）。结论：本研究证明了ACLR后阳极- tdcs对减轻适应不良股四头肌抑制和促进的有效性。我们证明了阳极- tdcs改善了ACLR后的促进和抑制，这是关节源性肌肉抑制的驱动因素。
Anodal transcranial direct current stimulation (tDCS) modulates quadriceps motor cortex inhibition and facilitation during rehabilitation following anterior cruciate ligament (ACL) reconstruction: a triple-blind, randomised controlled proof of concept trial.
Objectives: Following anterior cruciate ligament reconstruction (ACLR), maladaptive changes occur in the motor cortex representation of the quadriceps, evidenced by increases in intracortical inhibition and facilitation. The primary objective of this proof-of-concept study was to determine if anodal transcranial direct current stimulation (tDCS) can alter quadriceps intracortical inhibition and facilitation in an early-ACLR population after 6 weeks of application during exercise.
Methods: We performed a randomised, triple-blind controlled trial for proof of concept comparing anodal-tDCS to sham-tDCS following ACLR. Anodal-tDCS or sham-tDCS was delivered to the primary motor cortex for 20 min, three times per week, for 6 weeks from week 2 post ACLR. Transcranial magnetic stimulation quantified quadriceps short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI) and short-interval intracortical facilitation (SICF). Significance at p<0.05.
Results: Participants were randomised to anodal (n=11) or sham (n=10) tDCS. Participants were predominantly male (n=13) and had a mean (SD) age of 24.4 (4.7) years. For SICI, there was a group-by-time effect for anodal-tDCS (β=0.519, 95% CI 0.057 to 0.981, p=0.028) and an effect for time (β=-1.421, 95% CI -1.919 to -0.923, p<0.001). For LICI, there was no group-by-time (β=-0.217, 95% CI -0.916 to 0.482, p=0.543) or time effect (β=0.039, 95% CI -0.815 to -0.893, p=0.928). For SICF, there was a group-by-time effect for anodal-tDCS (β=-0.764, 95%CI -1.407 to -0.120, p=0.020) but not time (β=0.504, 95% CI -0.627 to 1.635, p=0.383).
Conclusion: This study provided proof of the efficacy of anodal-tDCS post ACLR in reducing maladaptive quadriceps inhibition and facilitation. We demonstrated anodal-tDCS improved facilitation and inhibition post ACLR, which are drivers of arthrogenic muscle inhibition.
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