Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy
Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy
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DOI：
10.1016/s0736-0266(02)00191-2
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发表时间：
2003-05-01
影响因子：
2.8
通讯作者：
McConnell, J
中科院分区：
文献类型：
--
作者：
Cowan, SM;Bennell, KL;McConnell, J
背景和目的：物理治疗康复策略通常针对功能性运动中肌肉募集的改变。本研究的目的是在一项随机、双盲、安慰剂对照试验中，研究髌骨股痛综合征患者的前馈策略是否可以通过物理治疗方案改变。对象：40名年龄在40岁及以下（27.2±7.8岁）的受试者（女性25人，男性15人）。方法：受试者被分配到安慰剂治疗组或物理治疗干预组。作为结果测量的姿势挑战不包括在训练计划中。在6周标准化治疗方案前后评估股内侧斜肌（VMO）、股外侧肌（VL）、胫骨前肌和比目鱼肌的肌电图（EMG）发作情况。结果：在基线时，两组受试者VL的肌电图发作均早于VMO。物理治疗干预后，与VL相比，VMO的肌电图发作时间发生显著变化，且发作时间同时发生。这种变化与症状的减轻有关。相比之下，在安慰剂干预后，VL的肌电图发作仍然发生在VMO之前。结论与讨论：结果表明中枢神经系统控制髌骨的前馈策略是可以恢复的。重要的是，数据表明，这种干预产生了一种变化，这种变化被转移到一个没有特别包括在培训计划中的任务上。此外，运动控制的改变与临床症状的改善有关。(C) 2002骨科研究学会。Elsevier Science Ltd.出版。版权所有。
Background and purpose: Physical therapy rehabilitation strategies are commonly directed at the alteration of muscle recruitment in functional movements. The aim of this study was to investigate whether feedforward strategies of the vasti in people with patellofemoral pain syndrome can be changed by a physical therapy treatment program in a randomised, double blind, placebo controlled trial.Subjects: Forty (25 female, 15 male) subjects aged 40 yrs or less (27.2 +/- 7.8 yrs).Methods: Subjects were allocated to either a placebo treatment or a physical therapy intervention program. The postural challenge used as the outcome measure was not included in the training program. Electromyography (EMG) onsets of vastus medialis obliquus (VMO), vastus lateralis (VL), tibialis anterior and soleus were assessed before and after the six week standardised treatment programs.Results: At baseline the EMG onset of VL occurred prior to that of VMO in both subject groups. Following physical therapy intervention there was a significant change in the time of onset of EMG of VMO compared to VL with the onsets occurring simultaneously. This change was associated with a reduction in symptoms. In contrast, following placebo intervention the EMG onset of VL still occurred prior to that of VMO.Conclusion and discussion: The results indicate that the feedforward strategy used by the central nervous system to control the patella can be restored. Importantly, the data suggest that this intervention produced a change that was transferred to a task that was not specifically included in the training program. Furthermore, the change in motor control was associated with clinical improvement in symptoms. (C) 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.