Strengthening and neuromuscular reeducation of the gluteus maximus in a triathlete with exercise-associated cramping of the hamstrings.
Strengthening and neuromuscular reeducation of the gluteus maximus in a triathlete with exercise-associated cramping of the hamstrings.
复制标题
对患有运动相关腘绳肌痉挛的铁人三项运动员的臀大肌进行强化和神经肌肉再训练。
DOI：
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发表时间：
2010
影响因子：
6.1
通讯作者：
C. Powers
中科院分区：
文献类型：
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作者：
Tracey Wagner;Nazly Behnia;Won;Richard Shen;S. Farrokhi;C. Powers
研究设计
病例报告。
目的
强调干预计划的影响，包括加强和神经肌肉再教育的臀大肌在优秀铁人三项运动员与运动相关的肌肉痉挛（EAMC）。
背景
研究人员描述了两种关于EAMC病因学的理论：（1）肌肉疲劳和（2）电解质缺乏。因此，EAMC的干预通常包括拉伸/加强所涉及的肌肉和/或补充剂以恢复电解质失衡。
病例描述
患者是一名42岁的男性铁人三项运动员，主要主诉为右腿肌腱肌肉反复痉挛，这使他无法以理想的速度完成比赛。力量测试显示双侧臀大肌无力。肌电图（EMG）分析（表面电极，1560 Hz）显示，在终端摆动和前半阶段的立场（48.1%的最大自愿等长收缩[MVIC]），右腿肌被过度激活。
成果
干预后，患者能够完成3项铁人三项，无腿筋痉挛。力量测试显示，右髋伸展力量从35.6公斤提高到54.7公斤，在末端摆动和站立阶段的前半部分，腿筋的激活降低到MVIC的36.4%。
讨论
臀大肌强化和神经肌肉训练计划消除了该患者的腘绳肌EAMC。考虑到腿筋和臀大肌作为激动剂工作，以减速大腿在终端摆动阶段和控制髋关节屈曲在负载响应的运行，我们假设，加强臀大肌减少了腿筋所需的相对努力，从而减少EAMC。作为本病例报告的一部分进行的EMG评价的结果为该假设提供了支持。
证据等级
心理治疗，第四层。
STUDY DESIGN
Case report.
OBJECTIVE
To highlight the effects of an intervention program consisting of strengthening and neuromuscular reeducation of the gluteus maximus in an elite triathlete with exercise-associated muscle cramping (EAMC).
BACKGROUND
Researchers have described 2 theories concerning the etiology of EAMC: (1) muscle fatigue and (2) electrolyte deficit. As such, interventions for EAMC typically consist of stretching/strengthening of the involved muscle and/or supplements to restore electrolyte imbalances.
CASE DESCRIPTION
The patient was a 42-year-old male triathlete with a primary complaint of recurrent cramping of his right hamstring muscle, which prevented him from completing races at his desired pace. Strength testing revealed gluteus maximus muscle weakness bilaterally. Electromyographic (EMG) analysis (surface electrodes, 1560 Hz) revealed that the right hamstrings were being activated excessively during terminal swing and the first half of the stance phase (48.1% maximum voluntary isometric contraction [MVIC]).
OUTCOMES
Following the intervention, the patient was able to complete 3 triathlons without hamstring cramping. Strength testing revealed that the right hip extension strength improved from 35.6 to 54.7 kg, and activation of the hamstrings during terminal swing and the first half of the stance phase decreased to 36.4% of MVIC.
DISCUSSION
A program of gluteus maximus strengthening and neuromuscular training eliminated EAMC of the hamstrings in this patient. Given that the hamstrings and gluteus maximus work as agonists to decelerate the thigh during terminal swing phase and control hip flexion during loading response of running, we postulate that strengthening of the gluteus maximus decreased the relative effort required by the hamstrings, thus reducing EAMC. The results of the EMG evaluation that was performed as part of this case report provides support for this hypothesis.
LEVEL OF EVIDENCE
Therapy, level 4.