Background

Corticospinal adaptations have been observed following anterior cruciate ligament reconstruction around the time of returning to activity. These measures have been related to quadriceps strength deficits. Visuomotor therapy, combining motor control tasks with visual biofeedback, has been shown to increase corticospinal excitability. The purpose of this study was to assess the immediate changes of corticospinal excitability following a single session of visuomotor therapy in patients following anterior cruciate ligament reconstruction.

Methods

This was a single blinded, sham-controlled crossover study. Ten patients following ACLR (8 Female, 26.1(6.2) years) completed assessments of quadriceps strength at approximately 4- and 6-months following anterior cruciate ligament reconstruction. At 6-months, quadriceps motor evoked potentials were assessed at 80%, 90%, 100%, 110%, 120%, 130%, 140%, and 150% of the patient's active motor threshold. Patients were randomized to receive a single session of visuomotor therapy(active) or passive motion(sham). Quadriceps motor evoked potentials were reassessed for treatment effect. Following a one-week washout period, all patients received the crossover intervention.

Findings

Moderate to large increases in motor response following visuomotor therapy 90%(P = .008, r = 0.60), 110%(P = .038, r = 0.46), 120%(P = .021, r = 0.52), 130%(P = .021, r = 0.52), 140%(P = .008, r = 0.60) and 150%(P = .021, r = 0.52) of the active motor threshold were found. Moderate increases in motor response was observed following the passive motion at 80% of the active motor threshold(P = .028, r = 0.49).

Interpretation

A single session of visuomotor therapy was found to increase quadriceps corticospinal motor response greater than the response to sham therapy. Visuomotor therapy is a potential supplement to quadriceps rehabilitation programs when upregulation of corticospinal excitability is indicated.

中文翻译：

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视运动疗法可调节前交叉韧带重建患者的皮质脊髓兴奋性：一项随机交叉试验

背景

在恢复活动之前，前十字韧带重建后观察到皮质脊髓适应。这些措施已与股四头肌力量不足有关。视觉运动疗法将运动控制任务与视觉生物反馈相结合，已显示可增加皮质脊髓兴奋性。这项研究的目的是评估前交叉韧带重建术后单次视觉运动疗法后皮质脊髓兴奋性的即时变化。

方法

这是单盲，假对照的交叉研究。接受ACLR的10例患者（8名女性，26.1（6.2）岁）在前交叉韧带重建后约4和6个月完成了股四头肌强度评估。在6个月时，评估股四头肌运动诱发电位为患者活动运动阈值的80％，90％，100％，110％，120％，130％，140％和150％。患者被随机分配接受一次视觉运动疗法（主动）或被动运动（假）。重新评估股四头肌运动诱发电位的治疗效果。经过一周的冲洗期后，所有患者均接受了交叉干预。

发现

视觉运动疗法后运动反应的中度至大幅度增加90％（P  = .008，r  = 0.60），110％（P  = .038，r  = 0.46），120％（P  = .021，r  = 0.52），130 分别找到有效电动机阈值的％（P  = .021，r  = 0.52），140％（P  = .008，r  = 0.60）和150％（P  = .021，r = 0.52）。在被动运动达到主动电机阈值的80％时，观察到电机响应适度增加（P  = .028，r  = 0.49）。

解释

发现单次视觉运动疗法增加了股四头肌皮质脊髓运动反应的增加，大于对假疗法的反应。当提示皮质脊髓兴奋性上调时，视运动疗法是股四头肌康复计划的潜在补充。