Conditioning of Motor Evoked Responses After Anterior Cruciate Ligament Reconstruction: Effects of Stimulus Intensity.

IF 2.7 2区医学 Q1 SPORT SCIENCES Sports Health-A Multidisciplinary Approach Pub Date : 2025-03-01 Epub Date: 2024-06-12 DOI:10.1177/19417381241257258

Kazandra M Rodriguez, Jungsun Moon, Chandramouli Krishnan, Riann M Palmieri-Smith

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Abstract

Background: Operant conditioning of motor evoked torque (MEP_TORQUE) can directly target the corticospinal pathway in patients with anterior cruciate ligament (ACL) reconstruction. However, it remains unclear whether operant conditioning can elicit short-term improvements in corticospinal excitability and whether these improvements are influenced by stimulus intensity.

Hypothesis: Quadriceps MEP_TORQUE responses can be upconditioned in a single session and will elicit short-term adaptations in corticospinal excitability, with higher stimulus intensities eliciting greater effects.

Study design: Randomized controlled laboratory study.

Level of evidence: Level 2.

Methods: Thirty-six participants were assessed during a single session of an operant conditioning protocol. Participants were randomized into 1 of 3 groups for stimulus intensity used during operant conditioning based on the participant's active motor threshold (AMT: 100%, 120%, and 140%). Quadriceps MEP_TORQUE amplitude was evaluated during a block of control transcranial magnetic stimulation trials (CTRL) to establish baseline corticospinal excitability, and 3 blocks of conditioning trials (COND) during which participants trained to upcondition their MEP_TORQUE. MEP_TORQUE recruitment curves were collected to evaluate the effect of operant conditioning on acute corticospinal adaptations.

Results: Participants with ACL reconstruction could upcondition their MEP_TORQUE in a single session (P < 0.01; CTRL, 17.27 ± 1.28; COND, 21.35 ± 1.28 [mean ± standard error [SE] in N·m]), but this ability was not influenced by the stimulus intensity used during training (P = 0.84). Furthermore, significant improvements in corticospinal excitability were observed (P = 0.05; PRE, 687.91 ± 50.15; POST, 761.08 ± 50.15 [mean ± SE in N·m %AMT]), but stimulus intensity did not influence corticospinal adaptations (P = 0.67).

Conclusion: Operant conditioning can elicit short-term neural adaptations in ACL-reconstructed patients. Future operant conditioning paradigms may effectively use any of the 3 stimulus intensities studied herein.

Clinical relevance: Operant conditioning may be a feasible approach to improve corticospinal excitability after ACL reconstruction.

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前十字韧带重建后运动诱发反应的条件反射：刺激强度的影响

背景：对运动诱发力矩（MEPTORQUE）进行操作性调节可直接针对前交叉韧带（ACL）重建患者的皮质脊髓通路。然而，操作性条件反射是否能在短期内改善皮质脊髓兴奋性，以及这些改善是否受刺激强度的影响，目前仍不清楚：研究设计：随机对照实验室研究：随机对照实验室研究：证据等级：2 级：对 36 名参与者进行了操作性条件反射方案的单次评估。根据参与者的主动运动阈值（AMT：100%、120% 和 140%），在操作性条件反射过程中使用的刺激强度将参与者随机分为 3 组中的 1 组。在对照组经颅磁刺激试验（CTRL）中评估股四头肌 MEPTORQUE 波幅，以确定皮质脊髓兴奋性基线；在 3 组调节试验（COND）中，参与者进行 MEPTORQUE 提升训练。收集 MEPTORQUE 招募曲线以评估操作性调节对急性皮质脊髓适应性的影响：结果：前交叉韧带重建的参与者可在单次训练中提高其 MEPTORQUE（P < 0.01；CTRL，17.27 ± 1.28；COND，21.35 ± 1.28 [平均值 ± 标准误差 [SE]，单位 N-m]），但这种能力不受训练中使用的刺激强度的影响（P = 0.84）。此外，还观察到皮质脊髓兴奋性的明显改善（P = 0.05；PRE，687.91 ± 50.15；POST，761.08 ± 50.15 [平均值±标准误差，单位为 N-m %AMT]），但刺激强度并不影响皮质脊髓的适应性（P = 0.67）：操作性条件反射可引起前交叉韧带重建患者的短期神经适应。未来的操作性条件反射范式可以有效地使用本文研究的 3 种刺激强度中的任何一种：操作性条件反射可能是改善前交叉韧带重建后皮质脊髓兴奋性的可行方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sports Health-A Multidisciplinary Approach Medicine-Orthopedics and Sports Medicine

CiteScore

6.90

自引率

9.10%

发文量

101

期刊介绍： Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals. Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS). The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor. Topics include: -Sports Injury and Treatment -Care of the Athlete -Athlete Rehabilitation -Medical Issues in the Athlete -Surgical Techniques in Sports Medicine -Case Studies in Sports Medicine -Images in Sports Medicine -Legal Issues -Pediatric Athletes -General Sports Trauma -Sports Psychology