Ayrton Moiroux-Sahraoui, Florian Forelli, Jean Mazeas, Alexandre Jm Rambaud, Andreas Bjerregaard, Jérôme Riera
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引用次数: 0
Abstract
Arthrogenic Muscle Inhibition (AMI) is a phenomenon observed in individuals with joint injury or pathology, characterized by a reflexive inhibition of surrounding musculature, altered neuromuscular control, and compromised functional performance. After anterior cruciate ligament reconstruction (ACLR) one of the most obvious consequences of AMI is the lack of quadriceps activation and strength. Understanding the underlying mechanisms of AMI is crucial for developing effective therapeutic interventions. The surgical procedure needed to reconstruct the ACL has biochemical et physiological consequences such as inflammation, pain, and altered proprioception. These alterations contribute to the development of AMI. Therapeutic interventions aimed at addressing AMI encompass a multidimensional approach targeting pain reduction, inflammation management, proprioceptive training, and quadriceps activation. Early management focusing on pain modulation through modalities like ice, compression, and pharmacological agents help mitigate the inflammatory response and alleviate pain, thereby reducing the reflexive inhibition of quadriceps. Quadriceps activation techniques such as neuromuscular electrical stimulation (NMES) and biofeedback training aid in overcoming muscle inhibition and restoring muscle strength. NMES elicits muscle contractions through electrical stimulation, bypassing the inhibitory mechanisms associated with AMI, thus facilitating muscle activation and strength gains. Comprehensive rehabilitation programs tailored to individual needs and stage of recovery are essential for optimizing outcomes in AMI. The objective of this clinical viewpoint is to delineate the significance of adopting a multimodal approach for the effective management of AMI, emphasizing the integration of pain modulation, proprioceptive training, muscle activation techniques, and manual therapy interventions. Highlighting the critical role of early intervention and targeted rehabilitation programs, this article aims to underscore their importance in restoring optimal function and mitigating long-term complications associated with AMI.
关节源性肌肉抑制(AMI)是一种在关节损伤或病变患者身上观察到的现象,其特征是对周围肌肉组织的反射性抑制、神经肌肉控制的改变以及功能表现的受损。在前十字韧带重建(ACLR)后,AMI 最明显的后果之一就是股四头肌缺乏激活和力量。了解 AMI 的基本机制对于制定有效的治疗干预措施至关重要。重建前交叉韧带所需的手术过程会产生生化和生理后果,如炎症、疼痛和本体感觉改变。这些改变会导致 AMI 的发生。针对 AMI 的治疗干预措施包括针对减轻疼痛、炎症控制、本体感觉训练和股四头肌激活的多维方法。早期治疗的重点是通过冰敷、压迫和药物等方式调节疼痛,这有助于减轻炎症反应和缓解疼痛,从而减少对股四头肌的反射性抑制。神经肌肉电刺激(NMES)和生物反馈训练等股四头肌激活技术有助于克服肌肉抑制和恢复肌肉力量。神经肌肉电刺激通过电刺激引起肌肉收缩,绕过与 AMI 相关的抑制机制,从而促进肌肉激活和力量增强。根据个人需求和康复阶段量身定制的综合康复计划对于优化急性心肌梗死的治疗效果至关重要。本临床观点旨在阐明采用多模式方法有效治疗急性心肌梗死的意义,强调疼痛调节、本体感觉训练、肌肉激活技术和徒手治疗干预的整合。本文强调早期干预和有针对性的康复计划的关键作用,旨在强调它们在恢复最佳功能和减轻急性心肌梗死相关长期并发症方面的重要性。