Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-26 DOI:10.1002/ksa.12480

Kazandra M. Rodriguez, Chandramouli Krishnan, Riann M. Palmieri-Smith

{"title":"Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty","authors":"Kazandra M. Rodriguez, Chandramouli Krishnan, Riann M. Palmieri-Smith","doi":"10.1002/ksa.12480","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>The primary purpose of this randomized, cross-sectional study was to determine whether operant conditioning of motor evoked torque (MEP<sub>TORQUE</sub>) in individuals with total knee arthroplasty (TKA) increases quadriceps MEP<sub>TORQUE</sub> responses within a single session and induces acute corticospinal adaptations by producing sustained increases in MEP<sub>TORQUE</sub> after training. A secondary purpose was to determine if these changes were affected by the stimulus intensity and number of training trials.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Thirty participants were block-randomized into one of three groups based on the participant's active motor threshold (100%, 120%, and 140%) to evaluate the effect of stimulus intensity. Participants received three blocks of conditioning trials (COND), where they trained to increase their MEP<sub>TORQUE</sub>. Control (CTRL) transcranial magnetic stimulation pulses were provided before and after each COND block to establish baseline corticospinal excitability and to evaluate the effect of the number of training trials. Two MEP<sub>TORQUE</sub> recruitment curves were collected to evaluate the effect of up-conditioning on acute corticospinal adaptations.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>TKA participants were able to successfully increase their MEP<sub>TORQUE</sub> in a single session (<i>F</i><sub>3,81</sub> = 10.719, <i>p</i> < 0.001) and induce acute corticospinal adaptations (<i>F</i><sub>1,27</sub> = 20.029, <i>p</i> < 0.001), indicating sustained increases in quadriceps corticospinal excitability due to operant conditioning. While the stimulus intensity used during training did not affect the ability to increase MEP<sub>TORQUE</sub> (<i>F</i><sub>2,26</sub> = 0.021, n.s.) or its associated acute adaptations (<i>F</i><sub>2,27</sub> = 0.935, n.s.), the number of training trials significantly influenced these outcomes (<i>F</i><sub>3,81</sub> = 10.719, <i>p</i> < 0.001; <i>F</i><sub>3,81</sub> = 4.379, <i>p</i> = 0.007, respectively).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Operant conditioning is a feasible approach for improving quadriceps corticospinal excitability following TKA. While any of the three stimulus intensities evaluated in this study may be used in future operant conditioning interventions, using a low or moderate stimulus intensity and 150 training trials are recommended to improve treatment efficiency and patient adherence.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level II.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 3","pages":"967-976"},"PeriodicalIF":5.0000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12480","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12480","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

The primary purpose of this randomized, cross-sectional study was to determine whether operant conditioning of motor evoked torque (MEP_TORQUE) in individuals with total knee arthroplasty (TKA) increases quadriceps MEP_TORQUE responses within a single session and induces acute corticospinal adaptations by producing sustained increases in MEP_TORQUE after training. A secondary purpose was to determine if these changes were affected by the stimulus intensity and number of training trials.

Methods

Thirty participants were block-randomized into one of three groups based on the participant's active motor threshold (100%, 120%, and 140%) to evaluate the effect of stimulus intensity. Participants received three blocks of conditioning trials (COND), where they trained to increase their MEP_TORQUE. Control (CTRL) transcranial magnetic stimulation pulses were provided before and after each COND block to establish baseline corticospinal excitability and to evaluate the effect of the number of training trials. Two MEP_TORQUE recruitment curves were collected to evaluate the effect of up-conditioning on acute corticospinal adaptations.

Results

TKA participants were able to successfully increase their MEP_TORQUE in a single session (F_3,81 = 10.719, p < 0.001) and induce acute corticospinal adaptations (F_1,27 = 20.029, p < 0.001), indicating sustained increases in quadriceps corticospinal excitability due to operant conditioning. While the stimulus intensity used during training did not affect the ability to increase MEP_TORQUE (F_2,26 = 0.021, n.s.) or its associated acute adaptations (F_2,27 = 0.935, n.s.), the number of training trials significantly influenced these outcomes (F_3,81 = 10.719, p < 0.001; F_3,81 = 4.379, p = 0.007, respectively).

Conclusion

Operant conditioning is a feasible approach for improving quadriceps corticospinal excitability following TKA. While any of the three stimulus intensities evaluated in this study may be used in future operant conditioning interventions, using a low or moderate stimulus intensity and 150 training trials are recommended to improve treatment efficiency and patient adherence.

Level of Evidence

Level II.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

调节试验次数（而非刺激强度）会影响全膝关节置换术后大脑反应的操作调节。

目的：本随机横断面研究的主要目的是确定对全膝关节置换术（TKA）患者进行运动诱发力矩（MEPTORQUE）操作性调节是否会在单次训练中增加股四头肌MEPTORQUE反应，以及通过在训练后产生持续的MEPTORQUE增加来诱导急性皮质脊髓适应。次要目的是确定这些变化是否受刺激强度和训练试验次数的影响：根据参与者的主动运动阈值（100%、120% 和 140%），将 30 名参与者随机分为三组，以评估刺激强度的影响。参与者接受了三个组块的调节试验（COND），在这些试验中，他们接受了提高其MEPTORQUE的训练。在每个调节试验区段前后都会提供控制（CTRL）经颅磁刺激脉冲，以确定皮质脊髓兴奋性基线，并评估训练试验次数的影响。收集了两条 MEPTORQUE 招募曲线，以评估上调对急性皮质脊髓适应性的影响：结果：TKA 参与者能够在单次训练中成功提高他们的 MEPTORQUE（F3,81 = 10.719，p 1,27 = 20.029，p TORQUE（F2,26 = 0.021，n.s.）或其相关的急性适应（F2,27 = 0.935，n.s.），训练试验次数对这些结果有显著影响（分别为 F3,81 = 10.719，p 3,81 = 4.379，p = 0.007）：操作性条件反射是改善 TKA 术后股四头肌皮质神经兴奋性的可行方法。虽然本研究中评估的三种刺激强度中的任何一种都可用于未来的操作性条件反射干预，但建议使用低强度或中等强度的刺激，并进行 150 次训练试验，以提高治疗效率和患者的依从性：证据等级：二级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).