Skip to main content
Top
Published in: Arthritis Research & Therapy 6/2014

Open Access 01-12-2014 | Research article

Quadriceps arthrogenic muscle inhibition: the effects of experimental knee joint effusion on motor cortex excitability

Authors: David Andrew Rice, Peter John McNair, Gwyn Nancy Lewis, Nicola Dalbeth

Published in: Arthritis Research & Therapy | Issue 6/2014

Login to get access

Abstract

Introduction

Marked weakness of the quadriceps muscles is typically observed following injury, surgery or pathology affecting the knee joint. This is partly due to ongoing neural inhibition that prevents the central nervous system from fully activating the quadriceps, a process known as arthrogenic muscle inhibition (AMI). This study aimed to further investigate the mechanisms underlying AMI by exploring the effects of experimental knee joint effusion on quadriceps corticomotor and intracortical excitability.

Methods

Seventeen healthy volunteers participated in this study. Transcranial magnetic stimulation was used to measure quadriceps motor evoked potential area, short-interval intracortical inhibition, intracortical facilitation and cortical silent period duration before and after experimental knee joint effusion. Joint effusion was induced by the intraarticular infusion of dextrose saline into the knee.

Results

There was a significant increase in quadriceps motor evoked potential area following joint infusion, both at rest (P = 0.01) and during voluntary muscle contraction (P = 0.02). Cortical silent period duration was significantly reduced following joint infusion (P = 0.02). There were no changes in short interval intracortical inhibition or intracortical facilitation over time (all P > 0.05).

Conclusions

The results of this study provide no evidence for a supraspinal contribution to quadriceps AMI. Paradoxically, but consistent with previous observations in patients with chronic knee joint pathology, quadriceps corticomotor excitability increased after experimental knee joint effusion. The increase in quadriceps corticomotor excitability may be at least partly mediated by a decrease in gamma-aminobutyric acid (GABA)-ergic inhibition within the motor cortex.
Appendix
Available only for authorised users
Literature
1.
go back to reference Rice DA, McNair PJ: Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum. 2010, 40: 250-266. 10.1016/j.semarthrit.2009.10.001.CrossRefPubMed Rice DA, McNair PJ: Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum. 2010, 40: 250-266. 10.1016/j.semarthrit.2009.10.001.CrossRefPubMed
2.
go back to reference Shakespeare DT, Stokes M, Sherman KP, Young A: Reflex inhibition of the quadriceps after meniscectomy: lack of association with pain. Clin Physiol. 1985, 5: 137-144. 10.1111/j.1475-097X.1985.tb00589.x.CrossRefPubMed Shakespeare DT, Stokes M, Sherman KP, Young A: Reflex inhibition of the quadriceps after meniscectomy: lack of association with pain. Clin Physiol. 1985, 5: 137-144. 10.1111/j.1475-097X.1985.tb00589.x.CrossRefPubMed
3.
go back to reference Holm B, Kristensen MT, Bencke J, Husted H, Kehlet H, Bandholm T: Loss of knee-extension strength is related to knee swelling after total knee arthroplasty. Arch Phys Med Rehabil. 2010, 91: 1770-1776. 10.1016/j.apmr.2010.07.229.CrossRefPubMed Holm B, Kristensen MT, Bencke J, Husted H, Kehlet H, Bandholm T: Loss of knee-extension strength is related to knee swelling after total knee arthroplasty. Arch Phys Med Rehabil. 2010, 91: 1770-1776. 10.1016/j.apmr.2010.07.229.CrossRefPubMed
4.
go back to reference Petterson SC, Barrance P, Marmon AR, Handling T, Buchanan TS, Snyder-Mackler L: Time course of quad strength, area, and activation after knee arthroplasty and strength training. Med Sci Sports Exerc. 2011, 43: 225-231. 10.1249/MSS.0b013e3181eb639a.PubMedCentralCrossRefPubMed Petterson SC, Barrance P, Marmon AR, Handling T, Buchanan TS, Snyder-Mackler L: Time course of quad strength, area, and activation after knee arthroplasty and strength training. Med Sci Sports Exerc. 2011, 43: 225-231. 10.1249/MSS.0b013e3181eb639a.PubMedCentralCrossRefPubMed
5.
go back to reference Becker R, Berth A, Nehring M, Awiszus F: Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee. J Orthop Res. 2004, 22: 768-773. 10.1016/j.orthres.2003.11.004.CrossRefPubMed Becker R, Berth A, Nehring M, Awiszus F: Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee. J Orthop Res. 2004, 22: 768-773. 10.1016/j.orthres.2003.11.004.CrossRefPubMed
6.
go back to reference Pietrosimone BG, Hertel J, Ingersoll CD, Hart JM, Saliba SA: Voluntary quadriceps activation deficits in patients with tibiofemoral osteoarthritis: a meta-analysis. PM R. 2011, 3: 153-162. 10.1016/j.pmrj.2010.07.485.CrossRefPubMed Pietrosimone BG, Hertel J, Ingersoll CD, Hart JM, Saliba SA: Voluntary quadriceps activation deficits in patients with tibiofemoral osteoarthritis: a meta-analysis. PM R. 2011, 3: 153-162. 10.1016/j.pmrj.2010.07.485.CrossRefPubMed
7.
go back to reference Petterson SC, Barrance P, Buchanan T, Binder-Macleod S, Snyder-Mackler L: Mechanisms underlying quadriceps weakness in knee osteoarthritis. Med Sci Sports Exerc. 2008, 40: 422-427. 10.1249/MSS.0b013e31815ef285.PubMedCentralCrossRefPubMed Petterson SC, Barrance P, Buchanan T, Binder-Macleod S, Snyder-Mackler L: Mechanisms underlying quadriceps weakness in knee osteoarthritis. Med Sci Sports Exerc. 2008, 40: 422-427. 10.1249/MSS.0b013e31815ef285.PubMedCentralCrossRefPubMed
8.
go back to reference Hurley MV, Jones DW, Newham DJ: Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries. Clin Sci (Lond). 1994, 86: 305-310.CrossRef Hurley MV, Jones DW, Newham DJ: Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries. Clin Sci (Lond). 1994, 86: 305-310.CrossRef
9.
go back to reference Pietrosimone BG, Saliba SA, Hart JM, Hertel J, Kerrigan DC, Ingersoll CD: Effects of transcutaneous electrical nerve stimulation and therapeutic exercise on quadriceps activation in people with tibiofemoral osteoarthritis. J Orthop Sports Phys Ther. 2011, 41: 4-12. 10.2519/jospt.2011.3447.CrossRefPubMed Pietrosimone BG, Saliba SA, Hart JM, Hertel J, Kerrigan DC, Ingersoll CD: Effects of transcutaneous electrical nerve stimulation and therapeutic exercise on quadriceps activation in people with tibiofemoral osteoarthritis. J Orthop Sports Phys Ther. 2011, 41: 4-12. 10.2519/jospt.2011.3447.CrossRefPubMed
10.
go back to reference Felson DT, Niu J, McClennan C, Sack B, Aliabadi P, Hunter DJ, Guermazi A, Englund M: Knee buckling: prevalence, risk factors, and associated limitations in function. Ann Intern Med. 2007, 147: 534-540. 10.7326/0003-4819-147-8-200710160-00005.CrossRefPubMed Felson DT, Niu J, McClennan C, Sack B, Aliabadi P, Hunter DJ, Guermazi A, Englund M: Knee buckling: prevalence, risk factors, and associated limitations in function. Ann Intern Med. 2007, 147: 534-540. 10.7326/0003-4819-147-8-200710160-00005.CrossRefPubMed
11.
go back to reference Hurley MV, Scott DL, Rees J, Newham DJ: Sensorimotor changes and functional performance in patients with knee osteoarthritis. Ann Rheum Dis. 1997, 56: 641-648. 10.1136/ard.56.11.641.PubMedCentralCrossRefPubMed Hurley MV, Scott DL, Rees J, Newham DJ: Sensorimotor changes and functional performance in patients with knee osteoarthritis. Ann Rheum Dis. 1997, 56: 641-648. 10.1136/ard.56.11.641.PubMedCentralCrossRefPubMed
12.
go back to reference Liikavainio T, Lyytinen T, Tyrvainen E, Sipila S, Arokoski JP: Physical function and properties of quadriceps femoris muscle in men with knee osteoarthritis. Arch Phys Med Rehabil. 2008, 89: 2185-2194. 10.1016/j.apmr.2008.04.012.CrossRefPubMed Liikavainio T, Lyytinen T, Tyrvainen E, Sipila S, Arokoski JP: Physical function and properties of quadriceps femoris muscle in men with knee osteoarthritis. Arch Phys Med Rehabil. 2008, 89: 2185-2194. 10.1016/j.apmr.2008.04.012.CrossRefPubMed
13.
go back to reference Mikesky AE, Meyer A, Thompson KL: Relationship between quadriceps strength and rate of loading during gait in women. J Orthop Res. 2000, 18: 171-175. 10.1002/jor.1100180202.CrossRefPubMed Mikesky AE, Meyer A, Thompson KL: Relationship between quadriceps strength and rate of loading during gait in women. J Orthop Res. 2000, 18: 171-175. 10.1002/jor.1100180202.CrossRefPubMed
14.
go back to reference Amin S, Baker K, Niu J, Clancy M, Goggins J, Guermazi A, Grigoryan M, Hunter DJ, Felson DT: Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis. Arthritis Rheum. 2009, 60: 189-198. 10.1002/art.24182.PubMedCentralCrossRefPubMed Amin S, Baker K, Niu J, Clancy M, Goggins J, Guermazi A, Grigoryan M, Hunter DJ, Felson DT: Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis. Arthritis Rheum. 2009, 60: 189-198. 10.1002/art.24182.PubMedCentralCrossRefPubMed
15.
go back to reference Segal NA, Glass NA, Torner J, Yang M, Felson DT, Sharma L, Nevitt M, Lewis CE: Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort. Osteoarthritis Cartilage. 2010, 18: 769-775. 10.1016/j.joca.2010.02.002.PubMedCentralCrossRefPubMed Segal NA, Glass NA, Torner J, Yang M, Felson DT, Sharma L, Nevitt M, Lewis CE: Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort. Osteoarthritis Cartilage. 2010, 18: 769-775. 10.1016/j.joca.2010.02.002.PubMedCentralCrossRefPubMed
16.
go back to reference Rice D, McNair PJ, Dalbeth N: Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling. Arthritis Rheum. 2009, 61: 78-83. 10.1002/art.24168.CrossRefPubMed Rice D, McNair PJ, Dalbeth N: Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling. Arthritis Rheum. 2009, 61: 78-83. 10.1002/art.24168.CrossRefPubMed
17.
go back to reference Wood L, Ferrell WR, Baxendale RH: Pressures in normal and acutely distended human knee joints and effects on quadriceps maximal voluntary contractions. Q J Exp Physiol. 1988, 73: 305-314.CrossRefPubMed Wood L, Ferrell WR, Baxendale RH: Pressures in normal and acutely distended human knee joints and effects on quadriceps maximal voluntary contractions. Q J Exp Physiol. 1988, 73: 305-314.CrossRefPubMed
18.
go back to reference Geborek P, Moritz U, Wollheim FA: Joint capsular stiffness in knee arthritis. Relationship to intraarticular volume, hydrostatic pressures, and extensor muscle function. J Rheumatol. 1989, 16: 1351-1358.PubMed Geborek P, Moritz U, Wollheim FA: Joint capsular stiffness in knee arthritis. Relationship to intraarticular volume, hydrostatic pressures, and extensor muscle function. J Rheumatol. 1989, 16: 1351-1358.PubMed
19.
go back to reference Kennedy JC, Alexander IJ, Hayes KC: Nerve supply of the human knee and its functional importance. Am J Sports Med. 1982, 10: 329-335. 10.1177/036354658201000601.CrossRefPubMed Kennedy JC, Alexander IJ, Hayes KC: Nerve supply of the human knee and its functional importance. Am J Sports Med. 1982, 10: 329-335. 10.1177/036354658201000601.CrossRefPubMed
20.
go back to reference Spencer J, Hayes K, Alexander I: Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehabil. 1984, 65: 171-177.PubMed Spencer J, Hayes K, Alexander I: Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehabil. 1984, 65: 171-177.PubMed
21.
go back to reference McNair PJ, Marshall RN, Maguire K: Swelling of the Knee Joint: Effects of Exercise on Quadriceps Muscle Strength. Arch Phys Med Rehabil. 1996, 77: 896-899. 10.1016/S0003-9993(96)90277-4.CrossRefPubMed McNair PJ, Marshall RN, Maguire K: Swelling of the Knee Joint: Effects of Exercise on Quadriceps Muscle Strength. Arch Phys Med Rehabil. 1996, 77: 896-899. 10.1016/S0003-9993(96)90277-4.CrossRefPubMed
22.
go back to reference Grigg P, Hoffman AH: Properties of Ruffini afferents revealed by stress analysis of isolated sections of cat knee capsule. J Neurophysiol. 1982, 47: 41-54.PubMed Grigg P, Hoffman AH: Properties of Ruffini afferents revealed by stress analysis of isolated sections of cat knee capsule. J Neurophysiol. 1982, 47: 41-54.PubMed
23.
go back to reference Wood L, Ferrell WR: Response of slowly adapting articular mechanoreceptors in the cat knee joint to alterations in intra-articular volume. Ann Rheum Dis. 1984, 43: 327-332. 10.1136/ard.43.2.327.PubMedCentralCrossRefPubMed Wood L, Ferrell WR: Response of slowly adapting articular mechanoreceptors in the cat knee joint to alterations in intra-articular volume. Ann Rheum Dis. 1984, 43: 327-332. 10.1136/ard.43.2.327.PubMedCentralCrossRefPubMed
24.
go back to reference Lundberg A, Malmgren K, Schomburg ED: Role of joint afferents in motor control exemplified by effects on reflex pathways from Ib afferents. J Physiol. 1978, 284: 327-343.PubMedCentralCrossRefPubMed Lundberg A, Malmgren K, Schomburg ED: Role of joint afferents in motor control exemplified by effects on reflex pathways from Ib afferents. J Physiol. 1978, 284: 327-343.PubMedCentralCrossRefPubMed
25.
go back to reference Iles JF, Stokes M, Young A: Reflex actions of knee joint afferents during contraction of the human quadriceps. Clin Physiol. 1990, 10: 489-500. 10.1111/j.1475-097X.1990.tb00828.x.CrossRefPubMed Iles JF, Stokes M, Young A: Reflex actions of knee joint afferents during contraction of the human quadriceps. Clin Physiol. 1990, 10: 489-500. 10.1111/j.1475-097X.1990.tb00828.x.CrossRefPubMed
26.
go back to reference Heroux ME, Tremblay F: Corticomotor excitability associated with unilateral knee dysfunction secondary to anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc. 2006, 14: 823-833. 10.1007/s00167-006-0063-4.CrossRefPubMed Heroux ME, Tremblay F: Corticomotor excitability associated with unilateral knee dysfunction secondary to anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc. 2006, 14: 823-833. 10.1007/s00167-006-0063-4.CrossRefPubMed
27.
go back to reference On AY, Uludag B, Taskiran E, Ertekin C: Differential corticomotor control of a muscle adjacent to a painful joint. Neurorehabil Neural Repair. 2004, 18: 127-133. 10.1177/0888439004269030.CrossRefPubMed On AY, Uludag B, Taskiran E, Ertekin C: Differential corticomotor control of a muscle adjacent to a painful joint. Neurorehabil Neural Repair. 2004, 18: 127-133. 10.1177/0888439004269030.CrossRefPubMed
28.
go back to reference Merletti R, Hermens H: Introduction to the special issue on the SENIAM European Concerted Action. J Electromyogr Kinesiol. 2000, 10: 283-286. 10.1016/S1050-6411(00)00019-5.CrossRefPubMed Merletti R, Hermens H: Introduction to the special issue on the SENIAM European Concerted Action. J Electromyogr Kinesiol. 2000, 10: 283-286. 10.1016/S1050-6411(00)00019-5.CrossRefPubMed
29.
go back to reference Petersen NT, Pyndt HS, Nielsen JB: Investigating human motor control by transcranial magnetic stimulation. Exp Brain Res. 2003, 152: 1-16. 10.1007/s00221-003-1537-y.CrossRefPubMed Petersen NT, Pyndt HS, Nielsen JB: Investigating human motor control by transcranial magnetic stimulation. Exp Brain Res. 2003, 152: 1-16. 10.1007/s00221-003-1537-y.CrossRefPubMed
30.
go back to reference Chen R, Tam A, Butefisch C, Corwell B, Ziemann U, Rothwell JC, Cohen LG: Intracortical inhibition and facilitation in different representations of the human motor cortex. J Neurophysiol. 1998, 80: 2870-2881.PubMed Chen R, Tam A, Butefisch C, Corwell B, Ziemann U, Rothwell JC, Cohen LG: Intracortical inhibition and facilitation in different representations of the human motor cortex. J Neurophysiol. 1998, 80: 2870-2881.PubMed
31.
go back to reference Wagle-Shukla A, Ni Z, Gunraj CA, Bahl N, Chen R: Effects of short interval intracortical inhibition and intracortical facilitation on short interval intracortical facilitation in human primary motor cortex. J Physiol. 2009, 587: 5665-5678. 10.1113/jphysiol.2009.181446.PubMedCentralCrossRefPubMed Wagle-Shukla A, Ni Z, Gunraj CA, Bahl N, Chen R: Effects of short interval intracortical inhibition and intracortical facilitation on short interval intracortical facilitation in human primary motor cortex. J Physiol. 2009, 587: 5665-5678. 10.1113/jphysiol.2009.181446.PubMedCentralCrossRefPubMed
32.
go back to reference Soto O, Valls-Sole J, Shanahan P, Rothwell J: Reduction of intracortical inhibition in soleus muscle during postural activity. J Neurophysiol. 2006, 96: 1711-1717. 10.1152/jn.00133.2006.CrossRefPubMed Soto O, Valls-Sole J, Shanahan P, Rothwell J: Reduction of intracortical inhibition in soleus muscle during postural activity. J Neurophysiol. 2006, 96: 1711-1717. 10.1152/jn.00133.2006.CrossRefPubMed
33.
go back to reference Chen R, Yung D, Li JY: Organization of ipsilateral excitatory and inhibitory pathways in the human motor cortex. J Neurophysiol. 2003, 89: 1256-1264. 10.1152/jn.00950.2002.CrossRefPubMed Chen R, Yung D, Li JY: Organization of ipsilateral excitatory and inhibitory pathways in the human motor cortex. J Neurophysiol. 2003, 89: 1256-1264. 10.1152/jn.00950.2002.CrossRefPubMed
34.
go back to reference DeAndrade JR, Grant C, Dixon ASJ: Joint distension and reflex muscle inhibition in the Knee. J Bone Joint Surg Am. 1965, 47: 313-322.PubMed DeAndrade JR, Grant C, Dixon ASJ: Joint distension and reflex muscle inhibition in the Knee. J Bone Joint Surg Am. 1965, 47: 313-322.PubMed
35.
go back to reference Chen R, Lozano AM, Ashby P: Mechanism of the silent period following transcranial magnetic stimulation. Evidence from epidural recordings. Exp Brain Res. 1999, 128: 539-542. 10.1007/s002210050878.CrossRefPubMed Chen R, Lozano AM, Ashby P: Mechanism of the silent period following transcranial magnetic stimulation. Evidence from epidural recordings. Exp Brain Res. 1999, 128: 539-542. 10.1007/s002210050878.CrossRefPubMed
36.
go back to reference Fuhr P, Agostino R, Hallett M: Spinal motor neuron excitability during the silent period after cortical stimulation. Electroencephalogr Clin Neurophysiol. 1991, 81: 257-262. 10.1016/0168-5597(91)90011-L.CrossRefPubMed Fuhr P, Agostino R, Hallett M: Spinal motor neuron excitability during the silent period after cortical stimulation. Electroencephalogr Clin Neurophysiol. 1991, 81: 257-262. 10.1016/0168-5597(91)90011-L.CrossRefPubMed
37.
go back to reference Werhahn KJ, Kunesch E, Noachtar S, Benecke R, Classen J: Differential effects on motorcortical inhibition induced by blockade of GABA uptake in humans. J Physiol. 1999, 517: 591-597. 10.1111/j.1469-7793.1999.0591t.x.PubMedCentralCrossRefPubMed Werhahn KJ, Kunesch E, Noachtar S, Benecke R, Classen J: Differential effects on motorcortical inhibition induced by blockade of GABA uptake in humans. J Physiol. 1999, 517: 591-597. 10.1111/j.1469-7793.1999.0591t.x.PubMedCentralCrossRefPubMed
38.
go back to reference Stetkarova I, Kofler M: Differential effect of baclofen on cortical and spinal inhibitory circuits. Clin Neurophysiol. 2012, 124: 339-345. 10.1016/j.clinph.2012.07.005.CrossRefPubMed Stetkarova I, Kofler M: Differential effect of baclofen on cortical and spinal inhibitory circuits. Clin Neurophysiol. 2012, 124: 339-345. 10.1016/j.clinph.2012.07.005.CrossRefPubMed
39.
go back to reference Orth M, Rothwell JC: The cortical silent period: intrinsic variability and relation to the waveform of the transcranial magnetic stimulation pulse. Clin Neurophysiol. 2004, 115: 1076-1082. 10.1016/j.clinph.2003.12.025.CrossRefPubMed Orth M, Rothwell JC: The cortical silent period: intrinsic variability and relation to the waveform of the transcranial magnetic stimulation pulse. Clin Neurophysiol. 2004, 115: 1076-1082. 10.1016/j.clinph.2003.12.025.CrossRefPubMed
40.
go back to reference Ochi M, Iwasa J, Uchio Y, Adachi N, Sumen Y: The regeneration of sensory neurones in the reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 1999, 81: 902-906. 10.1302/0301-620X.81B5.9202.CrossRefPubMed Ochi M, Iwasa J, Uchio Y, Adachi N, Sumen Y: The regeneration of sensory neurones in the reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 1999, 81: 902-906. 10.1302/0301-620X.81B5.9202.CrossRefPubMed
41.
go back to reference Hopkins JT, Ingersoll CD, Krause BA, Edwards JE, Cordova ML: Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability. Med Sci Sports Exerc. 2001, 33: 123-126. 10.1097/00005768-200101000-00019.CrossRefPubMed Hopkins JT, Ingersoll CD, Krause BA, Edwards JE, Cordova ML: Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability. Med Sci Sports Exerc. 2001, 33: 123-126. 10.1097/00005768-200101000-00019.CrossRefPubMed
42.
go back to reference Henriksen M, Rosager S, Aaboe J, Graven-Nielsen T, Bliddal H: Experimental knee pain reduces muscle strength. J Pain. 2011, 12: 460-467. 10.1016/j.jpain.2010.10.004.CrossRefPubMed Henriksen M, Rosager S, Aaboe J, Graven-Nielsen T, Bliddal H: Experimental knee pain reduces muscle strength. J Pain. 2011, 12: 460-467. 10.1016/j.jpain.2010.10.004.CrossRefPubMed
43.
go back to reference Schabrun SM, Hodges PW: Muscle pain differentially modulates short interval intracortical inhibition and intracortical facilitation in primary motor cortex. J Pain. 2012, 13: 187-194. 10.1016/j.jpain.2011.10.013.CrossRefPubMed Schabrun SM, Hodges PW: Muscle pain differentially modulates short interval intracortical inhibition and intracortical facilitation in primary motor cortex. J Pain. 2012, 13: 187-194. 10.1016/j.jpain.2011.10.013.CrossRefPubMed
Metadata
Title
Quadriceps arthrogenic muscle inhibition: the effects of experimental knee joint effusion on motor cortex excitability
Authors
David Andrew Rice
Peter John McNair
Gwyn Nancy Lewis
Nicola Dalbeth
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 6/2014
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-014-0502-4

Other articles of this Issue 6/2014

Arthritis Research & Therapy 6/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.