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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2015

01-04-2015 | Knee

Quadriceps corticomotor excitability following an experimental knee joint effusion

Authors: Adam S. Lepley, Nael O. Bahhur, Amanda M. Murray, Brian G. Pietrosimone

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2015

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Abstract

Purpose

Deficits in quadriceps strength and voluntary activation are common following knee injury. These deficits are hypothesized to generate from a neural level, however, it remains unclear how corticomotor pathways are affected following acute injury. The purpose of this investigation was to examine whether corticomotor alterations of the quadriceps were present following a simulated knee joint injury using an experimental effusion model.

Methods

Participants completed two testing sessions, an experimental knee effusion and control session, separated by 7 days. The central activation ratio was used to assess change in quadriceps activation. Corticomotor excitability was assessed pre- and post-intervention via active motor thresholds (AMTs) and motor evoked potentials (MEPs) normalized to maximal muscle responses. MEPs were assessed at different percentages of AMT, and associated slopes between these percentages were analysed. Paired-sample t tests were performed on percentage change scores calculated from pre-intervention outcome measures to assess change in corticomotor excitability and changes in the slope of MEP values as percentage of AMT increased.

Results

Quadriceps activation significantly decreased during the effusion session. AMT and MEP change scores were not different between effusion and control conditions. No substantial differences were found in slope between any percentages of AMT.

Conclusions

An experimental knee effusion did not induce changes in corticomotor excitability. Further research is needed to understand how corticomotor pathways are affected following joint injury. Corticomotor excitability alterations may not be the cause of acute changes in neuromuscular activation following joint effusion. Future research should determine whether clinically altering corticomotor excitability will improve physical function.

Level of evidence

II.
Literature
1.
go back to reference Andrade MS, Cohen M, Picarro IC, Silva AC (2002) Knee performance after anterior cruciate ligament reconstruction. Isokinet Exerc Sci 10(2):81–86 Andrade MS, Cohen M, Picarro IC, Silva AC (2002) Knee performance after anterior cruciate ligament reconstruction. Isokinet Exerc Sci 10(2):81–86
2.
go back to reference Carroll TJ, Riek S, Carson RG (2001) Reliability of the input-output properties of the cortico-spinal pathway obtained from transcranial magnetic and electrical stimulation. J Neurosci Methods 112(2):193–202CrossRefPubMed Carroll TJ, Riek S, Carson RG (2001) Reliability of the input-output properties of the cortico-spinal pathway obtained from transcranial magnetic and electrical stimulation. J Neurosci Methods 112(2):193–202CrossRefPubMed
3.
go back to reference Chmielewski TL, Stackhouse S, Axe MJ, Snyder-Mackler L (2004) A prospective analysis of incidence and severity of quadriceps inhibition in a consecutive sample of 100 patients with complete acute anterior cruciate ligament rupture. J Orthop Res 22(5):925–930CrossRefPubMed Chmielewski TL, Stackhouse S, Axe MJ, Snyder-Mackler L (2004) A prospective analysis of incidence and severity of quadriceps inhibition in a consecutive sample of 100 patients with complete acute anterior cruciate ligament rupture. J Orthop Res 22(5):925–930CrossRefPubMed
4.
go back to reference Deandrad JR, Grant C, Dixon SSJ (1965) Joint distension and reflex muscle inhibition in knee. J Bone Joint Surg Am. A 47(2):313–315 Deandrad JR, Grant C, Dixon SSJ (1965) Joint distension and reflex muscle inhibition in knee. J Bone Joint Surg Am. A 47(2):313–315
5.
go back to reference Engelhardt M, Reuter I, Freiwald J (2001) Alterations of the neuromuscular system after knee injury. Eur J Sport Trauma R 23(2):75–81 Engelhardt M, Reuter I, Freiwald J (2001) Alterations of the neuromuscular system after knee injury. Eur J Sport Trauma R 23(2):75–81
6.
go back to reference Fitzgerald GK, Piva SR, Irrgang JJ, Bouzubar F, Starz TW (2004) Quadriceps activation failure as a moderator of the relationship between quadriceps strength and physical function in individuals with knee osteoarthritis. Arthritis Rheum 51(1):40–48CrossRefPubMed Fitzgerald GK, Piva SR, Irrgang JJ, Bouzubar F, Starz TW (2004) Quadriceps activation failure as a moderator of the relationship between quadriceps strength and physical function in individuals with knee osteoarthritis. Arthritis Rheum 51(1):40–48CrossRefPubMed
7.
8.
go back to reference Heroux ME, Trenblay F (2006) Corticomotor excitability associated with unilateral knee dysfunction secondary to anterior cruciate ligament injury. Knee Surg Sport Tr A 14(9):823–833CrossRef Heroux ME, Trenblay F (2006) Corticomotor excitability associated with unilateral knee dysfunction secondary to anterior cruciate ligament injury. Knee Surg Sport Tr A 14(9):823–833CrossRef
9.
go back to reference Hopkins JT (2006) Knee joint effusion and cryotherapy alter lower chain kinetics and muscle activity. J Athl Train 41(2):177–184PubMedCentralPubMed Hopkins JT (2006) Knee joint effusion and cryotherapy alter lower chain kinetics and muscle activity. J Athl Train 41(2):177–184PubMedCentralPubMed
10.
go back to reference Hopkins JT, Ingersoll CD, Edwards JE, Cordova ML (2000) Changes in soleus motoneuron pool excitability after artificial knee joint effusion. Arch Phys Med Rehabil 81(9):1199–1203CrossRefPubMed Hopkins JT, Ingersoll CD, Edwards JE, Cordova ML (2000) Changes in soleus motoneuron pool excitability after artificial knee joint effusion. Arch Phys Med Rehabil 81(9):1199–1203CrossRefPubMed
11.
go back to reference Hopkins JT, Ingersoll CD, Krause BA, Edwards JE, Cordova ML (2001) Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability. Med Sci Sports Exerc 33(1):123–126CrossRefPubMed Hopkins JT, Ingersoll CD, Krause BA, Edwards JE, Cordova ML (2001) Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability. Med Sci Sports Exerc 33(1):123–126CrossRefPubMed
12.
go back to reference Iles JF, Stokes M, Young A (1990) Reflex actions of knee-joint afferents during contraction of the human quadriceps. Clin Physiol 10(5):489–500CrossRefPubMed Iles JF, Stokes M, Young A (1990) Reflex actions of knee-joint afferents during contraction of the human quadriceps. Clin Physiol 10(5):489–500CrossRefPubMed
13.
go back to reference Jackson DW, Evans NA, Thomas BM (2002) Accuracy of needle placement into the intra-articular space of the knee. J Bone Joint Surg[Am] 84A(9):1522–1527 Jackson DW, Evans NA, Thomas BM (2002) Accuracy of needle placement into the intra-articular space of the knee. J Bone Joint Surg[Am] 84A(9):1522–1527
14.
go back to reference Kennedy JC, Alexander IJ, Hayes KC (1982) Nerve supply of the human knee and its functional importance. Am J Sport Med 10(6):329–335CrossRef Kennedy JC, Alexander IJ, Hayes KC (1982) Nerve supply of the human knee and its functional importance. Am J Sport Med 10(6):329–335CrossRef
15.
go back to reference Kimberley TJ, Borich MR, Prochaska KD, Mundfrom SL, Perkins AE, Poepping JM (2009) Establishing the definition and inter-rater reliability of cortical silent period calculation in subjects with focal hand dystonia and healthy controls. Neurosci Lett 464(2):84–87CrossRefPubMedCentralPubMed Kimberley TJ, Borich MR, Prochaska KD, Mundfrom SL, Perkins AE, Poepping JM (2009) Establishing the definition and inter-rater reliability of cortical silent period calculation in subjects with focal hand dystonia and healthy controls. Neurosci Lett 464(2):84–87CrossRefPubMedCentralPubMed
16.
go back to reference Lewek M, Rudolph K, Axe M, Snyder-Mackler L (2002) The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech 17(1):56–63CrossRef Lewek M, Rudolph K, Axe M, Snyder-Mackler L (2002) The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech 17(1):56–63CrossRef
17.
go back to reference Livingston SC, Ingersoll CD (2008) Intra-rater reliability of a transcranial magnetic stimulation technique to obtain motor evoked potentials. Int J Neurosci 118(2):239–256CrossRefPubMed Livingston SC, Ingersoll CD (2008) Intra-rater reliability of a transcranial magnetic stimulation technique to obtain motor evoked potentials. Int J Neurosci 118(2):239–256CrossRefPubMed
18.
go back to reference Luc BA, Lepley AS, Tevald MA, Gribble PA, White DB, Pietrosimone BG. [2013]. Reliability of corticomotor excitability in leg and thigh musculature at 14 and 28 days. J Sport Rehabil. Epub Luc BA, Lepley AS, Tevald MA, Gribble PA, White DB, Pietrosimone BG. [2013]. Reliability of corticomotor excitability in leg and thigh musculature at 14 and 28 days. J Sport Rehabil. Epub
19.
go back to reference Norte GE, Pietrosimone BG, Hart JM, Hertel J, Ingersoll CD (2010) Relationship between transcranial magnetic stimulation and percutaneous electrical stimulation in determining the quadriceps central activation ratio. Am J Phys Med Rehab 89(12):986–996CrossRef Norte GE, Pietrosimone BG, Hart JM, Hertel J, Ingersoll CD (2010) Relationship between transcranial magnetic stimulation and percutaneous electrical stimulation in determining the quadriceps central activation ratio. Am J Phys Med Rehab 89(12):986–996CrossRef
20.
go back to reference On AY, Uludag B, Taskiran E, Ertekin C (2004) Differential corticomotor control of a muscle adjacent to a painful joint. Neurorehabil Neural Repair 18(3):127–133CrossRefPubMed On AY, Uludag B, Taskiran E, Ertekin C (2004) Differential corticomotor control of a muscle adjacent to a painful joint. Neurorehabil Neural Repair 18(3):127–133CrossRefPubMed
21.
go back to reference Palmieri-Smith RM, Kreinbrink J, Ashton-Miller JA, Wojtys EM (2007) Quadriceps inhibition induced by an experimental knee joint effusion affects knee joint mechanics during a single-legged drop landing. Am J Sports Med 35(8):1269–1275CrossRefPubMed Palmieri-Smith RM, Kreinbrink J, Ashton-Miller JA, Wojtys EM (2007) Quadriceps inhibition induced by an experimental knee joint effusion affects knee joint mechanics during a single-legged drop landing. Am J Sports Med 35(8):1269–1275CrossRefPubMed
22.
go back to reference Palmieri RM, Ingersoll CD, Cordova ML, Kinzey SJ, Stone MB, Krause BA (2003) The effect of a simulated knee joint effusion on postural control in healthy subjects. Arch Phys Med Rehabil 84(7):1076–1079CrossRefPubMed Palmieri RM, Ingersoll CD, Cordova ML, Kinzey SJ, Stone MB, Krause BA (2003) The effect of a simulated knee joint effusion on postural control in healthy subjects. Arch Phys Med Rehabil 84(7):1076–1079CrossRefPubMed
23.
go back to reference Palmieri RM, Ingersoll CD, Edwards JE (2003) Arthrogenic muscle inhibition is not present in the limb contralateral to a simulated knee joint effusion. Am J Phys Med Rehabil 82(12):910–916CrossRefPubMed Palmieri RM, Ingersoll CD, Edwards JE (2003) Arthrogenic muscle inhibition is not present in the limb contralateral to a simulated knee joint effusion. Am J Phys Med Rehabil 82(12):910–916CrossRefPubMed
24.
go back to reference Palmieri RM, Tom JA, Edwards JE (2004) Arthrogenic muscle response induced by an experimental knee joint effusion is mediated by pre- and post-synaptic spinal mechanisms. J Electromyography Kinesiol 14(6):631–640CrossRef Palmieri RM, Tom JA, Edwards JE (2004) Arthrogenic muscle response induced by an experimental knee joint effusion is mediated by pre- and post-synaptic spinal mechanisms. J Electromyography Kinesiol 14(6):631–640CrossRef
25.
go back to reference Petersen NC, Butler JE, Taylor JL, Gandevia SC (2010) Probing the corticospinal link between the motor cortex and motoneurones: some neglected aspects of human motor cortical function. Acta Physiol (Oxf) 198(4):403–416CrossRef Petersen NC, Butler JE, Taylor JL, Gandevia SC (2010) Probing the corticospinal link between the motor cortex and motoneurones: some neglected aspects of human motor cortical function. Acta Physiol (Oxf) 198(4):403–416CrossRef
26.
go back to reference Phillips CG, Porter R (1977) Corticospinal neurones. Their role in movement. Monogr Physiol Soc 34:1–450 v-xii Phillips CG, Porter R (1977) Corticospinal neurones. Their role in movement. Monogr Physiol Soc 34:1–450 v-xii
27.
go back to reference Pietrosimone BG, Hart JM, Saliba SA, Hertel J, Ingersoll CD (2009) Immediate effects of transcutaneous electrical nerve stimulation and focal knee joint cooling on quadriceps activation. Med Sci Sports Exerc 41(6):1175–1181CrossRefPubMed Pietrosimone BG, Hart JM, Saliba SA, Hertel J, Ingersoll CD (2009) Immediate effects of transcutaneous electrical nerve stimulation and focal knee joint cooling on quadriceps activation. Med Sci Sports Exerc 41(6):1175–1181CrossRefPubMed
28.
go back to reference Pietrosimone BG, Hertel J, Ingersoll CD, Hart JM, Saliba SA (2011) Voluntary quadriceps activation deficits in patients with tibiofemoral osteoarthritis: a meta-analysis. PMR 3(2):153–162CrossRef Pietrosimone BG, Hertel J, Ingersoll CD, Hart JM, Saliba SA (2011) Voluntary quadriceps activation deficits in patients with tibiofemoral osteoarthritis: a meta-analysis. PMR 3(2):153–162CrossRef
29.
go back to reference Pietrosimone BG, Ingersoll CD (2009) Focal knee joint cooling increases the quadriceps central activation ratio. J Sports Sci 27(8):873–879CrossRefPubMed Pietrosimone BG, Ingersoll CD (2009) Focal knee joint cooling increases the quadriceps central activation ratio. J Sports Sci 27(8):873–879CrossRefPubMed
30.
go back to reference Plowman-Prine EK, Triggs WJ, Malcolm MP, Rosenbek JC (2008) Reliability of transcranial magnetic stimulation for mapping swallowing musculature in the human motor cortex. Clin Neurophysiol 119(10):2298–2303CrossRefPubMed Plowman-Prine EK, Triggs WJ, Malcolm MP, Rosenbek JC (2008) Reliability of transcranial magnetic stimulation for mapping swallowing musculature in the human motor cortex. Clin Neurophysiol 119(10):2298–2303CrossRefPubMed
31.
go back to reference Rice D, McNair PJ, Dalbeth N (2009) Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling. Arthritis Rheum 61(1):78–83CrossRefPubMed Rice D, McNair PJ, Dalbeth N (2009) Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling. Arthritis Rheum 61(1):78–83CrossRefPubMed
32.
go back to reference Spencer JD, Hayes KC, Alexander IJ (1984) Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehabil 65(4):171–177PubMed Spencer JD, Hayes KC, Alexander IJ (1984) Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehabil 65(4):171–177PubMed
33.
go back to reference Torry MR, Decker MJ, Millett PJ, Steadman JR, Sterett WI (2005) The effects of knee joint effusion on quadriceps electromyography during jogging. J Sports Sci Med 4(1):1–8PubMedCentralPubMed Torry MR, Decker MJ, Millett PJ, Steadman JR, Sterett WI (2005) The effects of knee joint effusion on quadriceps electromyography during jogging. J Sports Sci Med 4(1):1–8PubMedCentralPubMed
34.
go back to reference Torry MR, Decker MJ, Viola RW, O’Connor DD, Steadman JR (2000) Intra-articular knee joint effusion induces quadriceps avoidance gait patterns. Clin Biomech 15(3):147–159CrossRef Torry MR, Decker MJ, Viola RW, O’Connor DD, Steadman JR (2000) Intra-articular knee joint effusion induces quadriceps avoidance gait patterns. Clin Biomech 15(3):147–159CrossRef
Metadata
Title
Quadriceps corticomotor excitability following an experimental knee joint effusion
Authors
Adam S. Lepley
Nael O. Bahhur
Amanda M. Murray
Brian G. Pietrosimone
Publication date
01-04-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2816-1

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