Knee joint pathology and efferent pathway dysfunction: Mapping muscle inhibition from motor cortex to muscle force.

Autor: Sherman DA; Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA; Live4 Physical Therapy and Wellness, Acton, MA, USA. Electronic address: da.sherman@northeastern.edu., Rush J; Neuromuscular Biomechanics and Health Assessment Lab, College of Health Sciences and Professions, Ohio University, Athens, OH, USA; Ohio Musculoskeletal and Neurological Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA. Electronic address: jrush34@ohio.edu., Glaviano NR; Department of Kinesiology, University of Connecticut, Storrs, CT, USA; Institute for Sports Medicine, University of Connecticut, Storrs, CT, USA. Electronic address: neal.glaviano@uconn.edu., Norte GE; Cognition, Neuroplasticity, & Sarcopenia (CNS) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA. Electronic address: Grant.Norte@ucf.edu.
Jazyk: angličtina
Zdroj: Musculoskeletal science & practice [Musculoskelet Sci Pract] 2024 Nov; Vol. 74, pp. 103204. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1016/j.msksp.2024.103204
Abstrakt: Background: Dysfunction in efferent pathways after knee pathology is tied to long-term impairments in quadriceps and hamstrings muscle performance, daily function, and health-related quality of life. Understanding the underlying etiology is crucial for effective treatment and prevention of poor outcomes, such as post-traumatic osteoarthritis or joint replacement.
Objectives: To synthesize recent evidence of efferent pathway dysfunction (i.e., motor cortex, motor units) among individuals with knee pathology.
Design: Commentary.
Method: We summarize the current literature investigating the motor cortex, corticospinal tract, and motoneuron pool in individuals with three common knee pathologies: anterior cruciate ligament (ACL) injury, anterior knee pain (AKP), and knee osteoarthritis (OA). To offer a complete perspective, we draw from studies applying a range of neuroimaging and neurophysiologic techniques.
Results: Adaptations within the motor cortices, corticospinal tract, and motoneuron pool are present in those with knee pathology and underline impairments in quadriceps and hamstrings muscle function. Each pathology has evidence of altered motor system excitability and reduced volitional muscle activation and force-generating capacity, but few impairments were common across ACL injury, AKP, and OA studies. These findings underscore the central role of the motor cortex and motor unit behavior in the long-term outcomes of individuals with knee pathology.
Conclusions: Adaptations in the efferent pathways underlie persistent muscle dysfunction across three common knee pathologies. This review provides an overview of these changes and summarizes key findings from neurophysiology and neuroimaging studies, offering direction for future research and clinical application in the rehabilitation of joint injuries.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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