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Athletes after anterior cruciate ligament reconstruction demonstrate asymmetric intracortical facilitation early after surgery
Journal article   Open access   Peer reviewed

Athletes after anterior cruciate ligament reconstruction demonstrate asymmetric intracortical facilitation early after surgery

Ryan Zarzycki, Susanne M Morton, Charalambos C Charalambous, Brian Pietrosimone, Glenn N Williams and Lynn Snyder-Mackler
Journal of orthopaedic research, v 39(1), pp 147-153
Jan 2021
PMID: 32181907
url
https://doi.org/10.1002/jor.24666View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Anterior Cruciate Ligament Reconstruction - rehabilitation Athletes Cortical Excitability Female Humans Longitudinal Studies Male Muscle Strength Quadriceps Muscle - physiopathology Transcranial Magnetic Stimulation Young Adult
Quadriceps dysfunction persists after anterior cruciate ligament reconstruction (ACLR), yet the etiology remains elusive. Inhibitory and facilitatory intracortical networks (ie, intracortical excitability) may be involved in quadriceps dysfunction, yet the investigation of these networks early after ACLR is sparse. The purposes of this study were to examine (a) changes in intracortical excitability in athletes after ACLR compared to uninjured athletes during the course of postoperative rehabilitation, (b) the association between intracortical excitability and quadriceps strength in athletes after ACLR. Eighteen level I/II athletes after ACLR between the ages of 18 to 30 years and eighteen healthy sex, age, and activity matched athletes were tested at three-time points: (a) 2 weeks after surgery, (b) achievement of a "quiet knee" defined as full range of motion and minimal effusion, (c) return to running time point defined as achievement of a quadriceps index ≥80% and at least 12 weeks post-ACLR. Short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF), measured via transcranial magnetic stimulation and isometric quadriceps strength were examined bilaterally at each time point. There was a significant group × limb interaction (P = .017) for ICF. The ACLR group demonstrated asymmetric ICF (greater in the nonsurgical limb) compared to controls and a significant relationship between SICI and quadriceps strength of the surgical limb at the quiet knee time point (P = .018). ACLR individuals demonstrate differential effects on ICF between limbs. Also, SICI is associated with isometric quadriceps strength after ACLR, suggesting increased inhibition of the motor cortex may contribute to impaired quadriceps strength following ACLR.

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Orthopedics
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