MuscleQuadriceps Arthrogenic Muscle Inhibition: Neural Mechanisms and Treatment Perspectives
Section snippets
Methods
To implement the review, an initial search of the literature was undertaken using a variety of sources including experimental papers, review papers, and conference proceedings, as well as a general internet search. From this initial search an extensive keyword list was developed (eg, quadriceps, knee extensors, muscle inhibition, voluntary activation, arthrogenic, arthrogenous, knee injury, knee trauma, OA, gonarthrosis, rheumatoid arthritis, knee surgery, joint receptors, articular receptors,
The Presentation of AMI
AMI occurs across a wide range of knee joint pathologies, with significant quadriceps activation deficits observed in patients with OA (11, 28, 29), rheumatoid arthritis (RA) (9), anterior knee pain (30), patella contusion (31), following anterior cruciate ligament (ACL) rupture (10, 32) and reconstruction (33), after meniscal damage (34) and menisectomy (35, 36), and in patients who have undergone knee joint arthroplasty (17, 37, 38).
AMI has been quantified using electromyography (EMG),
Discussion
AMI remains a significant barrier to effective rehabilitation in patients with arthritis and following knee injury and surgery. AMI contributes to quadriceps atrophy and prevents full activation of the muscle, playing a major role in the marked quadriceps weakness that is commonly observed in these patients. Moreover, AMI may delay or prevent effective quadriceps strengthening. This is particularly apparent in the first few months after trauma or in the case of extensive joint damage when AMI
Acknowledgments
The authors thank Dr Gwyn Lewis for helpful comments on an earlier version of the manuscript. Support from the Accident Compensation Corporation and Health Research Council of New Zealand is gratefully acknowledged.
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Mr. Rice receives financial support from the Accident Compensation Corporation and Health Research Council of New Zealand in the form of a PhD Career Development Award.
The authors have no conflicts of interests to disclose.