Transcranial magnetic stimulation and volitional quadriceps activation.

Abstract:

CONTEXT:Quadriceps-activation deficits have been reported after meniscectomy. Transcranial magnetic stimulation (TMS) in conjunction with maximal contractions affects quadriceps activation in patients after meniscectomy. OBJECTIVE:To determine the effect of single-pulsed TMS on quadriceps central activation ratio (CAR) in patients after meniscectomy. DESIGN:Randomized controlled clinical trial. SETTING:University laboratory. PATIENTS OR OTHER PARTICIPANTS:Twenty participants who had partial meniscectomy and who had a CAR less than 85% were assigned randomly to the TMS group (7 men, 4 women; age  =  38.1 ± 16.2 years, height  =  176.8 ± 11.5 cm, mass  =  91.8 ± 27.5 kg, postoperative time  =  36.7 ± 34.9 weeks) or the control group (7 men, 2 women; age  =  38.2 ± 17.5 years, height  =  176.5 ± 7.9 cm, mass  =  86.2 ± 15.3 kg, postoperative time  =  36.6 ± 37.4 weeks). INTERVENTION(S):Participants in the experimental group received TMS over the motor cortex that was contralateral to the involved leg and performed 3 maximal quadriceps contractions with the involved leg. The control group performed 3 maximal quadriceps contractions without the TMS. MAIN OUTCOME MEASURE(S):Quadriceps activation was assessed using the CAR, which was measured in 70° of knee flexion at baseline and at 0, 10, 30, and 60 minutes posttest. The CAR was expressed as a percentage of full activation. RESULTS:Differences in CAR were detected over time (F(4,72)  =  3.025, P  = .02). No interaction (F(4,72)  =  1.457, P  =  .22) or between-groups differences (F(1,18)  =  0.096, P  =  .76) were found for CAR. Moderate CAR effect sizes were found at 10 (Cohen d  =  0.54, 95% confidence interval [CI]  =  -0.33, 1.37) and 60 (Cohen d  =  0.50, 95% CI  =  -0.37, 1.33) minutes in the TMS group compared with CAR at baseline. Strong effect sizes were found for CAR at 10 (Cohen d  =  0.82, 95% CI  =  -0.13, 1.7) and 60 (Cohen d  =  1.06, 95% CI  =  0.08, 1.95) minutes in the TMS group when comparing percentage change scores between groups. CONCLUSIONS:No differences in CAR were found between groups at selected points within a 60-minute time frame, yet moderate to strong effect sizes for CAR were found at 10 and 60 minutes in the TMS group, indicating increased activation after TMS.

journal_name

J Athl Train

authors

Gibbons CE,Pietrosimone BG,Hart JM,Saliba SA,Ingersoll CD

doi

10.4085/1062-6050-45.6.570

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

570-9

issue

6

eissn

1062-6050

issn

1938-162X

journal_volume

45

pub_type

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