ACL Repair Might Induce Further Abnormality of Gamma Loop in the Intact Side of the Quadriceps Femoris

Abstract

The purpose of this study was to investigate the effect of surgery on the gamma-loop in the quadriceps of patients with ACL injuries. We compared the response to vibration stimulation in subjects with ACL repair, subjects with ACL rupture, and normal subjects, by measuring the maximal strength and integrated electromyography (I-EMG) of the quadriceps. Pre-vibration data were obtained from each subject by measuring the MVC of the knee extension and the I-EMG from the vastus medialis, vastus lateralis, and rectus femoris. Vibration stimulation was applied to the infrapatellar tendon, followed immediately by repeating maximal strength and I-EMG recording. The results of this study indicated that alpha motor neuron activity of the intact side of the vastus lateralis in response to prolonged vibration stimulation was altered by surgery, but no effect was detected in the injured side. The results could suggest that abnormality of the gamma-loop existed even in the quadriceps of patients with ACL rupture since the vibration stimulus failed to elicit changes in ACL-rupture group as compared with those of normal subjects. In comparison, abnormality of the gamma-loop in the intact side of the QF was probably induced by the rupture, and further abnormality of gamma-loop was induced by surgery.

vibration stimulation - ACL injury - reflex inhibition - EMG

References

• 1 Avela J, Kyrolainen H, Komi PV. Altered reflex sensitivity after repeated and prolonged passive muscle stretching.  J Appl Physiol. 1999;  86 1283-1291
• 2 Bongiovanni LG, Hagbarth KE, Stjernberg L. Prolonged muscle vibration reducing motor output in maximal voluntary contractions in man.  J Physiol. 1990;  423 15-26
• 3 Burke D, Hagbarth KE, Lofstedt L, Wallin BG. The responses of human muscle spindle endings to vibration of non-contracting muscles.  J Physiol. 1976;  261 673-693
• 4 Gandevia SC. Neural control in human muscle fatigue: changes in muscle afferents, motoneurones and motor cortical drive [corrected].  Acta Physiol Scand. 1998;  162 275-283
• 5 Hagbarth KE, Kunesch EJ, Nordin M, Schmidt R, Wallin EU. Gamma loop contributing to maximal voluntary contractions in man.  J Physiol. 1986;  380 575-591
• 6 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
• 7 Johansson H, Sjolander P, Sojka P. Receptors in the knee joint ligaments and their role in the biomechanics of the joint.  Crit Rev Biomed Eng. 1991;  18 341-368
• 8 Konishi Y, Aihara Y, Sakai M, Ogawa G, Fukubayashi T. Gamma loop dysfunction in the quadriceps femoris of patients who underwent anterior cruciate ligament reconstruction remains bilaterally.  Scand J Med Sci Sports. 2007;  17 393-399
• 9 Konishi Y, Fukubayashi T, Takeshita D. Mechanism of quadriceps femoris muscle weakness in patients with anterior cruciate ligament reconstruction.  Scand J Med Sci Sports. 2002;  12 371-375
• 10 Konishi Y, Fukubayashi T, Takeshita D. Possible mechanism of quadriceps femoris weakness in patients with ruptured anterior cruciate ligament.  Med Sci Sports Exerc. 2002;  34 1414-1418
• 11 Konishi Y, Konishi H, Fukubayashi T. Gamma loop dysfunction in quadriceps on the contralateral side in patients with ruptured ACL.  Med Sci Sports Exerc. 2003;  35 897-900
• 12 Konishi Y, Suzuki Y, Hirose N, Fukubayashi T. Effects of lidocaine into knee on QF strength and EMG in patients with ACL lesion.  Med Sci Sports Exerc. 2003;  35 1805-1808
• 13 Kouzaki M, Shinohara M, Fukunaga T. Decrease in maximal voluntary contraction by tonic vibration applied to a single synergist muscle in humans.  J Appl Physiol. 2000;  89 1420-1424
• 14 Lorentzon R, Elmqvist LG, Sjostrom M, Fagerlund M, Fuglmeyer AR. Thigh musculature in relation to chronic anterior cruciate ligament tear: muscle size, morphology, and mechanical output before reconstruction.  Am J Sports Med. 1989;  17 423-429
• 15 Rice DA, McNair PJ. Quadriceps Arthrogenic Muscle Inhibition: Neural mechanisms and treatment perspectives.  Semin Arthritis Rheum. 2009; 
• 16 Roll JP, Vedel JP, Ribot E. Alteration of proprioceptive messages induced by tendon vibration in man: a microneurographic study.  Exp Brain Res. 1989;  76 213-222
• 17 Snyder-Mackler L, De Luca PF, Williams PR, Eastlack ME, Bartolozzi 3rd AR. Reflex inhibition of the quadriceps femoris muscle after injury or reconstruction of the anterior cruciate ligament.  J Bone Joint Surg Am. 1994;  76 555-560
• 18 Urbach D, Awiszus F. Impaired ability of voluntary quadriceps activation bilaterally interferes with function testing after knee injuries. A twitch interpolation study.  Int J Sports Med. 2002;  23 231-236
• 19 Urbach D, Nebelung W, Weiler HT, Awiszus F. Bilateral deficit of voluntary quadriceps muscle activation after unilateral ACL tear.  Med Sci Sports Exerc. 1999;  31 1691-1696

Correspondence