膝关节压力及活动度的改善可以提高屈肌的屈曲能力.pdf

The Journal of Pain, Vol 11, No 2 (February), 2010: pp 179-185 Available online at Heightened Flexor Withdrawal Response in Individuals With Knee Osteoarthritis Is Modulated by Joint Compression and Joint Mobilization Carol A. Courtney, Paul O. Witte, Samuel J. Chmell, and T. George Hornby University of Illinois at Chicago, Chicago, Illinois. Abstract: Patients with chronic pain often present with hyperalgesia, possibly due to hyperexcit- ability of nociceptive pathways. The aim of the present study was to investigate alterations in ?exor withdrawal re?ex (FWR) excitability in individuals with knee osteoarthritis (OA) and the potential ef- fect of speci?c physical inputs or therapeutic interventions (ie, joint compression and mobilization) on these behaviors. Ten subjects with and 10 without knee OA (age 45–75) were recruited. The FWR was examined utilizing suprathreshold, noxious electrocutaneous stimuli applied at the medial foot. Surface electromyographic (EMG) was recorded from the tibialis anterior (TA) and biceps femo- ris (BF), and peak joint torques recorded at the hip, knee, and ankle. FWR threshold was ascertained and responses at 2? threshold recorded after the following conditions: a maximal, volitional, joint- compression task, a sham hands-on intervention, and a Grade III oscillatory joint-mobilization inter- vention. A decreased threshold-to-?exor withdrawal response was found in the OA vs control group (P .01). EMG and joint-torque FWR responses were further augmented in the OA group following the maximal joint-compression task (P .05), yet remained unchanged or diminished in controls. Joint mobilization, but not sham intervention, reduced re?ex responses signi?cantly, although primari