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document
Neuromuscular excitability changes in the vastus medialis following anterior cruciate ligament reconstruction . PURPOSE Quadriceps weakness following anterior cruciate ligament reconstruction ( ACLR ) is prevalent despite intensive rehabilitation . Diminished neuromuscular excitability is one potential factor that may limit muscular recovery following injury or surgery . The H-reflex provides a measure of alpha motorneuron ( neuromuscular ) excitability in the sensory-motor pathway of the respective muscle and nerve . To date the vastus medialis ( VM ) and soleus ( SOL ) H-reflexes have been examined primarily in control subjects with induced knee joint effusion . This prospective , randomized clinical trial evaluated the affect of ACLR , utilizing hamsting ( HS ) or bone-patellar tendon-bone ( BTB ) autograft , on VM and SOL H-reflex latency and amplitude in twenty subjects . METHODS Preoperatively bilateral VM and SOL H-reflex tests were conducted . VM and SOL H-reflexes were subsequently conducted on the involved lower extremity at 1 and 3 months post surgery . At each test session subjects completed visual analog scales and knee girth was measured . RESULTS The VM H-reflex amplitude increased in the HS group at 3 months compared to 1-month post surgery ( p < .05 ) . Significant changes over time were also noted in the visual analog pain and functional scales and the mid-patella girth . CONCLUSIONS The increased VM H-reflex amplitude at 3 months following HS autograft ACLR demonstrates an increase in VM neuromuscular excitability . Increased VM neuromuscular excitability was not evident in patients following BTB reconstruction . The increased neuromuscular excitability , observed only in the HS group , warrants consideration when selecting graft type for patients with extensive preoperative quadriceps dysfunction .
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Intervention_Surgical
anterior cruciate ligament reconstruction
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Intervention_Surgical
cruciate ligament reconstruction ( ACLR )
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Intervention_Surgical
ACLR
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Intervention_Surgical
hamsting ( HS ) or bone-patellar tendon-bone ( BTB ) autograft
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Intervention_Surgical
ACLR
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Outcome_Physical
H-reflex
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Outcome_Physical
hamsting ( HS )
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Outcome_Physical
bone-patellar tendon-bone ( BTB ) autograft
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Outcome_Physical
VM and SOL H-reflex latency and amplitude
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Outcome_Physical
VM and SOL H-reflexes
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Outcome_Other
visual analog scales
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Outcome_Physical
knee girth
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Outcome_Physical
VM H-reflex amplitude
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Outcome_Pain
visual analog pain
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Outcome_Physical
functional scales and the mid-patella girth
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Outcome_Physical
VM H-reflex amplitude
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Outcome_Physical
VM neuromuscular excitability
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Outcome_Physical
VM neuromuscular excitability
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Outcome_Physical
neuromuscular excitability