Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review

被引:99
作者
Rio, Ebonie [1 ,2 ]
Kidgell, Dawson [3 ]
Moseley, G. Lorimer [4 ]
Gaida, Jamie [1 ,5 ,6 ]
Docking, Sean [1 ,2 ]
Purdam, Craig [7 ]
Cook, Jill [1 ,2 ]
机构
[1] Monash Univ, Dept Physiotherapy, Sch Primary Hlth Care, Melbourne, Vic 3004, Australia
[2] Ballarat Federat Univ, Australian Ctr Res Injury Sport & Prevent, Melbourne, Vic, Australia
[3] La Trobe Univ, Sch Allied Hlth, Dept Rehabil Nutr & Sport, Melbourne, Vic, Australia
[4] Univ South Australia & Pain, Sansom Inst Hlth Res, Adelaide, SA, Australia
[5] Univ Canberra, Dept Physiotherapy, Bruce, Australian Capi, Australia
[6] Univ Canberra, Res Inst Sport & Exercise, Canberra, ACT 2601, Australia
[7] Australian Inst Sport, Dept Phys Therapies, Bruce, Australian Capi, Australia
关键词
MOTOR CORTEX EXCITABILITY; TRANSCRANIAL MAGNETIC STIMULATION; CHRONIC ACHILLES TENDINOSIS; ROTATOR CUFF TENDINOPATHY; LOW-BACK-PAIN; JUMPERS KNEE; PATELLAR TENDINOPATHY; VOLLEYBALL PLAYERS; INTERHEMISPHERIC INHIBITION; INTRACORTICAL INHIBITION;
D O I
10.1136/bjsports-2015-095215
中图分类号
G8 [体育];
学科分类号
04 ; 0403 ;
摘要
Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence. Outcomes of interest include the effect of strength training on tendon pain, corticospinal excitability and short interval cortical inhibition. The aims of this concept paper are to: (1) review what is known about changes to the primary motor cortex and motor control in tendinopathy, (2) identify the parameters shown to induce neuroplasticity in strength training and (3) align these principles with tendon rehabilitation loading protocols to introduce a combination approach termed as tendon neuroplastic training. Strength training is a powerful modulator of the central nervous system. In particular, corticospinal inputs are essential for motor unit recruitment and activation; however, specific strength training parameters are important for neuroplasticity. Strength training that is externally paced and akin to a skilled movement task has been shown to not only reduce tendon pain, but modulate excitatory and inhibitory control of the muscle and therefore, potentially tendon load. An improved understanding of the methods that maximise the opportunity for neuroplasticity may be an important progression in how we prescribe exercise-based rehabilitation in tendinopathy for pain modulation and potentially restoration of the corticospinal control of the muscle-tendon complex.
引用
收藏
页码:209 / U99
页数:8
相关论文
共 69 条
[1]   Promoting use-dependent plasticity with externally-paced training [J].
Ackerley, Suzanne J. ;
Stinear, Cathy M. ;
Byblow, Winston D. .
CLINICAL NEUROPHYSIOLOGY, 2011, 122 (12) :2462-2468
[2]   Tenocyte hypercellularity and vascular proliferation in a rabbit model of tendinopathy: contralateral effects suggest the involvement of central neuronal mechanisms [J].
Andersson, Gustav ;
Forsgren, Sture ;
Scott, Alexander ;
Gaida, James Edmund ;
Stjernfeldt, Johanna Elgestad ;
Lorentzon, Ronny ;
Alfredson, Hakan ;
Backman, Clas ;
Danielson, Patrik .
BRITISH JOURNAL OF SPORTS MEDICINE, 2011, 45 (05) :399-406
[3]   Laterality of interhemispheric inhibition depends on handedness [J].
Baeumer, T. ;
Dammann, E. ;
Bock, F. ;
Kloeppel, S. ;
Siebner, H. R. ;
Muenchau, A. .
EXPERIMENTAL BRAIN RESEARCH, 2007, 180 (02) :195-203
[4]   Jump frequency may contribute to risk of jumper's knee: a study of interindividual and sex differences in a total of 11 943 jumps video recorded during training and matches in young elite volleyball players [J].
Bahr, Martin A. ;
Bahr, Roald .
BRITISH JOURNAL OF SPORTS MEDICINE, 2014, 48 (17) :1322-1326
[5]   Is movement variability important for sports biomechanists? [J].
Bartletti, Roger ;
Wheat, Jon ;
Robins, Matthew .
SPORTS BIOMECHANICS, 2007, 6 (02) :224-243
[6]   Bilateral sensorimotor abnormalities in unilateral lateral epicondylalgia [J].
Bisset, LM ;
Russell, T ;
Bradley, S ;
Ha, B ;
Vicenzino, BT .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2006, 87 (04) :490-495
[7]   Isometric abduction muscle activation in patients with rotator tendinosis of the shoulder [J].
Brox, JI ;
Roe, C ;
Saugen, E ;
Vollestad, NK .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1997, 78 (11) :1260-1267
[8]   Relationship between interhemispheric inhibition and motor cortex excitability in subacute stroke patients [J].
Buetefisch, Cathrin M. ;
Wessling, Marion ;
Netz, Johannes ;
Seitz, Ruediger J. ;
Hoemberg, Volker .
NEUROREHABILITATION AND NEURAL REPAIR, 2008, 22 (01) :4-21
[9]   Studies of neuroplasticity with transcranial magnetic stimulation [J].
Cohen, LG ;
Ziemann, U ;
Chen, R ;
Classen, J ;
Hallett, M ;
Gerloff, C ;
Butefisch, C .
JOURNAL OF CLINICAL NEUROPHYSIOLOGY, 1998, 15 (04) :305-324
[10]   Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy [J].
Cook, J. L. ;
Purdam, C. R. .
BRITISH JOURNAL OF SPORTS MEDICINE, 2009, 43 (06) :409-416