Assessment of Electromyographic Activity in the Quadriceps and Hamstrings of the Operated Limb Versus the Unaffected Limb in Patients Who Have Undergone ACL Surgery, With and Without Post-operative AMI - an Exploratory Study (AMIMYO)
Traumatic injuries to the knee joint, such as an anterior cruciate ligament tear, can compromise the ability of the muscle at the front of your thigh-known as the quadriceps-to contract voluntarily, despite the anatomical integrity of the nerve and muscle structures responsible for contraction. This phenomenon, commonly known as 'arthrogenic motor inhibition' (AMI), is a major limiting factor for recovery and rehabilitation following an anterior cruciate ligament tear, as well as a potential cause of functional disability if left undiagnosed and untreated. Indeed, motor inhibition that persists during the early months of rehabilitation could lead to under-activation of the quadriceps and over-activation of the hamstrings (the muscles at the back of your thigh).
It is of interest to assess, during the rehabilitation phase, the contraction capacity of the various quadriceps and hamstring muscles in the operated limb compared with the unaffected limb in patients who have undergone anterior cruciate ligament surgery and who experience post-operative motor inhibition, and in patients who have undergone anterior cruciate ligament surgery but do not experience post-operative motor inhibition. This is why this study has been initiated.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
An ACL tear and reconstruction can lead to a neurophysiological dysfunction commonly known as 'arthrogenic muscle inhibition' (AMI). This phenomenon impairs the ability to voluntarily activate the quadriceps, despite the anatomical integrity of the nerve and muscle structures responsible for contraction.
AMI is responsible for the quadriceps deficits observed following an ACL rupture and thus appears to be a major limiting factor in the patient's rehabilitation and functional recovery. Consequently, its diagnosis and treatment are imperative. The diagnosis of AMI (post-rupture and post-operative) is based on a classification system that categorises AMI diagnoses according to the identification of a deficit in activation of the vastus medialis (VM) alone (grade 1) or in combination with an extension deficit due to a grade 2 hamstring contracture (grade 2) (Sonnery-Cottet et al, 2022).
During the clinical examination, normal VM contraction (during relaxation) can be achieved without the recruitment of all motor units (minimal VM activation), and full knee extension (i.e. without reflex contraction of the hamstrings) can be restored without a return to adequate hamstring activation for the required task. Deficits in activation (inadequate activation) of the quadriceps and over-activation of the hamstrings (Hamstrings) during movements involving greater forces could be the consequences of an AMI still present in the early months of rehabilitation. This AMI could then disrupt the electromyographic (EMG) activation patterns of the quadriceps and hamstrings and contribute to long-term quadriceps deficits.
In this context, it is of interest to assess, during the rehabilitation phase, the EMG activity of the different muscle heads of the quadriceps and hamstrings in the operated limb versus the healthy limb in patients who have undergone ACL surgery and experienced post-operative IMA, and in patients who have undergone ACL surgery without post-operative IMA.
No studies have been published on this topic. This is why this research has been initiated.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Bertrand SONNERY-COTTET, MD
- Numéro de téléphone: + 33 4 37 53 00 22
- E-mail: sonnerycottet@aol.com
Lieux d'étude
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Lyon, France, 69008
- Hôpital privé Jean Mermoz
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Contact:
- Bertrand SONNERY-COTTET, MD
- Numéro de téléphone: + 33 4 37 53 00 22
- E-mail: sonnerycottet@aol.com
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
Accepte les volontaires sains
La description
Inclusion Criteria:
- Patient who has undergone ACL surgery at least 3 weeks ago
- Patient with no severe knee inflammation: stroke test ≤ 1+ and pain ≤ 3/10 (EN) at rest
- Patient with a Tegner score ≥ 5
- Patient with a Marx score ≥ 8
- Patient with or without a diagnosis of subjective AMI (Sonnery-Cottet et al. classification)
- French-speaking patients who do not object to the use of their data
Exclusion Criteria:
- Patient with a previous injury or surgery to the same or opposite knee
- Patient with a multi-ligament injury
- Patient with an AMI > grade 2b (Sonnery-Cottet et al. classification)
- Patient with a BMI > 30
- Pregnant or breastfeeding woman
- Patient with previous or current neurological and cardiovascular disorders or diseases
- Patient under legal protection: adult under guardianship, curatorship or other legal protection, deprived of liberty by judicial or administrative decision
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Science basique
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: ACL Arm
Patient with ACL rupture
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Surface EMG of the quadriceps (vastus medialis, vastus lateralis and vastus longus) and the semimembranosus and biceps femoris muscles of the hamstrings on both the affected and unaffected sides, to objectively assess quadriceps inhibition.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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EMG activity
Délai: Month 3
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The average amplitude of EMG activity in the VM (Vastus Medialis) is assessed using the Root Mean Square (RMS) value, which is expressed in millivolts (mV).
The RMS is recorded using surface electrodes placed on the vastus medialis.
The primary outcome measure (activation deficit) is the absolute difference in RMS between the operated leg and the unaffected leg.
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Month 3
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Collaborateurs et enquêteurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Blessures et Blessures
- Blessures aux jambes
- Blessures au genou
- Blessures du ligament croisé antérieur
- Thérapeutique
- Thérapies corps-esprit
- Thérapies complémentaires
- Thérapie comportementale
- Psychothérapie
- Disciplines et activités comportementales
- Biofeedback, psychologie
- Rétroaction, psychologique
- Neurofeedback
Autres numéros d'identification d'étude
- 2026-A00008-43
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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