Physiother Theory Pract. 2025 Mar;41(3):664-681. doi: 10.1080/09593985.2024.2346729. Epub 2024 Apr 26.
ABSTRACT
BACKGROUND: Primary motor cortex (M1) organization and quadriceps femoris excitability may change after anterior cruciate ligament injury (ACLi) and anterior cruciate ligament reconstruction (ACLr), as demonstrated by transcranial magnetic stimulation (TMS) studies.
OBJECTIVE: To systematically review studies evaluating changes in quadriceps femoris corticospinal and intracortical excitability in subjects with ACLi and ACLr.
METHODS: Database searches were conducted in PubMed, Embase, Scopus, and ScienceDirect, with the last search performed on November 23, 2023. Newcastle-Ottawa Scale and a specific checklist for evaluating descriptions in studies using TMS assessment were used. Continuous variables were expressed as mean and standard deviation and represented by the estimated difference from the mean and 95% confidence interval (CI). Heterogeneity was assessed by Chi2 and I2 and the level of statistical significance was 5%.
RESULTS: Fourteen studies, comprising 381 individuals, using TMS were identified. Meta-analysis results showed significantly higher motor threshold (MT) in ACLi/ACLr individuals compared to healthy controls (p < .01, mean difference 6.72). Additionally, MTs were significantly higher on the uninjured side compared to healthy controls (p < .0001, mean difference 3.82). Motor-evoked potentials (MEP) amplitude was significantly higher on the uninjured side compared to the injured side (p < .00001, mean difference 0.01). Short-interval intracortical inhibition (SICI) amplitude was significantly lesser on the injured limb compared to the uninjured side (p < .00001, mean difference 0.50).
CONCLUSION: Quadriceps MT and SICI are altered in ACLi and ACLr populations, and minor alterations were identified in MEP, demonstrating brain changes related to anterior cruciate ligament injury and/or reconstruction.
PMID:39992686 | DOI:10.1080/09593985.2024.2346729
