In his PT Podcast, University Orthopedics Physical Therapist Dan Bien discusses the role of therapy related to various orthopedic injuries and surgeries.
In Episode 6, David Sherman, DPT, from Northeastern University joins Dan to discuss Arthrogenic Muscle Inhibition following knee injury or surgery.
Podcast Timeline:
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0:00 Intro/Bio
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02:05 Quick overview of AMI and genesis of AMI
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04:05 What is the timeframe for changes to occur at a local joint level and what is the timetable for related changes at Brain or upper CNS level?
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06:58 What accounts for differences in manifestation between different individuals
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09:05 Is there a marker or clinical indicator for who may struggle post-op, or what are the greatest contributors to the onset of AMI?
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10:06 Any clinical screening or assessment tools that do not involve expensive lab equipment or PhD in neuroscience?
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12:32 Is there research to show that it is modifiable? Is there a timeframe point where changes are most malleable and conversely is there a point where it’s too advanced and changes are too entrenched?
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18:30 Early focus in rehab- Should pain/effusion control be the priority, rather than doing any exercises that prolong pain/effusion and resultant AMI? Should we treat the pain/effusion now and worry about building strength once AMI contributors are controlled?
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21:40 Recent literature and focus reinforcing the use of NMES and ideal parameters and application. Is there an ideal implementation method and/or parameters? Added Value of home NMES units and reinforcement? Does fiber order recruitment matter since it’s not organic with NMES and opposite of normal?
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33:28 Added value of commercial cryotherapy units?
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35:57 Changes in rate of force development and slow return to normal …if it does return to normal. Difficulties in measuring and how do we train it best
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47:43 Where can any listeners find out more about you and your work? What’s the next step or direction for your research?
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48:46 Off topic- tell us something not in the Northeastern bio. Any other hobbies or interests?
REFERENCES FROM THE DISCUSSION
Hopkins JT, Ingersoll CD, Krause BA, Edwards JE, Cordova ML. Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability. Med Sci Sports Exerc. 2001 Jan;33(1):123-6. doi: 10.1097/00005768-200101000-00019. PMID: 11194097.
Hopkins J, Ingersoll CD, Edwards J, Klootwyk TE. Cryotherapy and Transcutaneous Electric Neuromuscular Stimulation Decrease Arthrogenic Muscle Inhibition of the Vastus Medialis After Knee Joint Effusion. J Athl Train. 2002 Mar;37(1):25-31. PMID: 12937440; PMCID: PMC164304.
Hart JM, Kuenze CM, Diduch DR, Ingersoll CD. Quadriceps muscle function after rehabilitation with cryotherapy in patients with anterior cruciate ligament reconstruction. J Athl Train. 2014 Nov-Dec;49(6):733-9. doi: 10.4085/1062-6050-49.3.39. PMID: 25299442; PMCID: PMC4264644.
Arhos EK, Ito N, Hunter-Giordano A, Nolan TP, Snyder-Mackler L, Silbernagel KG. Who’s Afraid of Electrical Stimulation? Let’s Revisit the Application of NMES at the Knee. J Orthop Sports Phys Ther. 2024 Feb;54(2):101-106. doi: 10.2519/jospt.2023.12028. PMID: 37904496; PMCID: PMC10872626.
Chaput M, Simon JE, Taberner M, Grooms DR. From Control to Chaos: Visual-Cognitive Progression During Recovery from ACL Reconstruction. J Orthop Sports Phys Ther. 2024 Jul;54(7):431-439. doi: 10.2519/jospt.2024.12443. Epub 2024 Jun 4. PMID: 38832659.
Grooms DR, Chaput M, Simon JE, Criss CR, Myer GD, Diekfuss JA. Combining Neurocognitive and Functional Tests to Improve Return-to-Sport Decisions Following ACL Reconstruction. J Orthop Sports Phys Ther. 2023 Aug;53(8):415–419. doi: 10.2519/jospt.2023.11489. PMID: 37186672; PMCID: PMC10847844.
Burland JP, Lepley AS, Cormier M, DiStefano LJ, Arciero R, Lepley LK. Learned Helplessness After Anterior Cruciate Ligament Reconstruction: An Altered Neurocognitive State? Sports Med. 2019 May;49(5):647-657. doi: 10.1007/s40279-019-01054-4. PMID: 30659498.
PEER-REVIEWED RELEVANT SUBJECT EVIDENCE FROM DR. SHERMAN
Sherman DA, Rush J, Glaviano NR, Norte GE. Knee joint pathology and efferent pathway dysfunction: Mapping muscle inhibition from motor cortex to muscle force. Musculoskelet Sci Pract. 2024 Nov;74:103204. doi: 10.1016/j.msksp.2024.103204. Epub 2024 Oct 11. PMID: 39426249.
Sherman DA, Baumeister J, Stock MS, Murray AM, Bazett-Jones DM, Norte GE. Brain activation and single-limb balance following anterior cruciate ligament reconstruction. Clin Neurophysiol. 2023 May;149:88-99. doi: 10.1016/j.clinph.2023.02.175. Epub 2023 Mar 9. PMID: 36933325.
Rush JL, Murray AM, Sherman DA, Gokeler A, Norte GE. Single-Leg Hop Performance After Anterior Cruciate Ligament Reconstruction: Ready for Landing but Cleared for Take-Off? J Athl Train. 2024 Nov 1;59(11):1100-1109. doi: 10.4085/1062-6050-0628.23. PMID: 38779887; PMCID: PMC11611365.
Sherman DA, Lehmann T, Baumeister J, Grooms DR, Norte GE. Somatosensory perturbations influence cortical activity associated with single-limb balance performance. Exp Brain Res. 2022 Feb;240(2):407-420. doi: 10.1007/s00221-021-06260-z. Epub 2021 Nov 12. PMID: 34767059.
Sherman DA, Rush J, Stock MS, D Ingersoll C, E Norte G. Neural drive and motor unit characteristics after anterior cruciate ligament reconstruction: implications for quadriceps weakness. PeerJ. 2023 Oct 6;11:e16261. doi: 10.7717/peerj.16261. PMID: 37818333; PMCID: PMC10561646.
Sherman DA, Baumeister J, Stock MS, Murray AM, Bazett-Jones DM, Norte GE. Weaker Quadriceps Corticomuscular Coherence in Individuals after ACL Reconstruction during Force Tracing. Med Sci Sports Exerc. 2023 Apr 1;55(4):625-632. doi: 10.1249/MSS.0000000000003080. Epub 2022 Nov 4. PMID: 36730761.
Sherman DA, Glaviano NR, Norte GE. Hamstrings Neuromuscular Function After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. Sports Med. 2021 Aug;51(8):1751-1769. doi: 10.1007/s40279-021-01433-w. Epub 2021 Feb 20. PMID: 33609272.
Sherman DA, Baumeister J, Stock MS, Murray AM, Bazett-Jones DM, Norte GE. Inhibition of Motor Planning and Response Selection after Anterior Cruciate Ligament Reconstruction. Med Sci Sports Exerc. 2023 Mar 1;55(3):440-449. doi: 10.1249/MSS.0000000000003072. Epub 2022 Oct 19. PMID: 36731010.
Rush JL, Sherman DA, Bazett-Jones DM, Ingersoll CD, Norte GE. Understanding Athletic Trainers’ Knowledge, Intervention, and Barriers Toward Arthrogenic Muscle Inhibition. J Sport Rehabil. 2021 Dec 1;31(6):667-675. doi: 10.1123/jsr.2021-0162. PMID: 34853183.
Scheurer SA, Sherman DA, Glaviano NR, Ingersoll CD, Norte GE. Corticomotor function is associated with quadriceps rate of torque development in individuals with ACL surgery. Exp Brain Res. 2020 Feb;238(2):283-294. doi: 10.1007/s00221-019-05713-w. Epub 2020 Jan 2. PMID: 31897518.
About Dan Bien
Dan Bien is a physical therapist at our Kettle Point Campus in East Providence. Dan has worked at University Orthopedics since 2006 and serves as the Coordinator of Clinical Education for the physical therapy department.
Dan is currently recognized as an Orthopedic Certified Specialist by the American Board of Physical Therapy Specialties, a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association, and a Credentialed Clinical Instructor by the American Physical Therapy Association.