Abstract
Central activation deficits have been recognised to be partially responsible for quadriceps
muscle weakness after knee injuries effecting the injured as well as the uninjured
leg. The purpose of this study was to assess the extent of bilateral activation deficits
and its effect on functional muscle tests using the uninjured leg as reference. The
study included 30 patients with isolated rupture of the anterior cruciate ligament
(group 1), 42 patients with rupture of the anterior cruciate ligament and accompanying
joint damage (group 2) and 34 healthy volunteers as reference. The maximum isometric
knee extension torque and the maximal voluntary muscle activation (VA) were measured
bilaterally using a sensitive twitch-interpolation method. The measured and the true
functional deficit, adjusted to a physiological VA of the uninjured side, was calculated.
Isolated rupture of the anterior cruciate ligament caused a minor VA-deficit and severe
knee injuries more severe VA-deficits of the quadriceps muscles of the injured (VA
group 1: 83.8 ± 1.9 %; group 2: 76.9 ± 1.8 %) and on the uninjured side (VA group
1: 85.9 ± 1.8 %; group 2: 77.9 ± 1.8 %) compared to the control group (VA 91 ± 0.64
%). Due to contralateral VA-deficits the mean underestimation of the isometric muscle-force
deficit was 22 % in group 1 and 48% in group 2. Unilateral knee injuries lead to significant
VA-deficits of the quadriceps muscles on both the injured and uninjured legs related
to the severity of injury. The validity of tests for the assessment of muscle function
is questionable when using the uninjured side as reference.
Key words
Anterior cruciate ligament - torque - arthrogenous muscle inhibition - maximal voluntary
contraction - validity - isometric
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D. Urbach, M.D.
Department of Orthopaedics · Otto-von-Guericke University
Leipziger Straße 44 · 39120 Magdeburg · Germany ·
Phone: +49 391 67 14015
Fax: +49 391 67 14029
Email: dietmar.urbach@medizin.uni-magdeburg.de
