Immediate Effects Of An Intramuscular Patch On Neuromuscular Control Of VL And PL In The Lower Limb Of Functional Ankle Instability

Introduction:The aims of this study were: 1.To analyze and compare the neuromuscular feedback control mechanisms of the lateral femoralis(Vastus lateralis)and peroneus longus(PL)muscles in the lower limbs of the experimental and control groups,and to investigate the differences in the neuromuscular control mechanisms of the VL and PL muscles in the lower limbs of FAI patients when maintaining dynamic and static postural stability;2.To investigate the effect of the intramuscular patch intervention on the feedback control mechanisms of VL and PL in the lower limb of FAI subjects by applying the intramuscular patch and the ankle-knee joint intramuscular patch to the affected lower limb of functional ankle instability(FAI)subjects.Methods:In this study,30 patients with unilateral FAI were screened as the experimental group based on the Cumberland Ankle Scale and history of ankle injury,and 30 subjects with no history of lower limb injury were screened as the control group based on the age,height and leg length of the subjects in the experimental group.In Experiment 1,the experimental and control groups were measured on the Balance Error Scoring System(BESS),the Star Excursion Balance Test(SEBT),the Dynamic Leap and Balance Test(DLBT),and the Balance Scoring System(BESS).The surface electromyographic(s EMG)signals of the VL and PL of both lower limbs during the BESS,Star Excursion Balance Test(SEBT)and Dynamic Leap and Balance Test(DLBT).In Experiment 2,the experimental groups were randomly divided into non-intervention and intervention groups,and the intervention group underwent ankle intramuscular patch intervention(H intervention)and ankle-knee intramuscular patch intervention(HX intervention)respectively,with 2 weeks elapsed between interventions.BESS,SEBT and DLBT tests were performed to compare the differences in VL and PL electromyographic signals between the two intervention and nonintervention groups.Results:Experiment 1:In the BESS test,the root mean square amplitude(RMS)of VL in the experimental group was increased in the open and closed eye mode with support on the affected side compared to the control group(P < 0.05);the mobilization rate(% Maximum Voluntary Contraction(%MVIC)of VL was increased in the closed eye mode with support leg on the affected and healthy side each compared to the control group(P < 0.05)The muscle activation time of VL and PL in the experimental group was delayed in the open and closed test mode on the affected and healthy side compared to the control group(P < 0.01).2.In the SEBT test,the RMS of VL and PL was increased in the affected side support test mode in the experimental group compared to the control group in the external,posterior external,posterior and posterior internal directions(P < 0.05);the %MVIC of VL was increased in the experimental group compared to the control group,and the %MVIC of PL was decreased in the experimental group compared to the control group,with significant differences in the anterior,anterior external,external,posterior external and posterior directions(P < 0.05);the VL and PL activation times were delayed in the anterior,anterior extrinsic,extrinsic,posterior extrinsic and posterior directions compared to the control group(P < 0.05).In the healthy side support test mode,the RMS of the experimental group VL increased compared to the control group in the outer,outer posterior,posterior,and inner posterior directions(P < 0.05);the RMS of PL was not significantly different compared to the control group in any direction(P > 0.05);the %MVIC of the experimental group VL increased compared to the control group,and the %MVIC of PL decreased compared to the control group,with significant differences in the anterior-outer and other directions(P <0.05);the activation time of VL was delayed in the external direction compared to the control group(P < 0.05),and the activation time of PL was delayed in the internal direction compared to the control group(P < 0.05).3.In the DLBT test,the RMS of the VL and PL increased compared to the control group at the points of internal short and internal long in the test mode with the affected side as the supporting leg(P < 0.05);the %MVIC of the VL increased compared to the control group and the %MVIC of the PL decreased compared to the control group,with significant differences at the points of anterior internal long,internal short,posterior long and posterior internal short(P < 0.05);the activation time of the VL increased compared to the control group at the points of anterior internal long,posterior long and posterior internal short(P <0.05);the activation time of the VL increased compared to the control group at the points of control group at the anterior-long and posterior-long points(P < 0.05)and PL activation time was delayed at the anterior-short,anterior-internal-short,anterior-internal-long,posteriorinternal-short and posterior-internal-long points(P < 0.05)compared to the control group.In the supported leg test mode on the healthy side,the RMS of VL and PL were increased at the anterior short and internal long points compared to the control group(P < 0.05);the %MVIC was increased at the anterior internal long,internal short and posterior long points compared to the control group(P < 0.05);the activation time of VL was delayed at the anterior short,anterior long and posterior internal long points compared to the control group(P < 0.05);the activation time of PL was delayed at the anterior internal short,internal long and posterior internal long points compared to the control group(P < 0.05),inner short sites than controls(P < 0.05).Experiment 2: 1.In the BESS test,the RMS value of PL decreased in the H intervention group before the intervention compared to after the intervention,with a significant difference in the open-PL test mode(P < 0.05),and the activation time of VL and PL decreased,with a significant difference in the close-VL,close-PL,and open-VL test modes(P < 0.05).the HX intervention group had a lower RMS value of VL compared to the non-RMS values of VL decreased in the HX intervention group compared to the non-intervention group,with a significant difference in the close-VL test mode(P < 0.05),and activation time of PL decreased,with a significant difference in the open-PL test mode(P < 0.05);RMS values of PL decreased in the HX intervention group before compared to after the intervention,with a significant difference in the open-PL test mode(P < 0.05);The activation time of VL and PL was reduced,with significant differences in close-VL,open-PL,open-VL and close-PL test modes(P < 0.05).2.In the SEBT test,the RMS value of VL decreased in the H intervention group before compared to the post-intervention group,with significant differences in the anterior,anteriorexternal,external,posterior-external,posterior,posterior-internal,and internal test directions(P < 0.05);the %MVIC of VL decreased in the H intervention group compared to the nonintervention group,with significant differences in the posterior-external direction(P < 0.05),and the %MVIC of VL decreased in the H intervention group before compared to the postintervention group(P < 0.05)The %MVIC of VL decreased and the %MVIC of PL increased in the H intervention group compared to the post-intervention group,with significant differences in the anterior-external and posterior-external directions(P < 0.05);the activation time of VL and PL decreased in the H intervention group compared to the post-intervention group,with significant differences in the posterior-internal and internal directions(P < 0.05).The RMS values of VL decreased in the HX intervention group before compared to after the intervention,with statistically significant differences(P < 0.05)in the anterior,anterior external,external,posterior external,posterior,posterior internal,internal,and anterior internal test directions;the %MVIC of VL decreased in the HX intervention group compared to the non-intervention group,and the %MVIC of PL increased,with significant differences((P < 0.05)in the posterior external and other test directions,and the %MVIC of VL decreased in the HX intervention group before compared to the non-intervention group,with statistically significant differences(P < 0.05)in the posterior internal and internal test directions.The %MVIC of VL decreased and the %MVIC of PL increased in the postintervention group,with significant differences((P < 0.05)in the anterior,anterior-exterior,posterior-exterior,posterior and internal directions of testing;the activation times of VL,PL decreased in the HX intervention group compared to the non-intervention group,with significant differences((P < 0.05)in the anterior-interior and other directions of testing,and the activation times of VL,PL decreased in the HX intervention group before compared to the post-intervention group.Significant differences(P < 0.05)in the post-external,posterior,post-internal and internal test directions;3.In the DLBT test,the RMS of VL and PL decreased in the H intervention group compared to the non-intervention group,and there was a significant difference(P < 0.05)in the post-internal short and other test points,and the RMS of PL decreased in the H intervention group before the intervention compared to the post-intervention,and there was a significant difference(P < 0.05)in the pre-internal long and post-internal short;the %MVIC of VL decreased in the H intervention group compared to the non-intervention group,and the %MVIC of PL increased The %MVIC of VL decreased in the H intervention group compared to the post-intervention group,and the %MVIC of PL increased in the anterior short,anterior long,anterior internal long,internal short and internal long test points(P < 0.05).The activation time of VL decreased in the H intervention group compared to the non-intervention group,and there was a significant difference in the anterior long,internal long test points(P <There was a significant difference(P < 0.05)in the activation time of VL and PL in the H intervention group compared to the non-intervention group,and a significant difference(P < 0.05)in the test points of anterior short,anterior long,posterior short,posterior long and posterior long.There was a significant difference(P < 0.05)in the RMS of VL before the HX intervention group compared to after the intervention at the posterior internal short test site and a significant difference(P < 0.05)in the RMS of PL at the posterior long test site;the %MVIC of VL decreased and the %MVIC of PL increased in the HX intervention group compared to the non-intervention group.(P < 0.05);%MVIC of VL decreased and %MVIC of PL increased in the HX intervention group compared to the non-intervention group,and there were significant differences in the test points of anterior short,anterior long and posterior long(P < 0.05);activation time of VL and PL decreased in the HX intervention group compared to the non-intervention group,and there were significant differences in the test points of anterior short,anterior long,posterior internal short and posterior long test points(P < 0.05),and the activation time of VL and PL was reduced in the HX intervention group before compared to the intervention group,and there were significant differences at the points of anterior short,anterior intra-long,anterior intralong,posterior intra-long and posterior short(P < 0.05).Conclusion:1.In FAI patients,VL force generation is increased compared to normal when maintaining postural stability,muscle mobilisation rate is increased and activation time is prolonged.2.Patients with FAI have increased PL force,decreased muscle mobilisation and prolonged activation time when maintaining postural stability compared to normal.3.The altered neuromuscular control of the affected side is more pronounced in FAI patients compared to the healthy side.4.Both the ankle and knee intramuscular patch interventions reduced the root mean square amplitude and activation time of VL and PL on the affected side,and reduced the muscle mobilisation rate of VL and increased the muscle mobilisation rate of PL in FAI patients.Both intramuscular patch interventions improved the immediate neuromuscular control of VL and PL in FAI patients.5.The ankle and knee intramuscular patch intervention was effective in improving dynamic postural stability tests.