title: Neuromuscular deficits after peripheral joint injury: a neurophysiological hypothesis.
abstract: In addition to biomechanical disturbances, peripheral joint injuries (PJIs) can also result in chronic neuromuscular alterations due in part to loss of mechanoreceptor-mediated afferent feedback. An emerging perspective is that PJI should be viewed as a neurophysiological dysfunction, not simply a local injury. Neurophysiological and neuroimaging studies have provided some evidence for central nervous system (CNS) reorganization at both the cortical and spinal levels after PJI. The novel hypothesis proposed is that CNS reorganization is the underlying mechanism for persisting neuromuscular deficits after injury, particularly muscle weakness. There is a lack of direct evidence to support this hypothesis, but future studies utilizing force-matching tasks with superimposed transcranial magnetic stimulation may be help clarify this notion.
authors.affiliation: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, 161 Barry Street, Carlton, Melbourne, Victoria, 3053, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ward
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Pearce
authors.forename: Brian
authors.initials: B
authors.lastname: Pietrosimone
authors.forename: Kim
authors.initials: K
authors.lastname: Bennell
authors.forename: Ross
authors.initials: R
authors.lastname: Clark
authors.forename: Adam L
authors.initials: AL
authors.lastname: Bryant
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000503:physiopathology; D000070598:Anterior Cruciate Ligament Injuries; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology*; D007719:Knee Joint / Q000294:innervation / Q000502:physiology; D018908:Muscle Weakness / Q000175:diagnosis / Q000503:physiopathology; D009468:Neuromuscular Diseases / Q000175:diagnosis / Q000503:physiopathology*; D009473:Neuronal Plasticity / Q000502:physiology*
keywords: central nervous system; joint injury; neuroplasticity; reorganization; transcranial magnetic stimulation