Arthrogenic Muscle Inhibition

Original Editor - Sehriban Özmen
Top Contributors - Sehriban Ozmen

Definition[edit | edit source]

Arthrogenic muscle inhibition (AMI) is the presynaptic, ongoing reflex inhibition of the musculature surrounding the injured joint. It is a natural response generated by the human body to protect the joint from further damage. [1]

Mechanism[edit | edit source]

Change in afferent input to the spinal cord from the joint mechanoreceptors (Ruffini endings, Pacinian capsule, Golgi tendon organ, Free nerve endings) appears to play a strong role in the mechanism of AMI. Following an injury, the joint mechanoreceptors activation acts on inhibitory interneurons synapsing on the motoneuron pool of joint musculature, thus, the contractions created by the motoneuron pool decrease. [1]

Clinical Relevance[edit | edit source]

Since 2000, the number of studies investigating interventions for the treatment of AMI has increased, and these studies have included people with different conditions including anterior cruciate ligament deficient/ repair/reconstruction (43.9%), osteoarthritis (19.8%), knee pain (7.8), total knee arthroplasty (7.8%), experimental effusion (4.3%), experimental knee pain (4.3%), meniscectomy /meniscal repair (4.3%), general knee injury (3.5%), chronic ankle instability (2.6%). Quadriceps (84.3%) and Hamstring (8.9%) have been the most investigated muscles in total. [2]

Outcome Measures[edit | edit source]

  • Voluntary Force Measurement [1]
  • The Hoffmann Reflex: It measures the motor neuron pool recruitment. [1]

Management / Interventions[edit | edit source]

A scoping review [3] assessed the evidence level for the interventions used for the treatment of AMI after ACL reconstruction and it found; moderate-quality evidence for exercise and cryotherapy, low-quality evidence for neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation, very low-quality evidence for vibration therapy and ultrasound.

Beside that, two studies [4] [5] which measured the efficacy of virtual reality and pressure biofeedback on AMI exist. Both studies showed that those relatively new interventions are beneficial in the treatment of the AMI.

Resources[edit | edit source]

Article: "Arthrogenic muscle inhibition: 20 years on" by Journal of Sport Rehabilitation [6]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 Hopkins JT, Ingersoll CD. Arthrogenic muscle inhibition: a limiting factor in joint rehabilitation. Journal of sport rehabilitation. 2000 May 1;9(2):135-59.
  2. Norte G, Rush J, Sherman D. Arthrogenic muscle inhibition: best evidence, mechanisms, and theory for treating the unseen in clinical rehabilitation. Journal of sport rehabilitation. 2021 Dec 9;31(6):717-35.
  3. Sonnery-Cottet B, Saithna A, Quelard B, Daggett M, Borade A, Ouanezar H, Thaunat M, Blakeney WG. Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. British journal of sports medicine. 2019 Mar 1;53(5):289-98.
  4. Flórez Fonnegra JP, Pino Prestan AC, López LL, Yepes JC, Pérez VZ. Rehabilitation of Patients with Arthrogenic Muscular Inhibition in Pathologies of Knee Using Virtual Reality. Sensors. 2023 Nov 11;23(22):9114.
  5. Achens JT, Victor VS, Joseph JK. Early Activation of Quadriceps With Pressure Biofeedback for the Prevention of Arthrogenic Muscle Inhibition Following Lower Limb Orthopedic Surgeries: A Proof of Concept Clinical Trial. Journal of Chiropractic Medicine. 2022 Dec 1;21(4):296-304.
  6. Hopkins JT, Ingersoll CD. Arthrogenic muscle inhibition: 20 years on. Journal of Sport Rehabilitation. 2022 Jul 13;31(6):665-6.