Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability

Purpose: To examine changes in quadriceps and soleus MN pool activity resulting from knee joint effusion over a 4-h period and assess the relationship between the muscles. Methods: A repeated measures before-after trial design was used for this study. Eight, neurologically sound volunteers (age 23.3 ± 2.1 yr, height 171.8 ± 15.9 cm, mass 65.5 ± 17.7 kg) participated in this study. An area superomedial to the patella was cleaned and anesthetized, and 30 mL of sterile saline was injected into the knee joint capsule to mimic mechanical joint effusion. The Hoffman reflex (H-reflex) was elicited by applying a percutaneous stimulus to the appropriate nerve and recording the response through surface electromyography. Soleus and vastus medialis H-reflex measures were collected from each volunteer before, at 30 min, 90 min, 150 min, and 210 rain intervals over a 4-h period after knee effusion. Results: All soleus H-reflex measures after effusion (30 min 5.89 ± 0.92 V; 90 min 6.16 ± 0.48 V; 150 rain 6.59 ± 0.50 V; 210 min 6.70 ± 0.56 V) were increased in relation to the preeffusion measure (5.01 ± 0.79 V). All vastus medialis H-reflex measures after effusion (30 min 4.23 ± 0.94 V; 90 min 4.15 ± 1.11 V; 150 min 4.16 ± 0.57 V; and 210 min 4.99 ± 1.23) were decreased in relation to the preeffusion measure (5.88 ± 1.44 V; P ≤ 0.05). Conclusions: Afferent activity from the knee joint capsule resulted in an inhibitory effect on the vastus medialis and a facilitatory effect on the soleus. Facilitation of the soleus in cooperation with other lower extremity musculature could be a mechanism for compensation of the inhibited quadriceps to maintain lower kinetic chain function.