{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:42:42Z","timestamp":1792370562914,"version":"4.4.0"},"reference-count":32,"publisher":"National Athletic Trainers' Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,23]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>After knee-joint injury, pain, effusion, and mechanoreceptor damage alter afferent signaling, which can result in quadriceps inhibition and subsequent weakness. The individual contributions of each factor to inhibition remain unclear due to confounding knee-joint injuries and indirect experimental models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To characterize the influence of naturally occurring knee damage and pain on quadriceps neuromuscular function in individuals with patellar tendinopathy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Research laboratory.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>Twenty participants who self-reported patellar tendinopathy (PT) and 10 healthy control individuals underwent ultrasonic tendon assessment. Injured participants were dichotomized by an orthopaedic surgeon into groups with (1) pain and structural tendon abnormality and (2) regional pain alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>Quadriceps inhibition was assessed with the Hoffman reflex and the central activation ratio via the superimposed-burst technique. Normally distributed measures were analyzed using a 1-way analysis of variance and post hoc independent t tests. Kruskal-Wallis tests with post hoc Mann-Whitney U tests were used to analyze nonnormally distributed data. An a priori \u03b1 level of P \u2264 .05 was set.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Control participants presented with more spinal-reflex excitability (0.37 \u00b1 0.23) than the PT (0.10 \u00b1 0.06; P = .03) and regional-pain (0.18 \u00b1 0.05; P = .02) groups. Knee-extension strength was greater in the control (3.37 \u00b1 0.59 Nm\/kg) than in the PT (2.41 \u00b1 0.67 Nm\/kg; P = .01) group but not the regional-pain group (3.05 \u00b1 0.66 Nm\/kg; P = .24). Control individuals presented with more quadriceps activation (97.93% \u00b1 3.12) than the PT (84.44% \u00b1 16.98; P &amp;lt; .01) and regional-pain (91.17% \u00b1 10.56; P = .01) groups. No differences were present for any measures between the PT and regional-pain groups (P values &amp;gt; .05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Deficits in spinal-reflex excitability, quadriceps activation, and strength were present in both the PT and regional-pain groups. A combination of pain and structural damage appeared to have the greatest negative effect on quadriceps function, as only the PT group presented with neuromuscular outcomes that failed to meet clinical thresholds.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-27-19","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T16:19:06Z","timestamp":1588177146000},"page":"608-614","source":"Crossref","is-referenced-by-count":25,"title":["Quadriceps Inhibition After Naturally Occurring Patellar Tendon Damage and Pain"],"prefix":"10.4085","volume":"55","author":[{"given":"Steven M.","family":"Davi","sequence":"first","affiliation":[{"name":"Department of Kinesiology, University of Connecticut, Storrs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Lepley","sequence":"first","affiliation":[{"name":"School of Kinesiology, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig R.","family":"Denegar","sequence":"first","affiliation":[{"name":"Department of Kinesiology, University of Connecticut, Storrs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay J.","family":"DiStefano","sequence":"first","affiliation":[{"name":"Department of Kinesiology, University of Connecticut, Storrs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey M.","family":"Edgar","sequence":"first","affiliation":[{"name":"University of Connecticut Health Center, Storrs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey K.","family":"Lepley","sequence":"first","affiliation":[{"name":"School of Kinesiology, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2020,4,29]]},"reference":[{"key":"2020062416091880700_i1062-6050-55-6-608-b01","doi-asserted-by":"crossref","unstructured":"Krishnan\n              C,\n            \n            \n              Williams\n              GN.\n            \n          \n          Factors explaining chronic knee extensor strength deficits after ACL reconstruction.\n\t\t\t\t\tJ Orthop Res.\n\t\t\t\t\t2011;\n\t\t\t\t\t29(5):\n\t\t\t\t\t633\u2013\n\t\t\t\t\t640.","DOI":"10.1002\/jor.21316"},{"key":"2020062416091880700_i1062-6050-55-6-608-b02","doi-asserted-by":"crossref","unstructured":"Lepley\n              LK,\n            \n            \n              Palmieri-Smith\n              RM.\n            \n          \n          Pre-operative quadriceps activation is related to post-operative activation, not strength, in patients post-ACL reconstruction.\n\t\t\t\t\tKnee Surg Sports Traumatol 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