关节源性肌肉抑制与股四头肌激活失败：协调不同恢复阶段的术语和临床观点
简介
这篇评论指出，ACL损伤及重建后常见股四头肌激活失败，但主张用该术语替代关节源性肌肉抑制，因其不预设机制且更贴合疼痛、废用、疲劳及心理等多因素影响。作者按程度和时间演变提出严重、显著和持续三种表现，分别对应急性/术后、康复期及重返运动后仍可检出。该框架有助于临床沟通、个体化康复和恢复监测。
英文摘要
Quadriceps activation failure, defined as the inability to fully activate the quadriceps during a maximal voluntary contraction, is a common consequence of anterior cruciate ligament injury and reconstruction. Although often attributed to arthrogenic muscle inhibition, activation deficits are likely influenced by a broader range of factors, including pain, disuse, fatigue and psychological influences. This commentary argues that the term quadriceps activation failure (or deficit) is preferable to arthrogenic muscle inhibition because it describes the clinical phenomenon without presuming a specific underlying mechanism and better reflects the multifactorial nature of impaired quadriceps activation. This commentary also proposes a clinically relevant framework that recognises three manifestations of quadriceps activation failure based on its magnitude and temporal evolution following anterior cruciate ligament injury and reconstruction: severe, substantial and persistent. Severe quadriceps activation failure typically occurs during the acute postinjury and postoperative phases, substantial activation failure characterises much of the rehabilitation period and persistent failure may remain detectable despite recovery of strength and return to sport. Recognising these distinct forms of quadriceps activation failure may facilitate communication among clinicians and researchers, support individualised rehabilitation strategies and enhance monitoring of recovery. Although illustrated in the context of anterior cruciate ligament injury, this framework may also be relevant to other musculoskeletal conditions associated with activation deficits. LEVEL OF EVIDENCE: N/A.