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在未经训练的姿势任务中,股四头肌同时进行的前馈性募集可通过物理治疗恢复。

Simultaneous feedforward recruitment of the vasti in untrained postural tasks can be restored by physical therapy.

作者信息

Cowan Sallie M, Bennell Kim L, Hodges Paul W, Crossley Kay M, McConnell Jenny

机构信息

Centre for Sports Medicine Research and Education, School of Physiotherapy, The University of Melbourne, 200 Berkeley Street, Carlton 3052, Australia.

出版信息

J Orthop Res. 2003 May;21(3):553-8. doi: 10.1016/S0736-0266(02)00191-2.

Abstract

BACKGROUND AND PURPOSE

Physical therapy rehabilitation strategies are commonly directed at the alteration of muscle recruitment in functional movements. The aim of this study was to investigate whether feedforward strategies of the vasti in people with patellofemoral pain syndrome can be changed by a physical therapy treatment program in a randomised, double blind, placebo controlled trial.

SUBJECTS

Forty (25 female, 15 male) subjects aged 40 yrs or less (27.2+/-7.8 yrs).

METHODS

Subjects were allocated to either a placebo treatment or a physical therapy intervention program. The postural challenge used as the outcome measure was not included in the training program. Electromyography (EMG) onsets of vastus medialis obliquus (VMO), vastus lateralis (VL), tibialis anterior and soleus were assessed before and after the six week standardised treatment programs.

RESULTS

At baseline the EMG onset of VL occurred prior to that of VMO in both subject groups. Following physical therapy intervention there was a significant change in the time of onset of EMG of VMO compared to VL with the onsets occurring simultaneously. This change was associated with a reduction in symptoms. In contrast, following placebo intervention the EMG onset of VL still occurred prior to that of VMO.

CONCLUSION AND DISCUSSION

The results indicate that the feedforward strategy used by the central nervous system to control the patella can be restored. Importantly, the data suggest that this intervention produced a change that was transferred to a task that was not specifically included in the training program. Furthermore, the change in motor control was associated with clinical improvement in symptoms.

摘要

背景与目的

物理治疗康复策略通常旨在改变功能性运动中的肌肉募集情况。本研究的目的是在一项随机、双盲、安慰剂对照试验中,调查物理治疗方案能否改变髌股疼痛综合征患者股四头肌的前馈策略。

受试者

40名年龄在40岁及以下(27.2±7.8岁)的受试者(25名女性,15名男性)。

方法

受试者被分配到安慰剂治疗组或物理治疗干预组。用作结果测量的姿势挑战不包含在训练方案中。在为期六周的标准化治疗方案前后,评估股内侧斜肌(VMO)、股外侧肌(VL)、胫骨前肌和比目鱼肌的肌电图(EMG)起始时间。

结果

在基线时,两个受试者组中VL的EMG起始时间均早于VMO。物理治疗干预后,与VL相比,VMO的EMG起始时间发生了显著变化,二者同时出现。这一变化与症状减轻相关。相比之下,安慰剂干预后,VL的EMG起始时间仍早于VMO。

结论与讨论

结果表明,中枢神经系统用于控制髌骨的前馈策略可以恢复。重要的是,数据表明这种干预产生的变化转移到了未专门包含在训练方案中的任务上。此外,运动控制的变化与症状的临床改善相关。

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