Dierks Tracy A, Manal Kurt T, Hamill Joseph, Davis Irene S
Department of Physical Therapy, Indiana University, Indianapolis, IN 46202, USA.
J Orthop Sports Phys Ther. 2008 Aug;38(8):448-56. doi: 10.2519/jospt.2008.2490. Epub 2008 Aug 1.
Cross-sectional experimental laboratory study.
To investigate the relationships between hip strength and hip kinematics, and between arch structure and knee kinematics during prolonged treadmill running in runners with and without patellofemoral pain syndrome (PFPS).
Hip weakness can lead to excessive femoral motions that adversely affect patellofemoral joint mechanics. Similarly, foot mechanics, which are influenced by foot structure, are also known to influence patellofemoral joint mechanics. Thus, proximal and distal factors should be considered when studying individuals with PFPS.
Twenty recreational runners with PFPS (5 male, 15 female) and 20 matched uninjured runners participated in the study. Hip abduction and hip external rotation isometric strength measurements were collected before and after a prolonged run, while the arch height index was recorded on all runners before the run. Lower extremity kinematic data were collected at the beginning and end of the run. Two-way repeated-measures analyses of variance (ANOVAs) were used for analysis.
Both groups displayed decreases in hip abductor and external rotator strengths at the end of the run. The PFPS group displayed significantly lower hip abduction strength [(kg x cm)/body mass] compared to controls (PFPS group: begin 15.3, end 13.5; uninjured group: begin 17.3, end 15.4). At the end of the run, the level of association between hip abduction strength and the peak hip adduction angle for the PFPS group was statistically significant, indicating a strong relationship (r = -0.74). No other associations with hip strength were observed in either group. Arch height did not differ between groups and no significant association was observed between arch height and peak knee adduction angle during running.
Runners with PFPS displayed weaker hip abductor muscles that were associated with an increase in hip adduction during running. This relationship became more pronounced at the end of the run.
Therapy, level 5.
横断面实验性实验室研究。
探讨有和没有髌股疼痛综合征（PFPS）的跑步者在长时间跑步机跑步过程中，髋部力量与髋部运动学之间的关系，以及足弓结构与膝部运动学之间的关系。
髋部无力会导致股骨过度运动，对髌股关节力学产生不利影响。同样，受足部结构影响的足部力学也已知会影响髌股关节力学。因此，在研究患有PFPS的个体时，应考虑近端和远端因素。
20名患有PFPS的休闲跑步者（5名男性，15名女性）和20名匹配的未受伤跑步者参与了该研究。在长时间跑步前后收集髋外展和髋外旋等长力量测量数据，同时在跑步前记录所有跑步者的足弓高度指数。在跑步开始和结束时收集下肢运动学数据。采用双向重复测量方差分析进行分析。
两组在跑步结束时髋外展肌和外旋肌力量均下降。与对照组相比，PFPS组的髋外展力量[(kg×cm)/体重]显著更低（PFPS组：开始时15.3，结束时13.5；未受伤组：开始时17.3，结束时15.4）。在跑步结束时，PFPS组髋外展力量与髋内收峰值角度之间的关联水平具有统计学意义，表明存在强相关性（r = -0.74）。两组均未观察到与髋部力量的其他关联。两组之间足弓高度无差异，且在跑步过程中足弓高度与膝内收峰值角度之间未观察到显著关联。
患有PFPS的跑步者髋外展肌较弱，这与跑步过程中髋内收增加有关。这种关系在跑步结束时变得更加明显。
治疗，5级。
