Akseki Devrim, Akkaya Gökhan, Erduran Mehmet, Pinar Halit
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Celal Bayar University, Manisa, Turkey.
Acta Orthop Traumatol Turc. 2008 Nov-Dec;42(5):316-21. doi: 10.3944/aott.2008.316.
The importance of proprioception in the etiology, treatment, and prevention of sports injuries and joint diseases has become increasingly clear. The purpose of this study was to investigate knee proprioception in patients with patellofemoral pain syndrome (PFPS).
The study included 28 patients (18 females, 10 males; mean age 28 years; range 16 to 48 years) with a clinical diagnosis of unilateral PFPS and 27 normal volunteers (13 females, 14 males; mean age 26 years; range 19 to 32 years) without any complaint related to the knee. The mean duration of complaints was 35.8 weeks (range 2 weeks to 3 years). In both patient and control groups, proprioception of the knee was measured by means of active joint position sense at four different target angles (15 degrees , 30 degrees , 45 degrees , 60 degrees ) with the use of a digital goniometer and the results were compared.
Proprioceptive errors were greater at all target angles in the affected knees compared to those measured in the contralateral knees and both knees of the controls. Differences between affected knees and contralateral knees ranged from 1.01+/-0.25 degrees to 1.65+/-0.43 degrees and were significant at three target angles (15 degrees , 30 degrees , 60 degrees ; p<0.05). Comparisons between the affected knees and both knees of the controls also showed significant differences at all target angles ranging from 2.48+/-0.92 degrees to 3.87+/-2.46 degrees (p<0.001). Errors obtained in the normal knees of the patients were also significantly greater compared to those seen in both knees of the controls, exceeding 2.7 degrees at some target angles (p<0.001).
Our results show that patients with PFPS have impaired proprioception in the affected knee accompanied by significant losses in the proprioception of the contralateral normal knee. Based on these findings, proprioceptive rehabilitation techniques should be incorporated into the treatment of PFPS.
本体感觉在运动损伤和关节疾病的病因、治疗及预防中的重要性已日益明确。本研究旨在调查髌股疼痛综合征(PFPS)患者的膝关节本体感觉。
本研究纳入了28例临床诊断为单侧PFPS的患者(18例女性,10例男性;平均年龄28岁;范围16至48岁)以及27名无任何膝关节相关主诉的正常志愿者(13例女性,14例男性;平均年龄26岁;范围19至32岁)。主诉的平均持续时间为35.8周(范围2周至3年)。在患者组和对照组中,均使用数字测角仪通过主动关节位置觉在四个不同目标角度(15度、30度、45度、60度)测量膝关节的本体感觉,并对结果进行比较。
与对侧膝关节及对照组的双侧膝关节相比,患侧膝关节在所有目标角度的本体感觉误差均更大。患侧膝关节与对侧膝关节之间的差异范围为1.01±0.25度至1.65±0.43度,在三个目标角度(15度、30度、60度;p<0.05)具有显著性。患侧膝关节与对照组的双侧膝关节之间的比较在所有目标角度也显示出显著差异,范围为2.48±0.92度至3.87±2.46度(p<0.001)。患者正常膝关节所获得的误差与对照组双侧膝关节相比也显著更大,在某些目标角度超过2.7度(p<0.001)。
我们的结果表明,PFPS患者患侧膝关节的本体感觉受损,同时对侧正常膝关节的本体感觉也有显著丧失。基于这些发现,本体感觉康复技术应纳入PFPS的治疗中。