Song Chen-Yi, Lin Yeong-Fwu, Wei Tung-Ching, Lin Da-Hon, Yen Tzu-Yu, Jan Mei-Hwa
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Phys Ther. 2009 May;89(5):409-18. doi: 10.2522/ptj.20080195. Epub 2009 Mar 19.
A common treatment for patients with patellofemoral pain syndrome (PFPS) is strength (force-generating capacity) training of the vastus medialis oblique muscle (VMO). Hip adduction in conjunction with knee extension is commonly used in clinical practice; however, evidence supporting the efficacy of this exercise is lacking.
The objective of this study was to determine the surplus effect of hip adduction on the VMO.
This study was a randomized controlled trial.
The study was conducted in a kinesiology laboratory.
Eighty-nine patients with PFPS participated.
Participants were randomly assigned to 1 of 3 groups: hip adduction combined with leg-press exercise (LPHA group), leg-press exercise only (LP group), or no exercise (control group). Training consisted of 3 weekly sessions for 8 weeks.
Ratings of worst pain as measured with a 100-mm visual analog scale (VAS-W), Lysholm scale scores, and measurements of VMO morphology (including cross-sectional area [CSA] and volume) were obtained before and after the intervention.
Significant improvements in VAS-W ratings, Lysholm scale scores, and VMO CSA and volume were observed after the intervention in both exercise groups, but not in the control group. Significantly greater improvements for VAS-W ratings, Lysholm scale scores, and VMO volume were apparent in the LP group compared with the control group. There were no differences between the LP and LPHA groups for any measures.
Only the VMO was examined by ultrasonography. The resistance level for hip adduction and the length of intervention period may have been inadequate to induce a training effect.
Similar changes in pain reduction, functional improvement, and VMO hypertrophy were observed in both exercise groups. Incorporating hip adduction with leg-press exercise had no impact on outcome in patients with PFPS.
髌股疼痛综合征（PFPS）患者的一种常见治疗方法是股内侧斜肌（VMO）力量（产生力的能力）训练。在临床实践中，通常将髋关节内收与膝关节伸展结合使用；然而，缺乏支持这种锻炼效果的证据。
本研究的目的是确定髋关节内收对VMO的额外影响。
本研究为随机对照试验。
研究在运动机能学实验室进行。
89名PFPS患者参与。
参与者被随机分配到3组中的1组：髋关节内收结合腿举运动（LPHA组）、仅腿举运动（LP组）或不运动（对照组）。训练包括每周3次，共8周。
在干预前后，采用100毫米视觉模拟量表（VAS-W）测量最严重疼痛程度、Lysholm量表评分，并测量VMO形态（包括横截面积[CSA]和体积）。
两个运动组在干预后，VAS-W评分、Lysholm量表评分以及VMO的CSA和体积均有显著改善，但对照组没有。与对照组相比，LP组在VAS-W评分、Lysholm量表评分和VMO体积方面有明显更大的改善。LP组和LPHA组在任何测量指标上均无差异。
仅通过超声检查VMO。髋关节内收的阻力水平和干预期的长度可能不足以产生训练效果。
两个运动组在疼痛减轻、功能改善和VMO肥大方面观察到相似的变化。将髋关节内收与腿举运动相结合对PFPS患者的治疗结果没有影响。
