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McConnell 打压术使髌股疼痛患者的髌骨向下移位:一项动态磁共振成像研究。

McConnell taping shifts the patella inferiorly in patients with patellofemoral pain: a dynamic magnetic resonance imaging study.

机构信息

Department of Orthopaedics, University of Miami, Miami, Florida, USA.

出版信息

Phys Ther. 2010 Mar;90(3):411-9. doi: 10.2522/ptj.20080365. Epub 2010 Jan 28.

Abstract

BACKGROUND

Patellar taping is widely used clinically to treat patients with patellofemoral pain syndrome (PFPS). Although patellar taping has been demonstrated to reduce patellofemoral pain in patients with PFPS, the kinematic source for this pain reduction has not been identified.

OBJECTIVE

The purpose of this study was to quantify the changes in the 6-degrees-of-freedom patellofemoral kinematics due to taping in patients with PFPS.

DESIGN

A within-subject design and a sample of convenience were used.

PARTICIPANTS

Fourteen volunteers (19 knees) who were diagnosed with patellofemoral pain that was present for a year or longer were included. Each knee had to meet at least 1 of the following inclusion criteria: Q-angle of > or =15 degrees, a positive apprehension test, patellar lateral hypermobility (> or =10 mm), or a positive "J sign."

METHODS

Each knee underwent 2 randomly ordered testing conditions (untaped and taped). A full fast-phase contrast (PC) magnetic resonance image set was acquired for each condition while the participants volitionally extended and flexed their knee. Three-dimensional displacements and rotations were calculated through integration of the fast-PC velocity data. Statistical comparisons between baseline patellofemoral kinematics and the change in kinematics due to taping were performed using a 2-tailed paired Student t test. Correlations between baseline patellofemoral kinematics and the change in kinematics due to taping also were quantified.

RESULTS

Patellar taping resulted in a significant patellofemoral inferior shift. The strongest correlation existed between the change in lateral-medial displacement with taping and baseline (r=-.60).

CONCLUSIONS

The inferior shift in patellar displacement with taping partially explains the previously documented decrease in pain due to increases in contact area. The lack of alteration in 5 of the 6 kinematic variables with taping may have been due to the fact that post-taping kinematic alterations are sensitive to the baseline kinematic values.

摘要

背景

髌腱贴扎在临床上被广泛用于治疗髌股疼痛综合征(PFPS)患者。虽然髌腱贴扎已被证明可以减轻 PFPS 患者的髌股疼痛,但这种疼痛减轻的运动学来源尚未确定。

目的

本研究旨在量化髌腱贴扎对 PFPS 患者髌股运动学的 6 自由度变化。

设计

采用自身对照设计和方便样本。

参与者

14 名志愿者(19 个膝关节)被诊断为髌股疼痛,持续时间超过 1 年。每个膝关节必须符合以下至少 1 项纳入标准:Q 角≥15 度、前抽屉试验阳性、髌骨外侧过度活动(>10mm)或“J 征”阳性。

方法

每个膝关节接受 2 种随机顺序的测试条件(未贴扎和贴扎)。在参与者自愿伸展和弯曲膝关节时,对每个条件采集一组完整的快速相对比(PC)磁共振图像。通过快速 PC 速度数据的积分计算三维位移和旋转。使用双侧配对学生 t 检验对基线髌股运动学与贴扎引起的运动学变化进行统计比较。还量化了基线髌股运动学与贴扎引起的运动学变化之间的相关性。

结果

髌腱贴扎导致髌股明显向下移位。与贴扎相关的外侧-内侧位移变化与基线之间的相关性最强(r=-.60)。

结论

髌腱贴扎导致髌骨位移向下移位,这部分解释了先前记录的由于接触面积增加而导致的疼痛减轻。在贴扎后,6 个运动学变量中有 5 个没有改变,这可能是因为贴扎后运动学改变对基线运动学值敏感。

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