Mason Marjon, Keays Susan L, Newcombe Peter A
Physiother Res Int. 2011 Jun;16(2):109-19. doi: 10.1002/pri.486. Epub 2010 Jul 14.
Quadriceps strengthening, quadriceps stretching and patellar taping are commonly prescribed together for patellofemoral pain patients. This study aimed to examine the effectiveness of each of these techniques in isolation for one week and in combination for one week.
A prospective double-blind randomized control study was designed involving 41 subjects with 60 knees diagnosed with patellofemoral pain. The knees were randomized in onto one of four groups (n = 15): infrapatellar taping, quadriceps strengthening, quadriceps stretching and control. The taping was worn continually for the week; the strengthening group followed a programme of non-weight-bearing terminal range quadriceps exercises, the stretching group performed rectus femoris stretches. The control group did not receive treatment. All subjects received advice. Seven pre- and post-treatment measures included isokinetic quadriceps strength, quadriceps length, pain measured during four activities and maximum eccentric, posturally controlled, pain-free knee flexion angle during a step-down. Results showed significant changes over time (p < 0.01) in two out of seven measures for the taping group, in five out of seven for the strengthening group and five out of seven for the stretching group and none in the control group. When the three modalities were combined for one week, (n = 60) all seven measures improved significantly (p < 0.01).
In isolation, quadriceps stretching and quadriceps strengthening resulted in more improvements than taping. Combining these treatments is recommended as the initial approach to treating patellofemoral pain but further individualized more functional, global treatment is essential.
对于髌股关节疼痛患者，通常会同时开具股四头肌强化训练、股四头肌拉伸以及髌骨贴扎治疗。本研究旨在分别考察这三种技术单独应用一周以及联合应用一周的效果。
设计了一项前瞻性双盲随机对照研究，纳入41名受试者共60个被诊断为髌股关节疼痛的膝关节。这些膝关节被随机分为四组之一（n = 15）：髌下贴扎组、股四头肌强化训练组、股四头肌拉伸组以及对照组。贴扎组连续佩戴一周；强化训练组进行非负重终末范围的股四头肌锻炼计划，拉伸组进行股直肌拉伸。对照组不接受治疗。所有受试者均接受了建议。治疗前后的七项测量指标包括等速股四头肌力量、股四头肌长度、四项活动期间测量的疼痛以及下台阶时最大离心、姿势控制、无痛膝关节屈曲角度。结果显示，贴扎组七项测量指标中有两项随时间有显著变化（p < 0.01），强化训练组七项中有五项，拉伸组七项中有五项，而对照组则无变化。当三种方式联合应用一周时（n = 60），所有七项测量指标均有显著改善（p < 0.01）。
单独应用时，股四头肌拉伸和股四头肌强化训练比贴扎带来的改善更多。建议将这些治疗方法联合应用作为治疗髌股关节疼痛的初始方法，但进一步的个体化、更具功能性的整体治疗至关重要。
