Ribeiro Alessandra de Castro Souza, Grossi Débora B, Foerster Bernd, Candolo Cecília, Monteiro-Pedro Vanessa
Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.
Rev Bras Fisioter. 2010 May-Jun;14(3):221-8.
To analyze the electrical activity of the vastus medialis obliquus (VMO), vastus lateralis longus (VLL) and vastus lateralis obliquus (VLO) muscles of individuals with patellofemoral pain syndrome (PFPS) during maximum voluntary isometric contraction (MVIC) of lower leg extension with the knee at 30 degrees; to assess pain using a visual analogue scale (VAS); and to assess patellar positioning using magnetic resonance imaging (MRI).
Twelve women with PFPS and 12 clinically normal women were evaluated. They performed five MVICs of lower leg extension at 30 degrees for electromyographic (EMG) analysis. Using MRI, the sulcus angle (SA), congruence angle (CA), patellar tilt angle (PTA) and patellar displacement (PD) were obtained. The following statistical tests were used: analysis of variance (ANOVA) for repeated measurements to assess EMGs; Mann-Whitney U test to analyze MRIs; Pearson's (r) correlation test between EMGs and MRIs; and one-way ANOVA to evaluate pain (p < or = 0.05).
In the PFPS group, there was greater electrical activity in the VLL than in the VMO. In both groups, there was greater electrical activity in the VMO and VLL than in the VLO. In the PFPS group, the MRI showed higher SA and lower CA values, and there was a negative correlation between the VMO and the PTA.
The data suggest that, in individuals with PFPS, greater electrical activity in the VLL combined with an increased SA and a decreased CA may contribute to patellar instability.
分析髌股疼痛综合征(PFPS)患者在膝关节处于30度时进行最大自主等长收缩(MVIC)小腿伸展过程中,股内侧斜肌(VMO)、股外侧长肌(VLL)和股外侧斜肌(VLO)的电活动;使用视觉模拟量表(VAS)评估疼痛;并使用磁共振成像(MRI)评估髌骨位置。
对12名患有PFPS的女性和12名临床正常的女性进行评估。她们在30度时进行五次小腿伸展的MVIC以进行肌电图(EMG)分析。使用MRI获得沟角(SA)、重合角(CA)、髌骨倾斜角(PTA)和髌骨位移(PD)。使用以下统计测试:重复测量方差分析(ANOVA)以评估EMG;Mann-Whitney U检验分析MRI;EMG与MRI之间的Pearson(r)相关性检验;以及单向ANOVA评估疼痛(p≤0.05)。
在PFPS组中,VLL的电活动比VMO更大。在两组中,VMO和VLL的电活动都比VLO更大。在PFPS组中,MRI显示SA值较高且CA值较低,并且VMO与PTA之间存在负相关。
数据表明,在患有PFPS的个体中,VLL中更大的电活动与SA增加和CA降低相结合可能导致髌骨不稳定。