Department of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Piazzale Aldo Moro 5, 00185 Rome, Italy.
Clin Rheumatol. 2012 Mar;31(3):535-9. doi: 10.1007/s10067-011-1883-2. Epub 2011 Nov 3.
Patellofemoral pain syndrome (PFPS) is a common source of anterior knee pain. While treatment for PFPS may be successful in the short term, long-term results are less promising. The purpose of this study was to record long-term pain and functionality outcomes following rehabilitation in patients affected by PFPS. A prospective cohort study of 44 patients with a diagnosis of PFPS and an activation imbalance between the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles were enrolled. Patients underwent patellar taping (2 weeks) followed by a rehabilitation program lasting until the end of the third month. Primary outcome measures were pain and the functional level of the patellofemoral joint. Secondary outcome measures were surface electromyographic (sEMG) onset timing of the VMO/VL during seated knee extension and squat and isometric knee extensor muscle strength. Significant differences in all the outcome measures were observed between the affected and unaffected sides before treatment. The pain score significantly decreased both posttreatment (Δ = -4.7; 95% CI = -5.4 to -3.9) and at the 12-month follow-up (Δ = -5.5; 95% CI = -6.1 to -4.8), while the functional level significantly increased both posttreatment (Δ = 24; 95% CI = 18.3 to 30.2) and at the 12-month follow-up (Δ = 26; 95% CI = 21.4 to 30.6). Posttreatment, 35/44 patients (79.5%) and 31/44 patients (70.5%) achieved normal sEMG onset timing of the VMO and VL in the seated knee extension exercise and in the squat exercise, respectively. A short period of patellar taping followed by an exercise program results in long-lasting pain control in PFPS associated with muscular dysfunction.
髌股疼痛综合征（PFPS）是膝关节前侧疼痛的常见原因。虽然 PFPS 的短期治疗可能有效，但长期结果并不理想。本研究旨在记录接受 PFPS 康复治疗的患者的长期疼痛和功能结果。对 44 例诊断为 PFPS 且股四头肌内侧头（VMO）和股外侧肌（VL）之间激活失衡的患者进行前瞻性队列研究。患者接受髌腱贴扎（2 周），然后进行持续至第 3 个月结束的康复计划。主要结局指标为疼痛和髌股关节的功能水平。次要结局指标为坐位膝关节伸展和深蹲时 VMO/VL 的表面肌电图（sEMG）起始时间和等长膝关节伸肌肌力。治疗前患侧和健侧所有结局指标均有显著差异。治疗后疼痛评分显著降低（Δ=-4.7；95%CI=-5.4 至-3.9），12 个月随访时疼痛评分显著降低（Δ=-5.5；95%CI=-6.1 至-4.8），功能水平显著提高（治疗后Δ=24；95%CI=18.3 至 30.2），12 个月随访时功能水平显著提高（Δ=26；95%CI=21.4 至 30.6）。治疗后，35/44 例（79.5%）和 31/44 例（70.5%）患者在坐位膝关节伸展运动和深蹲运动中 VMO 和 VL 的 sEMG 起始时间分别恢复正常。髌腱贴扎短期治疗后，辅以运动方案，可长期控制 PFPS 相关的肌肉功能障碍性疼痛。
