Orthopedic Physical Pherapy Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt -
Eur J Phys Rehabil Med. 2013 Oct;49(5):687-98. Epub 2013 Jul 2.
Patellofemoral pain syndrome (PFPS) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor. Isolated open kinetic chain hip abductors and lateral rotators exercises were added by many authors to the rehabilitation program. However, Closed Kinetic Chain (CKC) exercises focusing on hip and knee muscles were not investigated if they can produce similar effect of hip strengthening and decreasing pain without the need of isolated exercises for hip musculature.
The aim of the present study was to determine the effect of a CKC exercises program with or without additional hip strengthening exercises on pain and hip abductors and lateral rotators peak torque.
Prospective randomized clinical trial.
Patients with patellofemoral pain syndrome referred to the outpatient physical therapy clinic of the faculty of physical therapy, cairo university.
Thirty two patients who had patellofemoral pain syndrome with age ranged from eighteen to thirty years.
Patients were randomly assigned into two groups: CKC group and CKC with hip muscles strengthening exercises as a control (CO) group. Treatment was given 3 times/week, for 6 weeks. Patients were evaluated pre- and post-treatment for their pain severity using VAS, function of knee joint using Kujala questionnaire, hip abductors and external rotators concentric/eccentric peak torque.
There were significant improvements in pain, function and hip muscles peak torque in both groups (P<0.05). However, there was no statistically significant difference between groups in hip muscles torque (P<0.05) but pain and function improvements were significantly greater in the CO group (P<0.05).
Six weeks CKC program focusing on knee and hip strengthening has similar effect in improving hip muscles torque in patients with PFPS as a CKC exercises with additional hip strengthening exercises. However, adding isolated hip strengthening exercises has the advantage of more pain relief.
CKC exercises with additional hip strengthening could be more beneficial in decreasing pain in PFPS than CKC exercises alone.
髌股疼痛综合征（PFPS）是一种常见的肌肉骨骼疼痛疾病，尤其在女性中较为常见。有研究表明，髋关节肌肉力量下降是其发病的一个促成因素。许多作者在康复计划中增加了孤立的开链髋关节外展肌和外旋肌练习。然而，对于闭链（CKC）练习，即侧重于髋关节和膝关节肌肉的练习，尚未有研究表明它们是否可以在不需要对髋关节肌肉进行孤立练习的情况下，产生类似的增强髋关节力量和减轻疼痛的效果。
本研究旨在确定 CKC 练习方案（有或没有额外的髋关节强化练习）对疼痛和髋关节外展肌和外旋肌峰值扭矩的影响。
前瞻性随机临床试验。
患者为髌股疼痛综合征，来自开罗大学物理治疗学院的门诊物理治疗诊所。
32 名年龄在 18 至 30 岁之间的髌股疼痛综合征患者。
患者随机分为两组：CKC 组和 CKC 加髋关节肌肉强化练习作为对照组（CO 组）。治疗每周进行 3 次，持续 6 周。在治疗前后，使用视觉模拟评分（VAS）评估患者的疼痛严重程度，使用 Kujala 问卷评估膝关节功能，使用等速/等张测试评估髋关节外展肌和外旋肌的峰值扭矩。
两组患者的疼痛、功能和髋关节肌肉峰值扭矩均有显著改善（P<0.05）。然而，两组间髋关节肌肉扭矩无统计学差异（P<0.05），但 CO 组的疼痛和功能改善更为显著（P<0.05）。
为期 6 周的侧重于膝关节和髋关节强化的 CKC 方案在改善 PFPS 患者髋关节肌肉扭矩方面与 CKC 加额外髋关节强化练习具有相似的效果。然而，增加孤立的髋关节强化练习在减轻 PFPS 患者的疼痛方面具有更大的优势。
与单独进行 CKC 练习相比，在 PFPS 中，增加额外的髋关节强化练习可能更有利于减轻疼痛。
