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髌腱贴扎治疗髌股疼痛综合征:系统评价和荟萃分析以评估临床结局和生物力学机制。

Patellar taping for patellofemoral pain: a systematic review and meta-analysis to evaluate clinical outcomes and biomechanical mechanisms.

机构信息

Complete Sports Care, , Melbourne, Australia.

出版信息

Br J Sports Med. 2014 Mar;48(6):417-24. doi: 10.1136/bjsports-2013-092437. Epub 2013 Dec 5.

DOI:10.1136/bjsports-2013-092437
PMID:24311602
Abstract

OBJECTIVE

Patellar taping is frequently used to treat patellofemoral pain (PFP). This systematic review and meta-analysis (1) evaluates the efficacy of patellar taping for patients with PFP, (2) compares the efficacy of various taping techniques and (3) identifies potential biomechanical mechanisms of action.

METHODS

The MEDLINE, CINAHL, SPORTSDiscus, Web of Science and Google Scholar databases were searched in January 2013 for studies evaluating the effects of patellar taping on pain and lower-limb biomechanics in individuals with PFP. Three independent reviewers assessed each paper for inclusion and two assessed for quality. Means and SDs were extracted from each included study to allow effect size calculations.

RESULTS

Twenty studies were identified. There is moderate evidence that (1) tailored (customised to the patient to control lateral tilt, glide and spin) and untailored patellar taping provides immediate pain reduction of large and small effect, respectively and (2) tailored patellar taping promotes earlier onset of vastus medialis oblique (VMO) contraction (relative to vastus lateralis contraction). There is limited evidence that (1) tailored patellar taping combined with exercise provides superior pain reduction compared to exercise alone at 4 weeks, (2) untailored patellar taping added to exercise at 3-12 months has no benefit and (3) tailored patellar taping promotes increased internal knee extension moments.

CONCLUSIONS

Tailoring patellar taping application (ie, to control lateral tilt, glide and spin) to optimise pain reduction is important for efficacy. Evaluation of tailored patellar taping beyond the immediate term is limited and should be a research priority. Possible mechanisms behind patellar taping efficacy include earlier VMO onset and improved knee function capacity (ie, ability to tolerate greater internal knee extension moments).

摘要

目的

髌腱贴扎常用于治疗髌股疼痛(PFP)。本系统评价和荟萃分析(1)评估了髌腱贴扎治疗 PFP 患者的疗效,(2)比较了各种贴扎技术的疗效,(3)确定了潜在的生物力学作用机制。

方法

2013 年 1 月,检索 MEDLINE、CINAHL、SPORTSDiscus、Web of Science 和 Google Scholar 数据库,评估了髌腱贴扎对 PFP 患者疼痛和下肢生物力学的影响。三位独立评审员评估每篇论文的纳入情况,两位评审员评估质量。从每个纳入的研究中提取平均值和标准差,以允许计算效应量。

结果

确定了 20 项研究。有中等证据表明(1)定制(根据患者情况定制,以控制外侧倾斜、滑动和旋转)和非定制髌腱贴扎分别即刻提供大、小效应的疼痛减轻,以及(2)定制髌腱贴扎促进股四头肌内侧头(VMO)收缩(相对于股外侧肌收缩)更早开始。有有限的证据表明(1)定制髌腱贴扎结合运动在 4 周时比单独运动提供更好的疼痛缓解,(2)3-12 个月时将非定制髌腱贴扎添加到运动中没有益处,以及(3)定制髌腱贴扎促进增加的膝关节内伸力矩。

结论

定制髌腱贴扎应用(即控制外侧倾斜、滑动和旋转)以优化疼痛缓解对于疗效很重要。对定制髌腱贴扎的即时效果以外的效果评估有限,应成为研究重点。髌腱贴扎疗效的可能机制包括 VMO 更早开始和改善膝关节功能能力(即能够耐受更大的膝关节内伸力矩)。

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