Graci Valentina, Salsich Gretchen B
University of Maryland School of Medicine, Department of Neurology, USA.
Musculoskeletal Movement Science Laboratory, Department of Physical Therapy and Athletic Training, Saint Louis University, USA.
J Sci Med Sport. 2015 May;18(3):343-7. doi: 10.1016/j.jsams.2014.04.011. Epub 2014 Apr 26.
To understand how instructing females with patellofemoral pain to correct dynamic knee valgus affects pelvis, femur, tibia and trunk segment kinematics. To determine if pain reduction in the corrected condition was associated with improved segment kinematics.
Cross-sectional.
A 3D-motion capture system was used to collect multi-joint kinematics on 20 females with dynamic knee valgus and patellofemoral pain during a single-leg squat in two conditions: usual movement pattern, and corrected dynamic knee valgus. During each condition pain was assessed using a visual analog scale. Pelvis, femur, tibia and trunk kinematics in the frontal and transverse planes were compared between conditions using a paired T-test. Pearson correlation coefficients were generated between visual analog scale score and the kinematic variables in the corrected condition.
In the corrected condition subjects had increased lateral flexion of the pelvis toward the weight-bearing limb (p<0.001), decreased femoral adduction (p=0.001) and internal rotation (p=0.01). A trend toward decreased tibial internal rotation (p=0.057) and increased trunk lateral flexion toward the weight-bearing limb (p=0.055) was also found. Lower pain levels were associated with less femoral internal rotation (p=0.04) and greater trunk lateral flexion toward the weight-bearing limb (p=0.055).
Decreased hip adduction after instruction was comprised of motion at both the pelvis and femur. Decreased pain levels were associated with lower extremity segment kinematics moving in the direction opposite to dynamic knee valgus. These results increase our understanding of correction strategies used by females with patellofemoral pain and provide insight for rehabilitation.
了解指导患有髌股疼痛的女性纠正动态膝外翻如何影响骨盆、股骨、胫骨和躯干节段的运动学。确定纠正状态下疼痛减轻是否与节段运动学改善相关。
横断面研究。
使用三维运动捕捉系统，在两种情况下收集20名患有动态膝外翻和髌股疼痛的女性单腿深蹲时的多关节运动学数据：通常的运动模式和纠正后的动态膝外翻。在每种情况下，使用视觉模拟量表评估疼痛程度。使用配对t检验比较两种情况下骨盆、股骨、胫骨和躯干在额面和横面的运动学。在纠正状态下，生成视觉模拟量表评分与运动学变量之间的皮尔逊相关系数。
在纠正状态下，受试者向负重肢体侧的骨盆侧屈增加（p<0.001），股骨内收（p=0.001）和内旋减少（p=0.01）。还发现胫骨内旋有减少趋势（p=0.057），向负重肢体侧的躯干侧屈增加（p=0.055）。较低的疼痛水平与较少的股骨内旋（p=0.04）和向负重肢体侧更大的躯干侧屈（p=0.055）相关。
指导后髋内收减少包括骨盆和股骨的运动。疼痛水平降低与下肢节段运动学朝着与动态膝外翻相反的方向移动有关。这些结果增进了我们对患有髌股疼痛的女性所采用的纠正策略的理解，并为康复提供了见解。
