Baldon Rodrigo de Marche, Piva Sara Regina, Scattone Silva Rodrigo, Serrão Fábio Viadanna
Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil.
Department of Physical Therapy University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Am J Sports Med. 2015 Jun;43(6):1485-93. doi: 10.1177/0363546515574690. Epub 2015 Mar 19.
Altered movement patterns of the trunk and lower limbs have been associated with patellofemoral pain (PFP). It has been assumed that increasing the strength of the hip and trunk muscles would improve lower limb and trunk kinematics in these patients. However, evidence in support of that assumption is limited.
To determine whether increases in the strength of hip muscles and endurance of trunk muscles in response to functional stabilization training will mediate changes in frontal plane lower limb kinematics in patients with PFP.
Controlled laboratory study.
Thirty-one female athletes were randomized to either a functional stabilization training group that emphasized strengthening of the trunk and hip muscles or a standard training group that emphasized stretching and quadriceps strengthening. Patients attended a baseline assessment session, followed by 8 weeks of intervention, and were then reassessed at the end of the intervention period. The potential mediators that were evaluated included eccentric torque of hip muscles and endurance of the trunk muscles. The outcome variables were the lower limb and trunk kinematics in the frontal plane assessed during a single-legged squat task.
The eccentric strength of the gluteus muscles showed a mediation effect ranging from 18% to 32% on changes to frontal plane kinematics (decreased ipsilateral trunk inclination, pelvis contralateral depression, and hip adduction excursions) observed in the functional stabilization training group after intervention.
Although the mediation effects were small, the results suggest that improvements in the strength of the gluteus muscles can influence the frontal plane movement patterns of the lower limb and trunk in women with PFP.
Patients with PFP might benefit from strengthening of the hip muscles to improve frontal plane lower limb and trunk kinematics during functional tasks.
躯干和下肢运动模式的改变与髌股疼痛（PFP）有关。据推测，增强髋部和躯干肌肉力量可改善这些患者的下肢和躯干运动学。然而，支持该假设的证据有限。
确定功能性稳定训练后髋部肌肉力量的增加和躯干肌肉耐力的提高是否会介导PFP患者额面下肢运动学的变化。
对照实验室研究。
31名女性运动员被随机分为功能性稳定训练组（强调躯干和髋部肌肉强化）或标准训练组（强调拉伸和股四头肌强化）。患者参加基线评估，随后进行8周干预，然后在干预期结束时重新评估。评估的潜在中介因素包括髋部肌肉的离心扭矩和躯干肌肉的耐力。结果变量是单腿深蹲任务期间评估的额面下肢和躯干运动学。
臀肌的离心力量对功能性稳定训练组干预后观察到的额面运动学变化（同侧躯干倾斜度降低、对侧骨盆下降和髋内收偏移）的中介效应为18%至32%。
尽管中介效应较小，但结果表明臀肌力量的改善可影响PFP女性患者下肢和躯干的额面运动模式。
PFP患者可能受益于髋部肌肉强化，以改善功能任务期间的额面下肢和躯干运动学。
