Khoshkhoo M, Killingback A, Robertson C J, Adds P J
Institute of Medical and Biomedical Education (Anatomy), St George's, University of London, London, United Kingdom.
Department of Medical Physics and Clinical Engineering, St George's Healthcare NHS Trust, London, United Kingdom.
Clin Anat. 2016 Sep;29(6):752-8. doi: 10.1002/ca.22710. Epub 2016 Apr 9.
The vastus medialis oblique (VMO) is thought to be implicated in patellofemoral pain (PFP), and weakness in this portion of the vastus medialis muscle may lead to PFP. Management includes physiotherapy to strengthen the VMO. Although this intervention has been shown to be effective, the effects on the architecture of the muscle have not been investigated. This study aims to determine the changes in VMO architecture following a program of strengthening exercises. Twenty-one male participants underwent an initial ultrasound scan to measure the fiber angle and the insertion level of the VMO on the patella. Each subject then undertook a 6-week quadriceps femoris strengthening program; the scan and measurements were then repeated. A significant increase in VMO fiber angle and insertion length was observed. Average fiber angle increased by 5.24°; average insertion length increased by 2.7 mm. There was found to be a significant negative correlation between the initial values and the degree of change. Pearson's coefficient of correlation for measurements of patella length taken before and after exercise was 0.921, indicating a high degree of reliability. There was a significant positive correlation between fiber angle change and declared level of compliance (R(2) = 0.796). The results reported here indicate that physiotherapy leads to a significant change in VMO morphology. Given the inverse correlation noted between initial architectural parameters and the degree of change, we suggest that patients who would benefit most from physiotherapy can be identified in clinic using a simple ultrasound technique. Clin. Anat. 29:752-758, 2016. © 2016 Wiley Periodicals, Inc.
股内侧斜肌（VMO）被认为与髌股关节疼痛（PFP）有关，股内侧肌这一部分的无力可能导致PFP。治疗方法包括通过物理治疗来增强VMO。尽管这种干预已被证明是有效的，但对肌肉结构的影响尚未得到研究。本研究旨在确定强化训练计划后VMO结构的变化。21名男性参与者接受了首次超声扫描，以测量VMO在髌骨上的纤维角度和附着水平。然后，每个受试者进行了为期6周的股四头肌强化训练计划；之后再次进行扫描和测量。观察到VMO纤维角度和附着长度有显著增加。平均纤维角度增加了5.24°；平均附着长度增加了2.7毫米。发现初始值与变化程度之间存在显著的负相关。运动前后髌骨长度测量的Pearson相关系数为0.921，表明可靠性程度很高。纤维角度变化与宣称的依从水平之间存在显著的正相关（R(2) = 0.796）。此处报告的结果表明，物理治疗会导致VMO形态发生显著变化。鉴于初始结构参数与变化程度之间存在负相关，我们建议在临床上可以使用一种简单的超声技术来识别那些从物理治疗中获益最大的患者。《临床解剖学》2016年第29卷：752 - 758页。© 2016威利期刊公司。
