Thomson Catherine, Krouwel Oliver, Kuisma Raija, Hebron Clair
University of Brighton, Health Sciences, Robert Dodd Building, 49 Darley Road, Eastbourne BN20 7UR, UK.
University of Brighton, Health Sciences, Robert Dodd Building, 49 Darley Road, Eastbourne BN20 7UR, UK.
Man Ther. 2016 Dec;26:1-30. doi: 10.1016/j.math.2016.06.003. Epub 2016 Jun 11.
Patellofemoral pain (PFP) is one of the most common lower extremity conditions seen in clinical practice. Current evidence shows that there are hip strength deficits, delayed onset and shorter activation of gluteus medius in people with PFP. The aim of this review was to systematically review the literature to investigate the outcome of hip exercise in people with PFP.
AMED, CINAHL, Cochrane, EMBASE, PEDro, Pubmed, Science direct and SPORTDiscus databases were searched from inception to November 2014 for RCTs, non-randomised studies and case studies. Two independent reviewers assessed each paper for inclusion and quality.
Twenty one papers were identified; eighteen investigating strengthening exercise, two investigating the effect of neuromuscular exercise and one study investigated the effect of hip exercise for the prevention of PFP. Hip and knee strengthening programmes were shown to be equally effective. Limited evidence indicates that the addition of hip exercise to an exercise programme is beneficial. Limited evidence demonstrates that motor skill retraining in a participant group who displayed abnormal hip alignment in running improves pain.
The evidence consistently demonstrated that both hip strengthening and neuromuscular exercise has a beneficial effect on pain and function in people with PFP. Strengthening exercise predominantly addressed abductor and external rotator muscle groups. A consensus from PFP researchers for standardisation of methodology is recommended to enable meaningful comparison between trials.
髌股疼痛（PFP）是临床实践中最常见的下肢病症之一。目前的证据表明，PFP患者存在髋部力量不足、臀中肌延迟激活和激活时间缩短的情况。本综述的目的是系统回顾文献，以研究髋部运动对PFP患者的治疗效果。
检索了AMED、CINAHL、Cochrane、EMBASE、PEDro、Pubmed、Science direct和SPORTDiscus数据库，检索时间从建库至2014年11月，检索内容包括随机对照试验、非随机研究和病例研究。两名独立评审员评估每篇论文是否纳入及质量。
共识别出21篇论文；18篇研究强化运动，2篇研究神经肌肉运动的效果，1篇研究髋部运动对预防PFP的效果。髋部和膝部强化训练计划显示出同等效果。有限的证据表明，在运动计划中增加髋部运动有益。有限的证据表明，对跑步时髋部 alignment异常的参与者组进行运动技能再训练可改善疼痛。
证据一致表明，髋部强化训练和神经肌肉运动对PFP患者的疼痛和功能均有有益影响。强化运动主要针对外展肌和外旋肌肌群。建议PFP研究人员就方法标准化达成共识，以便能够在试验之间进行有意义的比较。
