Hamstra-Wright Karrie L, Aydemir Burcu, Earl-Boehm Jennifer, Bolgla Lori, Emery Carolyn, Ferber Reed
J Sport Rehabil. 2017 Jul;26(4):223-233. doi: 10.1123/jsr.2015-0176. Epub 2016 Aug 24.
BACKGROUND/OBJECTIVE: Hip- and knee-muscle-strengthening programs are effective in improving short-term patient-reported and disease-oriented outcomes in individuals with patellofemoral pain (PFP), but few to no data exist on moderate- to long-term postrehabilitative outcomes. The first purpose of the study was to assess differences in pain, function, strength, and core endurance in individuals with PFP before, after, and 6 mo after successful hip- or knee-muscle-strengthening rehabilitation. The second purpose was to prospectively follow these subjects for PFP recurrence at 6, 12, and 24 mo postrehabilitation.
For 24 mo postrehabilitation, 157 physically active subjects with PFP who reported treatment success were followed. At 6 mo postrehabilitation, pain, function, hip and knee strength, and core endurance were measured. At 6, 12, 18, and 24 mo, PFP recurrence was measured via electronic surveys.
Sixty-eight subjects (43%) returned to the laboratory at 6 mo. Regardless of rehabilitation program, subjects experienced significant improvements in pain and function, strength, and core endurance pre- to postrehabilitation and maintained improvements in pain and function 6 mo postrehabilitation (Visual Analog Scale/Pain-pre 5.12 ± 1.33, post 1.28 ± 1.14, 6 mo 1.68 ± 2.16 cm, P < .05; Anterior Knee Pain Scale/Function-pre 76.38 ± 8.42, post 92.77 ± 7.36, 6 mo 90.27 ± 9.46 points, P < .05). Over the 24 mo postrehabilitation, 5.10% of subjects who responded to the surveys reported PFP recurrence.
The findings support implementing a hip-or knee-muscle-strengthening program for the treatment of PFP. Both programs improve pain, function, strength, and core endurance in the short term with moderate- and long-term benefits of improved pain and function and low PFP recurrence.
背景/目的:髋部和膝部肌肉强化训练计划对于改善髌股疼痛(PFP)患者的短期患者报告结局和疾病导向结局有效,但关于康复后中长期结局的数据很少甚至没有。本研究的首要目的是评估成功进行髋部或膝部肌肉强化康复前、康复后及康复后6个月时PFP患者在疼痛、功能、力量和核心耐力方面的差异。第二个目的是前瞻性地随访这些受试者在康复后6个月、12个月和24个月时PFP复发情况。
在康复后的24个月内,对157名报告治疗成功的有身体活动能力的PFP受试者进行随访。在康复后6个月时,测量疼痛、功能、髋部和膝部力量以及核心耐力。在6个月、12个月、18个月和24个月时,通过电子调查问卷测量PFP复发情况。
68名受试者(43%)在6个月时返回实验室。无论康复计划如何,受试者在康复前至康复后疼痛、功能、力量和核心耐力均有显著改善,且在康复后6个月疼痛和功能仍保持改善(视觉模拟量表/疼痛 - 康复前5.12±1.33,康复后1.28±1.14,6个月时1.68±2.16 cm,P<.05;前膝疼痛量表/功能 - 康复前76.38±8.42,康复后92.77±7.36,6个月时90.27±9.46分,P<.05)。在康复后的24个月内,回复调查问卷的受试者中有5.10%报告PFP复发。
研究结果支持实施髋部或膝部肌肉强化训练计划来治疗PFP。两种计划在短期内均可改善疼痛、功能、力量和核心耐力,在中长期具有改善疼痛和功能的益处且PFP复发率低。