髌股关节压迫问题的当前概念与治疗
CURRENT CONCEPTS AND TREATMENT OF PATELLOFEMORAL COMPRESSIVE ISSUES.
作者信息
Mullaney Michael J, Fukunaga Takumi
出版信息
Int J Sports Phys Ther. 2016 Dec;11(6):891-902.
Abstract
Patellofemoral disorders, commonly encountered in sports and orthopedic rehabilitation settings, may result from dysfunction in patellofemoral joint compression. Osseous and soft tissue factors, as well as the mechanical interaction of the two, contribute to increased patellofemoral compression and pain. Treatment of patellofemoral compressive issues is based on identification of contributory impairments. Use of reliable tests and measures is essential in detecting impairments in hip flexor, quadriceps, iliotibial band, hamstrings, and gastrocnemius flexibility, as well as in joint mobility, myofascial restrictions, and proximal muscle weakness. Once relevant impairments are identified, a combination of manual techniques, instrument-assisted methods, and therapeutic exercises are used to address the impairments and promote functional improvements. The purpose of this clinical commentary is to describe the clinical presentation, contributory considerations, and interventions to address patellofemoral joint compressive issues.
摘要
髌股关节紊乱在运动和骨科康复环境中较为常见，可能由髌股关节压缩功能障碍引起。骨组织和软组织因素，以及两者之间的机械相互作用，会导致髌股关节压缩增加和疼痛。髌股关节压缩问题的治疗基于对相关损伤的识别。使用可靠的测试和测量方法对于检测髋屈肌、股四头肌、髂胫束、腘绳肌和腓肠肌的灵活性损伤，以及关节活动度、肌筋膜限制和近端肌肉无力至关重要。一旦识别出相关损伤，就会采用手法技术、仪器辅助方法和治疗性锻炼相结合的方式来解决这些损伤并促进功能改善。本临床评论的目的是描述髌股关节压缩问题的临床表现、相关影响因素和干预措施。
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本文引用的文献
1
2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures.2016年第四届国际髌股关节疼痛研究研讨会（曼彻斯特）髌股关节疼痛共识声明。第1部分：术语、定义、临床检查、自然病史、髌股关节骨关节炎及患者报告结局指标。
Br J Sports Med. 2016 Jul;50(14):839-43. doi: 10.1136/bjsports-2016-096384. Epub 2016 Jun 24.
2
An Anatomic Investigation of the Ober Test.奥伯试验的解剖学研究
Am J Sports Med. 2016 Mar;44(3):696-701. doi: 10.1177/0363546515621762. Epub 2016 Jan 11.
3
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Man Ther. 2016 Apr;22:179-89. doi: 10.1016/j.math.2015.12.005. Epub 2015 Dec 22.
4
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J Bodyw Mov Ther. 2015 Oct;19(4):690-6. doi: 10.1016/j.jbmt.2015.04.010. Epub 2015 May 5.
5
Patellofemoral pain.髌股关节疼痛。
BMJ. 2015 Nov 4;351:h3939. doi: 10.1136/bmj.h3939.
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8
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