Carry Patrick M, Gala Raj, Worster Kate, Kanai Susan, Miller Nancy H, James David, Provance Aaron J, Carollo James J
The Musculoskeletal Research Center, Department of Orthopaedic Surgery, Children's Hospital Colorado, Aurora, CO, USA.
Center for Gait and Movement Analysis, Children's Hospital Colorado, Aurora, CO, USA.
Int J Sports Phys Ther. 2017 Jun;12(3):314-323.
Idiopathic patellofemoral pain (PFP) has been linked to hip weakness and abnormal lower extremity mechanics. The effect of a strengthening intervention on balance has not been well studied among individuals with PFP.
HYPOTHESIS/PURPOSE: The primary aim of this study was to evaluate changes in center of pressure displacement during the single limb squat following a nine-week physical therapy intervention among adolescent females with PFP.
Interventional and cross-sectional.
Seven adolescent females with PFP (10 extremities) were included in the study. Center of Pressure (CoP) excursions during a single limb squat task were measured before and after a nine week of physical therapy intervention focused on strengthening of the hip and core. Seven asymptomatic females were matched to the PFP group on the basis of age and activity level, and were tested as a reference group. CoP trajectories were reduced into four variables: mean distance (MDIST), root-mean-square distance (RDIST), range (RANGE), and 95% confidence interval circle area (AREA-CC). Maximum knee flexion angle, peak knee power generation and absorption were also recorded. Linear mixed models were used to test for within and between group differences in CoP metrics.
Pre-intervention, CoP range, knee power absorption and generation were significantly decreased in the PFP group relative to the reference group. Post-intervention, the PFP group reported a significant decrease in symptom severity. There was also a significant (p<0.05) increase in MDIST, RDIST, RANGE, AREA-CC, peak knee flexion angle, peak power absorption and power generation. There was no difference (p>0.05) in knee flexion, knee power or CoP displacement between the two groups after the physical therapy intervention.
Hip and core-strengthening resulted in a significant decrease in symptom severity as well as significant reductions in CoP displacement.
特发性髌股疼痛（PFP）与髋部无力和下肢力学异常有关。对于PFP患者，强化干预对平衡的影响尚未得到充分研究。
假设/目的：本研究的主要目的是评估为期九周的物理治疗干预后，患有PFP的青春期女性单腿深蹲时压力中心位移的变化。
干预性和横断面研究。
本研究纳入了7名患有PFP的青春期女性（10条肢体）。在为期九周的以强化髋部和核心为重点的物理治疗干预前后，测量单腿深蹲任务期间的压力中心（CoP）偏移。根据年龄和活动水平，将7名无症状女性与PFP组进行匹配，并作为参照组进行测试。CoP轨迹被简化为四个变量：平均距离（MDIST）、均方根距离（RDIST）、范围（RANGE）和95%置信区间圆面积（AREA-CC）。还记录了最大膝关节屈曲角度、膝关节峰值发电和吸收功率。使用线性混合模型来测试CoP指标在组内和组间的差异。
干预前，PFP组的CoP范围、膝关节功率吸收和产生相对于参照组显著降低。干预后，PFP组报告症状严重程度显著降低。MDIST、RDIST、RANGE、AREA-CC、膝关节峰值屈曲角度、峰值功率吸收和发电也有显著（p<0.05）增加。物理治疗干预后，两组之间的膝关节屈曲、膝关节功率或CoP位移没有差异（p>0.05）。
强化髋部和核心导致症状严重程度显著降低，以及CoP位移显著减少。
3级。
