Salarie Sker Fatemeh, Anbarian Mehrdad, Yazdani Amir H, Hesari Pouria, Babaei-Ghazani Arash
Faculty of Physical Education and Sport Sciences, Bu Ali Sina University, Hamedan, Iran.
Hamedan University of Medical Sciences, Hamedan, Iran.
Gait Posture. 2017 Oct;58:7-12. doi: 10.1016/j.gaitpost.2017.06.271. Epub 2017 Jun 29.
Decreases in patellofemoral pain symptoms with bracing treatment have been established; but, the mechanisms remain unclear. The purpose of this study was to determine the immediate and long-term effects of the patellar bracing on electromyography (EMG) activity of the Vastus Medialis (VM) and Lateralis (VL), Rectus Femoris, lateral Gastrocnemius, Biceps Femoris and Semitendinosus (ST) muscles during level walking.
12 eligible women aged 20-30 years with diagnosis of patellofemoral pain participated in the before and after study. Intervention consisted of 8 weeks of patellar bracing. First, patients were tested without brace, then with a brace, and finally eight weeks later without a brace. Surface EMG activation of the selected muscles during level walking was recorded.
After eight weeks of patellar bracing, EMG activity of VM muscle was significantly higher when compared to first session without brace (p=0.011) at mid-stance sub-phase. Additionally, EMG activity of ST muscle during first session with brace was significantly lower when compared to first session without brace at mid-stance sub-phase (without brace) (p=0.012). EMG activity of VM muscle after eight weeks of patellar bracing was significantly higher than the first session without brace at late stance and preswing sub-phase (p=0.013).
Long-term wearing of patellar bracing increases EMG activity of VM during mid-stance and late stance and preswing sub-phases of gait and immediate effect of patellar brace is decrease of EMG activity of ST muscle during mid-stance.
髌骨支具治疗可减轻髌股关节疼痛症状，但其机制尚不清楚。本研究旨在确定髌骨支具对平路行走时股内侧肌（VM）、股外侧肌（VL）、股直肌、外侧腓肠肌、股二头肌和半腱肌（ST）肌电图（EMG）活动的即时和长期影响。
12名年龄在20 - 30岁、诊断为髌股关节疼痛的合格女性参与了前后对照研究。干预措施为佩戴髌骨支具8周。首先，患者在不佩戴支具的情况下进行测试，然后佩戴支具进行测试，最后在8周后不佩戴支具再次测试。记录平路行走时所选肌肉的表面肌电激活情况。
佩戴髌骨支具8周后，在站立中期子阶段，VM肌的肌电活动与首次不佩戴支具时相比显著升高（p = 0.011）。此外，在站立中期子阶段，首次佩戴支具时ST肌的肌电活动与首次不佩戴支具时相比显著降低（p = 0.012）。佩戴髌骨支具8周后，VM肌在站立后期和摆动前期子阶段的肌电活动显著高于首次不佩戴支具时（p = 0.013）。
长期佩戴髌骨支具可增加步态中站立中期、后期和摆动前期VM肌的肌电活动，而髌骨支具的即时效果是降低站立中期ST肌的肌电活动。
