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在股髌疼痛的女性中,将运动控制训练添加到肌肉强化训练中,对临床或运动学结果并没有显著改善:一项随机对照试验。

Adding motor control training to muscle strengthening did not substantially improve the effects on clinical or kinematic outcomes in women with patellofemoral pain: A randomised controlled trial.

作者信息

Rabelo Nayra Deise Dos Anjos, Costa Leonardo Oliveira Pena, Lima Bruna Maria de, Dos Reis Amir Curcio, Bley André Serra, Fukuda Thiago Yukio, Lucareli Paulo Roberto Garcia

机构信息

Human Motion Analysis Laboratory, Reabilitation Sciences Departament, Universidade Nove de Julho - UNINOVE, São Paulo, SP, Brazil.

Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo - UNICID, São Paulo, SP, Brazil.

出版信息

Gait Posture. 2017 Oct;58:280-286. doi: 10.1016/j.gaitpost.2017.08.018. Epub 2017 Aug 18.

Abstract

DESIGN

Randomized controlled trial.

BACKGROUND

Patients with Patellofemoral pain (PFP) usually present muscular weakness, pain and impaired motor control. Muscle strengthening is an effective treatment strategy for PFP, but the additional benefits of movement control training remain unknown. Therefore, the aim of this study was to compare the effects of movement control training associated with muscle strengthening, with a conventional program of strengthening alone in women with PFP.

METHODS

Thirty-four women were randomly assigned to two groups. The Strengthening group (S group) performed 12 sessions to strengthen the knee and hip muscles. The Movement Control & Strengthening group (MC&S group) performed the same exercises and movement control training of the trunk and lower limbs. Effects of the treatment (i.e., between-group differences) were calculated using linear mixed models. Primary outcomes were function and pain intensity after completion of the treatment protocol. Secondary outcomes were; muscle strength and kinematic outcomes during the step down task after 4 weeks of treatment; and function and pain intensity 3 and 6 months after randomization.

RESULTS

The MC&S group did not present significantly better function (MD -2.5 points, 95% CI;-10.7-5.5) or pain (MD -0.3 points, 95% CI;-1.7-1.0) at 4 weeks. There was a small difference in favour of the MC&S group for AKPS scores at 3 months (MD -8.5 points; 95% CI;-16.8 to -0.3). No significant between-group differences were observed for the other outcomes.

CONCLUSION

Movement control training was no more effective than the isolated strengthening protocol, in terms of pain, function, muscle strength, or kinematics.

摘要

设计

随机对照试验。

背景

髌股关节疼痛(PFP)患者通常存在肌肉无力、疼痛和运动控制受损的情况。肌肉强化训练是治疗PFP的有效策略,但运动控制训练的额外益处尚不清楚。因此,本研究的目的是比较运动控制训练联合肌肉强化训练与单纯传统强化训练方案对患有PFP的女性的效果。

方法

34名女性被随机分为两组。强化训练组(S组)进行12节训练课程以强化膝关节和髋关节肌肉。运动控制与强化训练组(MC&S组)进行相同的训练以及躯干和下肢的运动控制训练。使用线性混合模型计算治疗效果(即组间差异)。主要结局指标是完成治疗方案后的功能和疼痛强度。次要结局指标为:治疗4周后下台阶任务期间的肌肉力量和运动学指标;随机分组后3个月和6个月时的功能和疼痛强度。

结果

4周时,MC&S组在功能(平均差值-2.5分,95%可信区间:-10.7至5.5)或疼痛(平均差值-0.3分,95%可信区间:-1.7至1.0)方面并无显著更好的表现。3个月时,MC&S组在AKPS评分上有微小优势(平均差值-8.5分;95%可信区间:-16.8至-0.3)。在其他结局指标上未观察到显著的组间差异。

结论

在疼痛、功能、肌肉力量或运动学方面,运动控制训练并不比单纯的强化训练方案更有效。

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