J Orthop Sports Phys Ther. 2018 Jan;48(1):19-31. doi: 10.2519/jospt.2018.7365. Epub 2017 Oct 15.
Study Design Systematic review with meta-analysis. Background The addition of hip strengthening to knee strengthening for persons with patellofemoral pain has the potential to optimize treatment effects. There is a need to systematically review and pool the current evidence in this area. Objective To examine the efficacy of hip strengthening, associated or not with knee strengthening, to increase strength, reduce pain, and improve activity in individuals with patellofemoral pain. Methods A systematic review of randomized and/or controlled trials was performed. Participants in the reviewed studies were individuals with patellofemoral pain, and the experimental intervention was hip and knee strengthening. Outcome data related to muscle strength, pain, and activity were extracted from the eligible trials and combined in a meta-analysis. Results The review included 14 trials involving 673 participants. Random-effects meta-analyses revealed that hip and knee strengthening decreased pain (mean difference, -3.3; 95% confidence interval [CI]: -5.6, -1.1) and improved activity (standardized mean difference, 1.4; 95% CI: 0.03, 2.8) compared to no training/placebo. In addition, hip and knee strengthening was superior to knee strengthening alone for decreasing pain (mean difference, -1.5; 95% CI: -2.3, -0.8) and improving activity (standardized mean difference, 0.7; 95% CI: 0.2, 1.3). Results were maintained beyond the intervention period. Meta-analyses showed no significant changes in strength for any of the interventions. Conclusion Hip and knee strengthening is effective and superior to knee strengthening alone for decreasing pain and improving activity in persons with patellofemoral pain; however, these outcomes were achieved without a concurrent change in strength. Level of Evidence Therapy, level 1a-. J Orthop Sports Phys Ther 2018;48(1):19-31. Epub 15 Oct 2017. doi:10.2519/jospt.2018.7365.
系统评价与荟萃分析。
对于髌股疼痛患者，在膝关节强化训练的基础上增加髋关节强化训练可能会优化治疗效果。因此，有必要系统地回顾和汇总这一领域的现有证据。
评估髋关节强化训练（联合或不联合膝关节强化训练）对增加髌股疼痛患者的肌肉力量、减轻疼痛和改善活动能力的疗效。
系统检索了随机和/或对照试验。纳入研究的参与者为髌股疼痛患者，实验干预措施为髋关节和膝关节强化训练。从合格试验中提取与肌肉力量、疼痛和活动相关的数据，并进行荟萃分析。
该综述纳入了 14 项试验，共 673 名参与者。随机效应荟萃分析显示，与不训练/安慰剂相比，髋关节和膝关节强化训练可降低疼痛（平均差值，-3.3；95%置信区间[CI]：-5.6，-1.1）和改善活动能力（标准化均数差值，1.4；95% CI：0.03，2.8）。此外，与单纯膝关节强化训练相比，髋关节和膝关节强化训练在减轻疼痛（平均差值，-1.5；95% CI：-2.3，-0.8）和改善活动能力（标准化均数差值，0.7；95% CI：0.2，1.3）方面更具优势。这些效果在干预结束后仍能持续。荟萃分析显示，任何干预措施对力量都没有显著变化。
髋关节和膝关节强化训练对减轻髌股疼痛患者的疼痛和改善活动能力是有效且优于单纯膝关节强化训练的；然而，这些效果的产生并不伴随着力量的同步变化。
治疗性研究，1a 级。
美国骨科运动物理治疗杂志 2018 年；48（1）：19-31. 2017 年 10 月 15 日在线发表。doi：10.2519/jospt.2018.7365.
