Hoglund Lisa T, Pontiggia Laura, Kelly John D
1Department of Physical Therapy, Thomas Jefferson University, 901 Walnut Street, 5th Floor, Philadelphia, PA 19107 USA.
2Department of Mathematics, Physics and Statistics, University of the Sciences, Philadelphia, PA USA.
Pilot Feasibility Stud. 2018 Apr 6;4:70. doi: 10.1186/s40814-018-0262-z. eCollection 2018.
Patellofemoral joint (PFJ) osteoarthritis (OA) is prevalent in middle-aged and older adults. Despite this, there are minimal studies which have examined conservative interventions for PFJ OA. Weakness of proximal lower extremity muscles is associated with PFJ OA. It is unknown if a hip muscle strengthening and lumbopelvic-hip core stabilization program will improve symptoms and function in persons with PFJ OA. This study examined the feasibility and impact of a 6-week hip muscle strengthening and core stabilization program on pain, symptoms, physical performance, peak muscle torques, and quality of life in persons with PFJ OA.
Ten females with PFJ OA and ten age- and sex-matched controls participated in baseline tests. PFJ OA participants attended ten twice-a-week hip strengthening and core stabilization exercise sessions. Outcome measures included questionnaires, the Timed-Up-and-Go, and peak isometric torque of hip and quadriceps muscles. Data were tested for normality; parametric and non-parametric tests were used as appropriate.
At baseline, the PFJ OA group had significantly worse symptoms, slower Timed-Up-and-Go performance, and lower muscle torques than control participants. PFJ OA group adherence to supervised exercise sessions was adequate. All PFJ OA participants attended at least nine exercise sessions. Five PFJ OA participants returned 6-month follow-up questionnaires, which was considered fair retention. The PFJ OA participants' self-reported pain, symptoms, function in daily living, function in sport, and quality of life all improved at 6 weeks ( < 0.05). Timed-Up-and-Go time score improved at 6 weeks ( = 0.005). Peak hip external rotator torque increased ( = 0.01). Improvements in pain and self-reported function were no longer significant 6 months following completion of the intervention.
PFJ OA participants were adherent to the supervised sessions of the intervention. Improvement in symptoms, physical performance, and muscle torque were found after 6 weeks. Participant retention at 6 months was fair, and significant changes were no longer present. Our findings suggest that a hip strengthening and core stabilization program may be beneficial to improve symptoms, function, and physical performance in persons with PFJ OA. Future studies are needed, and additional measures should be taken to improve long-term adherence to exercise.
ClinicalTrials.gov NCT02825238. Registered 6 July 2016 (retrospectively registered).
髌股关节（PFJ）骨关节炎（OA）在中老年人中很常见。尽管如此，针对PFJ OA的保守干预措施的研究却很少。下肢近端肌肉无力与PFJ OA有关。目前尚不清楚髋部肌肉强化和腰骶骨盆-髋部核心稳定训练计划是否能改善PFJ OA患者的症状和功能。本研究探讨了为期6周的髋部肌肉强化和核心稳定训练计划对PFJ OA患者疼痛、症状、身体表现、肌肉峰值扭矩和生活质量的可行性和影响。
10名患有PFJ OA的女性和10名年龄及性别匹配的对照者参加了基线测试。PFJ OA患者参加了每周两次、每次时长为6周的髋部强化和核心稳定训练课程。结果测量包括问卷调查、计时起立行走测试以及髋部和股四头肌的等长收缩峰值扭矩。对数据进行正态性检验；根据情况使用参数检验和非参数检验。
在基线时，PFJ OA组的症状明显比对照组严重，计时起立行走测试表现更慢，肌肉扭矩更低。PFJ OA组对监督训练课程的依从性良好。所有PFJ OA患者至少参加了9次训练课程。5名PFJ OA患者返回了6个月随访问卷，这被认为是尚可的保留率。PFJ OA患者自我报告的疼痛、症状、日常生活功能、运动功能和生活质量在6周时均有所改善（P<0.05）。计时起立行走时间得分在6周时有所改善（P=0.005）。髋部外旋肌峰值扭矩增加（P=0.01）。干预完成6个月后，疼痛和自我报告功能的改善不再显著。
PFJ OA患者坚持了干预的监督训练课程。6周后发现症状、身体表现和肌肉扭矩有所改善。6个月时的患者保留率尚可，且不再有显著变化。我们的研究结果表明，髋部强化和核心稳定训练计划可能有助于改善PFJ OA患者的症状、功能和身体表现。需要进一步的研究，并应采取额外措施来提高长期运动依从性。
ClinicalTrials.gov NCT02825238。2016年7月6日注册（追溯注册）。
