Briani Ronaldo Valdir, Pazzinatto Marcella Ferraz, Waiteman Marina Cabral, de Oliveira Silva Danilo, de Azevedo Fábio Mícolis
Physical Therapy Department, School of Science and Technology, São Paulo State University (UNESP), Presidente Prudente, Brazil.
Physical Therapy Department, School of Science and Technology, São Paulo State University (UNESP), Presidente Prudente, Brazil; La Trobe University, School of Allied Health, La Trobe Sports and Exercise Medicine Research Centre (LASEM), Melbourne, Australia.
Knee. 2018 Jun;25(3):398-405. doi: 10.1016/j.knee.2018.03.009. Epub 2018 Apr 11.
The etiology of patellofemoral pain (PFP) is thought to be the result of increased patellofemoral joint (PFJ) load and aberrant lower extremity mechanics, including altered vertical ground reaction forces (VGRF). However, few studies have investigated the association between an increase in pain and VGRF loading rates in the context of PFP. Thus, this study aimed to investigate the immediate effects of PFJ loading on pain and VGRF loading rate, and to see if there is a link between modification of both pain and VGRF loading rate during stair negotiation.
Thirty-four women with PFP underwent VGRF analysis during stair negotiation under two conditions: with (condition 2) and without (condition 1) being previously submitted to a PFJ loading protocol in order to or not to exacerbate their knee pain, respectively.
The VGRF loading rates were significantly higher in condition 2 (Mean ± standard deviation (SD)=4.0±0.6N/s) compared to condition 1 (Mean±SD=3.6±0.5N/s) during stair ascent and during stair descent (Mean±SD: condition 1=6.3±1.1N/s; condition 2=7.0±1.4N/s). In addition, VGRF loading rates were higher during stair descent compared to stair ascent in both conditions. There were significant correlations between the increase in pain and VGRF loading rate during both tasks.
There seemed to be an important relation between the increase in pain and VGRF loading rates in women with PFP. Based on these findings, interventions aimed at reducing VGRF loading rates are important in the context of PFP.
髌股关节疼痛(PFP)的病因被认为是髌股关节(PFJ)负荷增加和下肢力学异常的结果,包括垂直地面反作用力(VGRF)改变。然而,很少有研究在PFP背景下调查疼痛增加与VGRF负荷率之间的关联。因此,本研究旨在调查PFJ负荷对疼痛和VGRF负荷率的即时影响,并观察在上下楼梯过程中疼痛和VGRF负荷率的改变之间是否存在联系。
34名患有PFP的女性在两种情况下进行上下楼梯时的VGRF分析:一种情况是(情况2)预先接受PFJ负荷方案以加剧或不加剧其膝关节疼痛,另一种情况是(情况1)不接受该方案。
在上下楼梯过程中,情况2(平均值±标准差(SD)=4.0±0.6N/s)的VGRF负荷率显著高于情况1(平均值±SD=3.6±0.5N/s)(平均值±SD:情况1=6.3±1.1N/s;情况2=7.0±1.4N/s)。此外,在两种情况下,下楼梯时的VGRF负荷率均高于上楼梯时。在两项任务中,疼痛增加与VGRF负荷率之间均存在显著相关性。
PFP女性的疼痛增加与VGRF负荷率之间似乎存在重要关联。基于这些发现,在PFP背景下,旨在降低VGRF负荷率的干预措施很重要。