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对于患有髌股疼痛综合征的女性,加强臀部力量是最佳治疗选择吗?三种不同类型运动的随机对照试验。

Is hip strengthening the best treatment option for females with patellofemoral pain? A randomized controlled trial of three different types of exercises.

机构信息

Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil; Programa de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.

Núcleo de Estudos Instituto Wilson Mello, Campinas, SP, Brazil.

出版信息

Braz J Phys Ther. 2018 Sep-Oct;22(5):408-416. doi: 10.1016/j.bjpt.2018.03.009. Epub 2018 Apr 4.


DOI:10.1016/j.bjpt.2018.03.009
PMID:29661570
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6157473/
Abstract

OBJECTIVE: To evaluate the effect of three types of exercise intervention in patients with patellofemoral pain and to verify the contributions of each intervention to pain control, function, and lower extremity kinematics. METHODS: A randomized controlled, single-blinded trial was conducted. Forty women with patellofemoral pain were randomly allocated into four groups: hip exercises, quadriceps exercises, stretching exercises and a control group (no intervention). Pain (using a visual analog scale), function (using the Anterior Knee Pain Scale), hip and quadriceps strength (using a handheld isometric dynamometer) and measuring lower limb kinematics during step up and down activities were evaluated at baseline and 8 weeks post intervention. RESULTS: All treatment groups showed significant improvements on pain and Anterior Knee Pain Scale after intervention with no statistically significant differences between groups except when compared to the control group. Only hip and quadriceps groups demonstrated improvements in muscle strength and knee valgus angle during the step activities. CONCLUSION: Hip strengthening exercises were not more effective for pain relief and function compared to quadriceps or stretching exercises in females with patellofemoral pain. Only hip and quadriceps groups were able to decrease the incidence of dynamic valgus during step-down activity. This study was approved by Brazilian Clinical Trials Registry registration number: RBR-6tc7mj (http://www.ensaiosclinicos.gov.br/rg/RBR-6tc7mj/).

摘要

目的:评估三种运动干预方式对髌股疼痛患者的疗效,并验证每种干预方式对疼痛控制、功能和下肢运动学的贡献。 方法:采用随机对照、单盲试验。40 名髌股疼痛女性患者被随机分为 4 组:髋关节运动组、股四头肌运动组、伸展运动组和对照组(无干预)。在基线和干预 8 周后,评估疼痛(使用视觉模拟评分法)、功能(使用前膝痛量表)、髋关节和股四头肌力量(使用手持式等速测力计)以及上下楼梯活动时的下肢运动学。 结果:所有治疗组在干预后疼痛和前膝痛量表均有显著改善,除与对照组相比外,组间无统计学差异。只有髋关节和股四头肌组在上下楼梯活动中肌肉力量和膝外翻角度有所改善。 结论:对于髌股疼痛女性患者,髋关节强化运动在缓解疼痛和功能方面并不优于股四头肌或伸展运动。只有髋关节和股四头肌组能够减少下楼梯活动中的动态外翻。本研究已在巴西临床试验注册中心注册,注册号:RBR-6tc7mj(http://www.ensaiosclinicos.gov.br/rg/RBR-6tc7mj/)。

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本文引用的文献

[1]
Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision-making process in patients with patellofemoral pain?

Braz J Phys Ther. 2017-11-8

[2]
RELIABILITY AND VALIDITY OF A MODIFIED ISOMETRIC DYNAMOMETER IN THE ASSESSMENT OF MUSCULAR PERFORMANCE IN INDIVIDUALS WITH ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION.

Rev Bras Ortop. 2015-11-16

[3]
Proximal muscle rehabilitation is effective for patellofemoral pain: a systematic review with meta-analysis.

Br J Sports Med. 2015-7-14

[4]
Effectiveness of hip muscle strengthening in patellofemoral pain syndrome patients: a systematic review.

Braz J Phys Ther. 2015-5-29

[5]
Exercise for treating patellofemoral pain syndrome.

Cochrane Database Syst Rev. 2015-1-20

[6]
Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis.

Br J Sports Med. 2014-3-31

[7]
Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial.

J Orthop Sports Phys Ther. 2014-4

[8]
Posterolateral hip muscle strengthening versus quadriceps strengthening for patellofemoral pain: a comparative control trial.

Arch Phys Med Rehabil. 2014-5

[9]
Using Session RPE to Monitor Different Methods of Resistance Exercise.

J Sports Sci Med. 2006-6-1

[10]
Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial.

Eur J Phys Rehabil Med. 2013-7-2

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