de Oliveira Silva Danilo, Barton Christian John, Briani Ronaldo Valdir, Taborda Bianca, Ferreira Amanda Schenatto, Pazzinatto Marcella Ferraz, Azevedo Fábio Mícolis de
Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil; La Trobe Sports and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Bundoora, Victoria, Australia; Translating Research Knowledge Evidence (TREK) group, Melbourne, Australia.
La Trobe Sports and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Bundoora, Victoria, Australia; Translating Research Knowledge Evidence (TREK) group, Melbourne, Australia.
Gait Posture. 2019 Feb;68:1-5. doi: 10.1016/j.gaitpost.2018.10.033. Epub 2018 Nov 1.
Evidence indicates the presence of both kinesiophobia and knee extension strength deficits in women with patellofemoral pain (PFP). Both impairments may contribute to apparent compensatory gait patterns including reduced cadence and peak knee flexion during stair negotiation.
Is kinesiophobia or knee extension strength associated with movement pattern in women with patellofemoral pain?
Forty women with PFP were assessed with three-dimensional kinematic analyses during stair descent; isokinetic dynamometry of the knee extensors (isometric, concentric and eccentric); and the Tampa scale for kinesiophobia. Pearson coefficients were calculated to determine relationship among variables.
Kinesiophobia correlated significantly with cadence (r = -0.62, p < 0.001), and peak knee flexion (r = -0.76, p < 0.001). No significant correlations were found between any knee extensor strength variables and kinematics (cadence or peak knee flexion); or kinesiophobia (p > 0.05).
Findings of this study could suggest addressing strength impairments alone may not adequately address kinesiophobia and movement pattern impairments in women with PFP. However, high-quality randomised controlled trials are needed to test this assumption. Further value may be added if currently evidence-based knee strengthening exercise is combined with education and/or graded exposure to address kinesiophobia, and consideration to gait retraining to address altered movement patterns at the knee.
有证据表明,患有髌股疼痛(PFP)的女性存在运动恐惧和膝关节伸展力量不足的情况。这两种损伤都可能导致明显的代偿性步态模式,包括在上下楼梯时步频降低和膝关节最大屈曲角度减小。
运动恐惧或膝关节伸展力量是否与患有髌股疼痛的女性的运动模式有关?
对40名患有PFP的女性在下楼梯过程中进行三维运动学分析;对膝关节伸肌进行等速肌力测试(等长、向心和离心);并使用坦帕运动恐惧量表进行评估。计算皮尔逊系数以确定变量之间的关系。
运动恐惧与步频(r = -0.62,p < 0.001)和膝关节最大屈曲角度(r = -0.76,p < 0.001)显著相关。未发现任何膝关节伸肌力量变量与运动学指标(步频或膝关节最大屈曲角度)之间存在显著相关性;与运动恐惧之间也无显著相关性(p > 0.05)。
本研究结果表明,仅解决力量损伤可能无法充分解决患有PFP的女性的运动恐惧和运动模式损伤问题。然而,需要高质量的随机对照试验来验证这一假设。如果将目前基于证据的膝关节强化训练与教育和/或分级暴露相结合以解决运动恐惧,并考虑进行步态再训练以解决膝关节运动模式改变的问题,可能会有更大的价值。