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下楼梯:鉴别患有髌股关节疼痛的女性的好任务还是坏任务?

Descending stairs: Good or bad task to discriminate women with patellofemoral pain?

作者信息

Novello Aline de Almeida, Garbelotti Silvio, Rabelo Nayra Deise Dos Anjos, Ferraz André Nogueira, Bley André Serra, Correa João Carlos Ferrari, Politti Fabiano, Lucareli Paulo Roberto Garcia

机构信息

Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.

Department of Morphology, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Gait Posture. 2018 Sep;65:26-32. doi: 10.1016/j.gaitpost.2018.06.170. Epub 2018 Jun 28.

Abstract

BACKGROUND

There is no consensus on kinematics alterations during descending stairs in females with patellofemoral pain (PFP). In addition, there are no studies that have evaluated the three dimensional kinematics of the trunk, pelvis, hip, knee, and ankle using a multi-segmental model of the foot simultaneously during this task in patients with PFP and evaluated the subphases of stair descent. The objectives of this study were to compare the three dimensional kinematics of the trunk, pelvis, and lower limbs during different subphases of stair descent and identify the discriminatory capacity of the kinematic variables among women with PFP and healthy women.

METHODS

In this cross-sectional study, thirty-four women with PFP and thirty-four pain free women between 18 and 35 years-old were submitted to three-dimensional kinematic evaluation during stair descent.

RESULTS

It was observed that kinematic differences between the groups occurred in the first double support phase of the stair descent, with the variables of internal rotation of the hindfoot in relation to the tibia in the initial contact (2.1°; sensitivity = 68.6%, specificity = 61.8%) and contralateral pelvic drop in load response (1.3°, sensitivity = 65.7%, specificity = 63.7%) presenting the best ability to discriminate women with and without PFP.

CONCLUSION

Our results suggest that kinematic changes during stair descent should be used with caution during the evaluation and decision-making process in women with PFP.

摘要

背景

对于患有髌股疼痛(PFP)的女性在下楼梯过程中的运动学改变,目前尚无共识。此外,尚无研究在PFP患者执行此任务期间,使用足部多节段模型同时评估躯干、骨盆、髋、膝和踝关节的三维运动学,并评估下楼梯的子阶段。本研究的目的是比较下楼梯不同子阶段中躯干、骨盆和下肢的三维运动学,并确定运动学变量在患有PFP的女性和健康女性之间的鉴别能力。

方法

在这项横断面研究中,34名患有PFP的女性和34名18至35岁无疼痛的女性在下行楼梯期间接受了三维运动学评估。

结果

观察到两组之间运动学差异出现在下楼梯的第一个双支撑阶段,其中后足相对于胫骨在初始接触时的内旋变量(2.°;敏感性=68.6%,特异性=61.8%)和负重反应时对侧骨盆下降(1.3°,敏感性=65.7%,特异性=63.7%)具有区分患有和未患有PFP女性的最佳能力。

结论

我们的结果表明,在对患有PFP的女性进行评估和决策过程中,应谨慎使用下楼梯期间的运动学变化。

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