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臀中肌和腰方肌激痛点针刺在改善女性髌股关节疼痛综合征运动员膝关节疼痛和功能方面的附加值:一项随机临床试验。

Added Value of Gluteus Medius and Quadratus Lumborum Dry Needling in Improving Knee Pain and Function in Female Athletes With Patellofemoral Pain Syndrome: A Randomized Clinical Trial.

机构信息

Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Science, Shiraz, Iran.

Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Arch Phys Med Rehabil. 2020 Feb;101(2):265-274. doi: 10.1016/j.apmr.2019.07.009. Epub 2019 Aug 26.

Abstract

OBJECTIVE

To compare the effects of exercise therapy alone and exercise therapy plus gluteus medius (GM) and quadratus lumbarum (QL) dry needling on pain and function in female athletes with patellofemoral pain (PFP).

DESIGN

Single-blind randomized controlled trial with follow-up.

SETTING

Physiotherapy clinic.

PARTICIPANTS

Convenience sample of female athletes with PFP (N=40), who were randomly assigned to the exercise therapy (Ex group) or exercise-therapy+dry needling (Ex+DN group) group.

INTERVENTIONS

The Ex group received exercise therapy for 4 weeks, and the Ex+DN group received exercise therapy in combination with dry needling directed at GM and QL trigger points for 4 weeks.

MAIN OUTCOME MEASURES

In all participants, pain intensity, function (Kujala score, modified star excursion balance test, step-down test), and QL and GM pressure pain threshold (PPT) were recorded at baseline and at 4 and 6 weeks after the start of treatment. Analysis of variance (2 groups×3 times) was used to compare within- and between-group differences.

RESULTS

The group versus time interaction effect was significant for all variables (P<.05). Both groups showed significant improvements in pain, function, and PPT at weeks 4 and 6 compared to baseline (P<.05). Between-groups comparisons showed significantly greater improvements in pain, function, and PPT in the Ex+DN group (P<.05).

CONCLUSIONS

Targeting intervention to treat trigger points in the GM and QL muscles combined with exercise therapy had superior beneficial effects compared to exercise alone in managing PFP. Therefore, adding GM and QL muscle dry needling to exercise therapy may be advisable to enhance the effects of PFP rehabilitation.

摘要

目的

比较单独运动疗法和运动疗法加臀中肌(GM)和腰方肌(QL)干针治疗对女性髌股疼痛(PFP)患者疼痛和功能的影响。

设计

单盲随机对照试验,随访。

地点

物理治疗诊所。

参与者

方便抽取的女性 PFP 运动员(N=40),随机分为运动疗法(Ex 组)或运动疗法+干针(Ex+DN 组)组。

干预措施

Ex 组接受 4 周的运动疗法,Ex+DN 组接受 4 周的 GM 和 QL 触发点干针联合运动疗法。

主要观察指标

所有参与者在基线时和治疗开始后 4 周和 6 周时记录疼痛强度、功能(Kujala 评分、改良星状偏移平衡测试、下台阶测试)和 QL 和 GM 压痛阈(PPT)。采用方差分析(2 组×3 次)比较组内和组间差异。

结果

所有变量的组与时间交互作用均有统计学意义(P<.05)。与基线相比,两组在第 4 周和第 6 周时疼痛、功能和 PPT 均有显著改善(P<.05)。组间比较显示,Ex+DN 组疼痛、功能和 PPT 的改善明显更大(P<.05)。

结论

与单独运动疗法相比,针对 GM 和 QL 肌肉触发点进行干预并结合运动疗法对管理 PFP 具有更好的有益效果。因此,将 GM 和 QL 肌肉干针治疗添加到运动疗法中可能有助于增强 PFP 康复的效果。

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