Institut für Rehabilitationsmedizinische Forschung an der Universität Ulm, Am Kurpark 1, 88422, Bad Buchau, Germany.
Institut für Sport- und Bewegungswissenschaft, Universität Stuttgart, Allmandring 28, 70569, Stuttgart, Germany.
Arch Orthop Trauma Surg. 2020 Jul;140(7):905-912. doi: 10.1007/s00402-020-03378-7. Epub 2020 Feb 27.
The aim of this randomized controlled trial was to investigate immediate effects of a patellar brace on pain, neuromuscular activity, and knee kinematics in subjects with patellofemoral pain syndrome.
Fifty subjects with a diagnosis of patellofemoral pain syndrome completed 6 activities each with and without a patellar brace in a randomized order. The subjects were asked to rate their perceived pain on a Visual Analog Scale after each activity. During the activities, neuromuscular activity of vastus medialis and vastus lateralis, as well as knee angles were measured.
Subjects showed a statistically significant pain reduction of 33-56% on the Visual Analog Scale during all activities while wearing the brace. Two groups with different onset patterns for vastus medialis and vastus lateralis were identified: one group who activated vastus medialis prior to vastus lateralis, and one who activated vastus medialis after vastus lateralis. In the subgroup of subjects activating vastus lateralis prior to vastus medialis, bracing resulted in a significantly (p = 0.048) earlier onset of vastus medialis by 56 ms. In all but one activity, the vastus medialis/vastus lateralis ratio without the patellar brace was < 1.0 and inverted with the patellar brace > 1.0. Knee angles in the sagittal plane increased significantly with the patellar brace in two activities.
Patellofemoral bracing results in an immediate decrease of pain, an earlier onset of vastus medialis and inverted vastus medialis/vastus lateralis ratio and altered knee kinematics.
本随机对照试验的目的是研究髌股疼痛综合征患者佩戴髌股支持带对疼痛、神经肌肉活动和膝关节运动学的即刻影响。
50 名髌股疼痛综合征患者以随机顺序完成了 6 项活动，每项活动均佩戴和不佩戴髌股支持带。每项活动后，患者使用视觉模拟评分法（VAS）评估他们的疼痛感知。在活动过程中，测量股直肌和股外侧肌的神经肌肉活动以及膝关节角度。
患者在佩戴支具时，在所有活动中 VAS 疼痛评分均降低了 33-56%。发现股直肌和股外侧肌的激活模式存在两个不同的组别：一组在股外侧肌之前激活股直肌，另一组在股外侧肌之后激活股直肌。在股外侧肌先于股直肌激活的亚组中，支具使股直肌的起始时间提前了 56ms，差异具有统计学意义（p=0.048）。在除一项活动外的所有活动中，不佩戴髌股支持带时股直肌/股外侧肌的比值<1.0，而佩戴髌股支持带时比值>1.0。在两个活动中，髌股支持带使矢状面的膝关节角度显著增加。
髌股支持带可立即减轻疼痛，使股直肌更早起始，股直肌/股外侧肌的比值倒置，并改变膝关节运动学。
