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髌股疼痛女性在功能性任务中动态膝外翻运动学与疼痛的一致性:一项横断面研究

CONSISTENCY OF DYNAMIC KNEE VALGUS KINEMATICS AND PAIN ACROSS FUNCTIONAL TASKS IN FEMALES WITH PATELLOFEMORAL PAIN: A CROSS-SECTIONAL STUDY.

作者信息

Scholtes Sara A, Salsich Gretchen B

机构信息

Program in Physical Therapy, North Central College, Naperville, IL, USA.

Program in Physical Therapy, Saint Louis University, St. Louis, MO, USA.

出版信息

Int J Sports Phys Ther. 2020 Dec;15(6):985-994. doi: 10.26603/ijspt20200985.

Abstract

BACKGROUND AND PURPOSE

Dynamic knee valgus has been associated with patellofemoral pain (PFP) during high-level tasks, however, repeated lower-level stresses may be an alternative pain mechanism. The primary purpose of the current study was to examine the consistency of dynamic knee valgus and task-elicited pain demonstrated by females with PFP across four common functional tasks (stair ascent, stair descent, sit-to-stand, and stand-to-sit). A secondary purpose was to assess the correlation between the clinical test of single-limb squat and functional tasks.

HYPOTHESIS

Females with patellofemoral pain will demonstrate a positive relationship in magnitude of dynamic knee valgus and task-elicited pain across functional tasks. Individuals who demonstrated greater dynamic knee valgus and task-elicited pain during the clinical test of single-limb squat would demonstrate greater dynamic knee valgus and task elicited pain during stair ascent/descent and sit-to-stand/stand-to-sit tasks.

STUDY DESIGN

Cross-sectional study; secondary analysis of a feasibility intervention study.

METHODS

Twenty-three women with patellofemoral pain (age: 21.8 SD 3.7 years; BMI: 22.2 SD 2.0 kg/m) participated. Three-dimensional kinematic data were captured during task completion. Hip and knee frontal and transverse plane angles at 45 ° of knee flexion, and pain using a visual analog scale, were assessed during single-limb squat, stair ascent/descent, and sit-to-stand. Pearson product-moment correlation coefficients were calculated to examine between-task relationships for each variable at the pre-intervention assessment.

RESULTS

Correlation coefficients between tasks ranged from 0.23-0.76 for hip frontal plane measures (7/10 significant relationships, p<0.02), 0.31-0.90 for hip transverse plane measures (7/10 significant, p<0.01), 0.87-0.95 for knee frontal plane measures (10/10 significant, p<0.01), and 0.54-0.86 for knee transverse plane measures (10/10 significant, p<0.01). Correlations spanned 0.59-0.85 for pain during tasks (10/10 significant, p<0.01).

CONCLUSION

Females with patellofemoral pain demonstrated positive correlations in dynamic knee valgus kinematics and task-elicited pain across five tasks. Movement and pain during the clinical test of single-limb squat test also was correlated with movement and pain during the functional tasks of stair ascent/descent and sit-to-stand.

LEVEL OF EVIDENCE

Level 2b.

摘要

背景与目的

在高水平任务中,动态膝外翻与髌股关节疼痛(PFP)相关,然而,反复的低水平应力可能是另一种疼痛机制。本研究的主要目的是检验患有PFP的女性在四项常见功能任务(上楼梯、下楼梯、从坐到站、从站到坐)中动态膝外翻与任务诱发疼痛的一致性。次要目的是评估单腿深蹲临床测试与功能任务之间的相关性。

假设

患有髌股关节疼痛的女性在功能任务中动态膝外翻程度与任务诱发疼痛之间将呈现正相关关系。在单腿深蹲临床测试中表现出更大动态膝外翻和任务诱发疼痛的个体,在上下楼梯以及从坐到站/从站到坐任务中也会表现出更大的动态膝外翻和任务诱发疼痛。

研究设计

横断面研究;可行性干预研究的二次分析。

方法

23名患有髌股关节疼痛的女性(年龄:21.8±3.7岁;体重指数:22.2±2.0kg/m²)参与研究。在任务完成过程中采集三维运动学数据。在单腿深蹲、上下楼梯以及从坐到站过程中,评估膝关节屈曲45°时髋关节和膝关节额状面及横断面角度,并用视觉模拟量表评估疼痛程度。在干预前评估时,计算Pearson积差相关系数以检验各变量在不同任务之间的关系。

结果

髋关节额状面测量值在不同任务之间的相关系数范围为0.23 - 0.76(7/10具有显著相关性,p<0.02),髋关节横断面测量值为0.31 - 0.90(7/10具有显著相关性,p<0.01),膝关节额状面测量值为0.87 - 0.95(10/10具有显著相关性,p<0.01),膝关节横断面测量值为0.54 - 0.86(10/10具有显著相关性,p<0.01)。任务过程中的疼痛相关性范围为0.59 - 0.85(10/10具有显著相关性,p<0.01)。

结论

患有髌股关节疼痛的女性在五项任务中的动态膝外翻运动学与任务诱发疼痛之间呈现正相关。单腿深蹲临床测试中的运动和疼痛也与上下楼梯以及从坐到站功能任务中的运动和疼痛相关。

证据水平

2b级。

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