Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Bodyw Mov Ther. 2021 Jan;25:248-254. doi: 10.1016/j.jbmt.2020.08.007. Epub 2020 Sep 2.
To identify differences in architectural parameters (size, fiber/pennation angle, fiber length, and echogenicity) of the quadriceps muscle, as a whole or any individual part of it, using imaging techniques in individuals with patellofemoral pain (PFP) compared to contralateral, asymptomatic limb or separate control group.
Quadriceps muscles imbalance and weakness were proposed as risk factors for developing PFP. Although the muscle architecture (size, pennation/fiber angle and fiber length) is highly associated with skeletal muscle strength, it is not clear whether atrophy or any changes in architectural parameters of the quadriceps are presented in the PFP patients.
Observational studies in which the total size of the quadriceps or individual parts of it were measured using imaging techniques in the PFP patients were included in this review. Electronic databases (PubMed, SCOPUS, PEDro, CINAHL, WOS, and EMBASE) were searched between January 1990 and December 2019 with no restriction of language. Study selection and data extraction and quality assessment were conducted by two independent reviewers.
Five cross-sectional studies were eligible to include in this review. Three out of five included studies that assessed the total size of the quadriceps and reported no significant differences between the PFP and healthy control group. Two out of five of the studies assessed the total size of the quadriceps between the symptomatic and asymptomatic limb of the PFP patients and reported the statistical difference between limbs. Only one study measured the fiber angle of the VMO muscle at the patella. Controversial results were found between studies that assessed the size of individual parts of the quadriceps.
Due to the controversial results of the included studies, this systematic review failed to draw a conclusion on the role of quadriceps atrophy in PFP pathology. The limitation in PFP literature considering pennation/fiber angle, echogenicity and fiber length of individual parts of the quadriceps muscle, rises the need for research that focuses on the biomechanical properties of the quadriceps in PFP patients.
使用影像学技术比较髌股疼痛（PFP）患者与对侧无症状肢体或单独对照组之间整个股四头肌或其各部分的结构参数（大小、纤维/羽状角、纤维长度和回声）的差异。
股四头肌失衡和无力被认为是发生 PFP 的危险因素。尽管肌肉结构（大小、羽状/纤维角和纤维长度）与骨骼肌力量高度相关，但尚不清楚 PFP 患者的股四头肌是否存在萎缩或任何结构参数变化。
本综述纳入了使用影像学技术测量 PFP 患者股四头肌总大小或其各部分大小的观察性研究。电子数据库（PubMed、SCOPUS、PEDro、CINAHL、WOS 和 EMBASE）从 1990 年 1 月至 2019 年 12 月进行了搜索，不限制语言。两名独立审查员进行了研究选择、数据提取和质量评估。
共有 5 项横断面研究符合纳入标准。其中 3 项研究评估了股四头肌的总大小，报告 PFP 患者与健康对照组之间无显著差异。5 项研究中有 2 项评估了 PFP 患者的症状侧和无症状侧的股四头肌总大小，并报告了肢体之间的统计学差异。只有 1 项研究测量了髌腱上 VMO 肌的纤维角。评估股四头肌各部分大小的研究结果存在争议。
由于纳入研究的结果存在争议，本系统评价未能得出股四头肌萎缩在 PFP 病理中的作用的结论。考虑到 PFP 文献中股四头肌各部分的羽状/纤维角、回声和纤维长度，需要开展针对 PFP 患者股四头肌生物力学特性的研究。
