Robinson Matthew, Norte Grant E, Murray Amanda, Glaviano Neal R
J Sport Rehabil. 2022 Mar 1;31(3):279-285. doi: 10.1123/jsr.2021-0095. Epub 2021 Dec 11.
Gluteus medius (GMed) weakness is a common impairment seen across multiple lower-extremity pathologies. Greater GMed weakness is moderately associated with greater frontal plane motion, often termed dynamic knee valgus during functional tasks which may increase risk of lower-extremity injury. Neuromuscular electrical stimulation (NMES) superimposed to targeted muscles has emerged in clinical practice; however, NMES superimposed to the GMed in unknown. It is essential to assess the safety, credibility, and expectancy of NMES superimposed to the GMed prior to implementation in clinical practice. The objective of this study was to evaluate feasibility, safety, credibility, and expectancy of improvement with a 2-week intervention with or without NMES to the GMed in females with dynamic knee valgus.
Feasibility study.
A total of 22 adult females with dynamic knee valgus (age = 21.8 [1.4] y, mass = 76.9 [18.8] kg, height = 1.7 [0.1] m) completed a 2-week intervention with NMES or a sham treatment superimposed to the GMed during all therapeutic exercises. Feasibility was assessed by recruitment and completion rate, while safety was assessed by the total number of adverse events. Treatment credibility and expectancy was assessed with the Credibility Expectancy Questionnaire. Mixed-measure analysis of variance were used for statistical analysis (P ≤ .05).
Recruitment was completed in 5 months with 100% completion rate and no adverse events. There was no difference in treatment credibility between groups (NMES = 23.7 [2.3], sham = 21.7 [3.4], P = .12); however, the NMES group demonstrated a greater expectancy score (NMES = 20.0 [3.8], sham = 15.9 [5.1], P = .045).
Resistance training with NMES superimposed to the GMed is a feasible and safe intervention that resulted in greater expectance of success. Clinicians may consider superimposing NMES to the gluteal muscles when addressing muscle weakness in individuals with dynamic knee valgus.
臀中肌(GMed)无力是多种下肢疾病中常见的功能障碍。臀中肌无力程度越高,与额状面运动幅度越大呈中度相关,在功能性任务中常表现为动态膝外翻,这可能会增加下肢受伤的风险。在临床实践中,已出现将神经肌肉电刺激(NMES)应用于目标肌肉的情况;然而,将NMES应用于臀中肌的情况尚不清楚。在临床实践中实施之前,评估将NMES应用于臀中肌的安全性、可信度和预期效果至关重要。本研究的目的是评估在有动态膝外翻的女性中,对臀中肌进行为期2周的干预(有无NMES)的可行性、安全性、可信度以及改善预期。
可行性研究。
共有22名有动态膝外翻的成年女性(年龄 = 21.8 [1.4]岁,体重 = 76.9 [18.8]千克,身高 = 1.7 [0.1]米)完成了为期2周的干预,在所有治疗性锻炼过程中,对臀中肌进行NMES或假治疗。通过招募率和完成率评估可行性,通过不良事件总数评估安全性。使用可信度预期问卷评估治疗可信度和预期。采用混合测量方差分析进行统计分析(P≤0.05)。
招募工作在5个月内完成,完成率为100%,且无不良事件。两组之间的治疗可信度无差异(NMES组 = 23.7 [2.3],假治疗组 = 21.7 [3.4],P = 0.12);然而,NMES组的预期得分更高(NMES组 = 20.0 [3.8],假治疗组 = 15.9 [5.1],P = 0.045)。
对臀中肌进行NMES的抗阻训练是一种可行且安全的干预措施,能带来更高的成功预期。在处理有动态膝外翻个体的肌肉无力问题时,临床医生可考虑将NMES应用于臀肌。