Department of Health Sciences, European University Cyprus, Nicosia, Cyprus -
Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia Cyprus.
Eur J Phys Rehabil Med. 2022 Apr;58(2):225-235. doi: 10.23736/S1973-9087.22.06691-6. Epub 2022 Jan 5.
Hip and knee strengthening exercises are implemented in rehabilitation of patellofemoral pain patients, but typically use high loads (70% of 1 repetition maximum). This may lead to increased patellofemoral joint stress. Low load training (20-30% of 1 repetition maximum) with blood flow restriction could allow for exercise strength benefits to proximal and distal muscles with reduced joint stress and by promoting hypoalgesia.
The aim of this study was to compare hip and knee focused exercises with and without blood flow restriction in adults with patellofemoral pain for short term effectiveness.
A randomized observed-blind controlled trial.
Musculoskeletal laboratories of the European University Cyprus, Nicosia, Cyprus.
60 volunteer patients, 18-40 years of age with patellofemoral pain.
Participants were randomly assigned to (1 reference group) hip and knee strengthening at (70% of 1 repetition maximum) or (2 experimental group) Strengthening with blood flow restriction at (30% of 1 repetition maximum at 70% of limb occlution pressure). Treatments took place 3 times per week for 4weeks and outcomes were assessed at baseline, end of treatment and at 2-month follow-up. The primary outcome was the Kujala Anterior Knee Pain Scale and secondary outcomes were worst and usual pain, pain with Single leg Squats, the maximum pain free flexion angle, the Tampa Scale of kinesiophobia, the Pain Catastrophizing Scale and isometric strength of knee extensors, hip extensors and hip abductors.
No difference were found for the main outcome of this study between groups. There was a significant effect of time for all outcome measures in both groups. Between group differences showed a significant difference for isometric strength of Knee extensor values at 2 month follow-up F(1,58)=5.56, P=0.02, partial η2=0.09, 459.4 (412.13, 506.64) vs. 380.68 (333.42, 427.93) and in worst pain post-treatment F(1,58)=5.27, P=0.02, partial η=0.08, 0.76 (0.48, 1.04) vs. reference group 1.30 (0.91, 1.68) with significantly better scores in the blood flow restriction group.
Blood flow restriction exercises of the hip and knee musculature used in this study were as effective as usual exercises of Hip and knee musculature in reducing symptoms in the short term. They also indicated greater increases in strength and reduction of worst pain post-treatment.
Further research is needed to investigate the dose response relationship with longer follow-ups.
髋关节和膝关节强化练习被应用于髌股疼痛综合征患者的康复中，但通常使用高负荷（1 次最大重复次数的 70%）。这可能会导致髌股关节压力增加。血流限制的低负荷训练（1 次最大重复次数的 20-30%）可以使近端和远端肌肉获得运动强度的益处，同时减少关节压力并通过促进低痛觉来实现。
本研究旨在比较髌股疼痛综合征患者短期使用和不使用血流限制的髋关节和膝关节聚焦运动的效果。
随机观察性双盲对照试验。
塞浦路斯尼科西亚欧洲大学的肌肉骨骼实验室。
60 名志愿者患者，年龄 18-40 岁，患有髌股疼痛。
参与者被随机分配到（1 个参考组）髋关节和膝关节强化（1 次最大重复次数的 70%）或（2 个实验组）强化血流限制（肢体闭塞压力的 70%下的 1 次最大重复次数的 30%）。治疗每周进行 3 次，持续 4 周，在基线、治疗结束和 2 个月随访时评估结果。主要结果是 Kujala 髌前疼痛量表，次要结果是最痛和通常的疼痛、单腿深蹲时的疼痛、最大无痛屈伸角度、坦帕运动恐惧量表、疼痛灾难化量表和膝关节伸肌、髋关节伸肌和髋关节外展肌的等长力量。
两组之间在本研究的主要结果上没有发现差异。两组所有结果测量的时间都有显著的影响。组间差异在 2 个月随访时的膝关节伸肌等长力量上显示出显著差异，F(1,58)=5.56，P=0.02，部分 η2=0.09，459.4（412.13，506.64）与参考组 380.68（333.42，427.93），以及治疗后最痛疼痛 F(1,58)=5.27，P=0.02，部分 η=0.08，0.76（0.48，1.04）与参考组 1.30（0.91，1.68），血流限制组的评分明显更好。
本研究中使用的髋关节和膝关节肌肉的血流限制运动在短期内与通常的髋关节和膝关节肌肉运动一样有效，可以减轻症状。它们还表明，在治疗后，力量的增加和最痛疼痛的减轻更为显著。
需要进一步研究以调查更长随访时间的剂量反应关系。
