Exercise Physiology and Physical Assessment Laboratory, Serra Gaúcha University Center, Caxias do Sul, RS, Brazil; Department of Physical Therapy, Integrated Colleges of Taquara, Taquara, RS, Brazil; Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
J Electromyogr Kinesiol. 2022 Jun;64:102657. doi: 10.1016/j.jelekin.2022.102657. Epub 2022 Mar 18.
We aim to determine the neuromuscular differences in proximal and distal joints between patellofemoral pain (PFP) and healthy participants. Relevant articles were selected through seven databases. Studies comparing electromyography (EMG) or morphology parameters of trunk, hip, ankle/foot joints in PFP people compared to a healthy control group (CG) were included. 1458 studies were identified, from which 36 were included in the systematic review [PFP, n = 655; CG, n = 649] (31 involving EMG) and 32 in the meta-analysis (27 involving EMG). 75% of studies presented moderate to high methodological quality. The meta-analysis demonstrated that, compared to CG, PFP have: (i) similar transversus abdominis/internal oblique and erector spinae muscle onset, independently of sex; (ii) similar EMG amplitude of gluteus medius and gluteus maximus, independently of sex or task performed; (iii) similar gluteus medius muscle onset, independently of sex or task performed; (iv) similar gluteus maximus muscle onset, independently of sex; (v) a small effect for a shorter activation duration of gluteus medius (0.50; 95% CI [0.07; 0.93]; p = 0.02); (vi) a medium effect for a shorter activation duration of gluteus medius during stair/step down task (0.81; 95% CI [0.18; 1.45]; p = 0.01); (vii) similar external oblique, gluteus maximus, tensor fascia latae, tibialis anterior and fibularis muscle thickness and (viii) a small effect for a smaller gluteus medius muscle thickness (0.52; 95% CI [0.22; 0.82]; p = 0.007). We were not able to perform meta-analysis for EMG at distal joints. Neuromuscular differences in PFP seems to occur only in the gluteus medius muscle. Due to high heterogeneity and several methodological concerns observed, mainly in EMG studies, the interpretation of these results needs caution.
我们旨在确定髌股疼痛（PFP）和健康参与者近端和远端关节的神经肌肉差异。通过七个数据库选择了相关文章。纳入了比较 PFP 人群与健康对照组（CG）的躯干、臀部、踝关节/足部关节肌电图（EMG）或形态参数的研究。共确定了 1458 项研究，其中 36 项纳入系统评价[PFP，n=655；CG，n=649]（31 项涉及 EMG）和 32 项纳入荟萃分析（27 项涉及 EMG）。75%的研究具有中等到高度的方法学质量。荟萃分析表明，与 CG 相比，PFP 具有：（i）横腹内斜肌/内斜肌和竖脊肌的起始时间相似，与性别无关；（ii）臀中肌和臀大肌的 EMG 幅度相似，与性别或执行的任务无关；（iii）臀中肌的起始时间相似，与性别或执行的任务无关；（iv）臀大肌的起始时间相似，与性别无关；（v）臀中肌激活持续时间缩短（0.50；95%置信区间[0.07；0.93]；p=0.02），效应较小；（vi）下楼梯任务中臀中肌激活持续时间缩短（0.81；95%置信区间[0.18；1.45]；p=0.01），效应中等；（vii）外斜肌、臀大肌、阔筋膜张肌、胫骨前肌和腓骨肌厚度相似；（viii）臀中肌厚度较小（0.52；95%置信区间[0.22；0.82]；p=0.007），效应较小。我们无法对远端关节的 EMG 进行荟萃分析。PFP 的神经肌肉差异似乎仅发生在臀中肌。由于观察到高度异质性和几个方法学问题，主要是在 EMG 研究中，需要谨慎解释这些结果。
