Physiotherapy Postgraduate Program, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
Physiotherapy Postgraduate Program, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
Musculoskelet Sci Pract. 2023 Feb;63:102720. doi: 10.1016/j.msksp.2023.102720. Epub 2023 Jan 24.
Patellofemoral pain (PFP) is a knee pain condition with multifactorial aetiology, twice common in women. The recommended conservative treatment is based on strengthening of the core, hip, and knee musculatures. Addition of neuromuscular training to a strengthening protocol might provide further benefits on pain, function, and kinematics in PFP individuals. However, evidence for the effectiveness of this protocol is lacking.
To investigate whether adding neuromuscular training to strengthening program could provide any additional improvements of pain, function, and kinematics in PFP women.
71 PFP women were randomly into two groups and submitted to different interventions for 12 weeks. The strengthening group (SG) performed strengthening exercises for the trunk, hip, and knee muscles, while the neuromuscular training group (NMTG) performed the same exercises as SG, plus neuromuscular training from the 4th week onwards. The primary outcomes were pain intensity, function, and 2-D kinematics of the trunk and lower limb. The secondary outcomes were isometric muscle strength and patient satisfaction level. All outcomes were evaluated at 12 weeks, immediately post-treatment.
At 12 weeks, there was no evidence of between-group differences for any outcome, but both interventions provided clinically significant improvements for pain intensity (SG: mean difference -3.9, 95% confidence interval [CI] -5.0, -2.9; NMTG: mean difference -3.1, 95% CI -4.1, -2.0) and function (SG: mean difference 15.3, 95% CI 11.5, 19.2; NMTG: mean difference 16.9, 95% CI 13.2, 20.7).
Neuromuscular training did not produce any additional benefits for pain, function, or kinematics at 12 weeks of treatment.
髌股疼痛（PFP）是一种多因素病因的膝关节疼痛病症，女性发病率是男性的两倍。推荐的保守治疗方法基于核心、臀部和膝关节肌肉的强化。在强化方案中加入神经肌肉训练可能会为 PFP 患者的疼痛、功能和运动学提供进一步的益处。然而，这种方案的有效性证据不足。
研究在强化方案中加入神经肌肉训练是否可以为 PFP 女性提供任何额外的疼痛、功能和运动学改善。
71 名 PFP 女性被随机分为两组，并接受不同的干预措施 12 周。强化组（SG）进行躯干、臀部和膝关节肌肉的强化练习，而神经肌肉训练组（NMTG）则在第 4 周后开始进行相同的练习外加神经肌肉训练。主要结果是疼痛强度、功能和躯干和下肢的 2-D 运动学。次要结果是等长肌肉力量和患者满意度水平。所有结果均在 12 周时进行评估，即治疗后即刻。
在 12 周时，两组之间在任何结果上均无证据表明存在差异，但两种干预措施均为疼痛强度（SG：平均差异-3.9，95%置信区间[CI] -5.0，-2.9；NMTG：平均差异-3.1，95%CI -4.1，-2.0）和功能（SG：平均差异 15.3，95%CI 11.5，19.2；NMTG：平均差异 16.9，95%CI 13.2，20.7）提供了临床显著的改善。
在 12 周的治疗中，神经肌肉训练并未为疼痛、功能或运动学提供任何额外的益处。
