School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, OH, USA.
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Gait Posture. 2024 Mar;109:189-200. doi: 10.1016/j.gaitpost.2024.02.002. Epub 2024 Feb 3.
Patellofemoral pain (PFP) is a prevalent musculoskeletal disorder associated with functional impairments. Although postural control is commonly assessed in people with PFP, there are inconsistent results regarding potential postural control deficits in this population.
This review aims to evaluate whether postural control is impaired in people with patellofemoral pain (PFP) and the effectiveness of interventions on postural control measures.
We searched six databases from their inception to May 5, 2023. We included studies assessing clinic- or laboratory-based postural control measures in people with PFP compared to pain-free controls, and intervention studies with PFP populations. We assessed risk of bias using the Joanna Briggs Institute critical appraisal checklists and the Cochrane Risk of Bias 2 tool. We assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We used random-effects meta-analyses considering subgroups based on type of task, measure, and intervention.
Fifty-three studies were included. Very low certainty evidence indicated that people with PFP have shorter anterior (SMD = 0.53, 95 %CI:0.16,0.90), posteromedial (SMD = 0.54, 95 %CI:0.04,1.03) and posterolateral (SMD = 0.59, 95 %CI:0.11,1.07) reach distance, and worse composite score (SMD = 0.46, 95 %CI:0.22,0.70). Very low to moderate certainty evidence indicated that people with PFP have worse anterior-posterior and overall stability indexes during single-leg stance (SMD = -0.71, 95 %CI:-1.29,-0.14; SMD = -0.63, 95 %CI:-0.94,-0.32) and overall stability index during double-leg stance (SMD = -0.39, 95 %CI:-0.78,-0.00), but no differences in center of pressure area during stair ascent (SMD = 0.32, 95 %CI:-2.72, 3.36). Low certainty evidence indicated that kinesio taping improved anterior reach distance (SMD = -0.49, 95 %CI:-0.89,-0.09), while no significant differences were observed between pre- and post-intervention outcomes for conventional rehabilitation and rigid taping.
Clinicians should use clinic- (star excursion or Y-balance tests) and laboratory-based (stability indexes) measures to identify impairments of postural control in people with PFP. Low certainty of evidence suggests short-term improvement in postural control with kinesio taping.
髌股疼痛（PFP）是一种常见的肌肉骨骼疾病，与功能障碍有关。尽管在 PFP 患者中通常会评估姿势控制，但对于该人群中潜在的姿势控制缺陷存在不一致的结果。
本综述旨在评估髌股疼痛（PFP）患者的姿势控制是否受损，以及干预措施对姿势控制测量的影响。
我们从数据库建立之初到 2023 年 5 月 5 日搜索了六个数据库。我们纳入了比较 PFP 患者和无疼痛对照者的基于诊所或实验室的姿势控制测量的研究，以及针对 PFP 人群的干预研究。我们使用 Joanna Briggs 研究所的批判性评价清单和 Cochrane 风险偏倚 2 工具评估偏倚风险。我们使用 Grading of Recommendations, Assessment, Development and Evaluations（GRADE）方法评估证据的确定性。我们使用随机效应荟萃分析，根据任务类型、测量和干预的不同考虑亚组。
共纳入 53 项研究。非常低确定性证据表明，PFP 患者的前向（SMD=0.53，95%CI：0.16，0.90）、后内侧（SMD=0.54，95%CI：0.04，1.03）和后外侧（SMD=0.59，95%CI：0.11，1.07）伸展距离较短，综合评分较差（SMD=0.46，95%CI：0.22，0.70）。非常低到中等确定性证据表明，在单腿站立时，PFP 患者的前-后向和整体稳定性指数（SMD=-0.71，95%CI：-1.29，-0.14；SMD=-0.63，95%CI：-0.94，-0.32）和双腿站立时的整体稳定性指数（SMD=-0.39，95%CI：-0.78，0.00）较差，但在上楼梯时的压力中心面积没有差异（SMD=0.32，95%CI：-2.72，3.36）。低确定性证据表明，肌内效贴布可改善前向伸展距离（SMD=-0.49，95%CI：-0.89，-0.09），而常规康复和刚性贴布干预前后的结果无显著差异。
临床医生应使用基于诊所（星状伸展或 Y 平衡测试）和实验室（稳定性指数）的测量来识别 PFP 患者的姿势控制障碍。低确定性证据表明，肌内效贴布可在短期内改善姿势控制。
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