Wang Yongshen, Li Hongpeng, Zhang Di, Zhao Tianyu, Liu Zhixiang, Chen Jia, Gong Meng, Pan Juanhong, Lu Li, Jin Song
From the School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (YW, ZL, JC, JP); School of Medical and Life Science, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (HL, LL); Rehabilitation Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (DZ, TZ, SJ); and Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (MG).
Am J Phys Med Rehabil. 2024 Dec 1;103(12):1094-1103. doi: 10.1097/PHM.0000000000002513. Epub 2024 Apr 30.
The aim of the study is to investigate the effects of core strengthening exercises on pain, mobility, and lower limb muscle strength in patients with patellofemoral pain syndrome.
Six databases were searched from inception until August 11, 2023. Pain, function, and muscle strength-related outcomes were extracted and the quality of the studies was assessed using the PEDro scale and the level of evidence was assessed using the GRADE.
Nineteen studies involving 1138 patients were included. Very low-grade evidence supported the short-term pain-relieving effect of core training (standardized mean difference = -0.60, 95% confidence interval [-0.95, -0.25]), high-grade evidence supported the short-term functional improvement effects of core training (weighted mean difference = 3.61, 95% confidence interval [1.44, 5.78]), which was similarly significant within 3-12 mos of follow-up. The results of the subgroup analyses suggested that hip-knee training was most advantageous in relieving pain and enhancing motor function.
Although training that includes trunk core is clearly superior to knee strengthening alone, the effectiveness of hip-knee training, which is also a core training program for pain and function, is more pronounced. The available evidence supports that hip-knee training is the most valuable treatment option for patients with patellofemoral pain syndrome.
本研究旨在探讨核心强化训练对髌股疼痛综合征患者疼痛、活动能力及下肢肌肉力量的影响。
检索了6个数据库，检索时间从建库至2023年8月11日。提取了与疼痛、功能和肌肉力量相关的结果，并使用PEDro量表评估研究质量，使用GRADE评估证据水平。
纳入了19项研究，共1138例患者。极低质量证据支持核心训练的短期止痛效果（标准化均差=-0.60，95%置信区间[-0.95，-0.25]），高质量证据支持核心训练的短期功能改善效果（加权均差=3.61，95%置信区间[1.44，5.78]），在3至12个月的随访期内同样显著。亚组分析结果表明，髋膝训练在缓解疼痛和增强运动功能方面最具优势。
虽然包含躯干核心的训练明显优于单纯的膝关节强化训练，但作为针对疼痛和功能的核心训练方案，髋膝训练的效果更为显著。现有证据支持髋膝训练是髌股疼痛综合征患者最有价值的治疗选择。
