Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran.
Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran.
J Bodyw Mov Ther. 2024 Oct;40:141-147. doi: 10.1016/j.jbmt.2024.04.026. Epub 2024 Apr 10.
The evidence shows changes in plantar pressure asymmetry are associated with patellofemoral joint overloading and may be effective in patellofemoral pain (PFP) etiology. Psychological factors such as catastrophizing and kinesiophobia causes a change in movement behavior which can lead to a plantar pressure distribution asymmetry. This study evaluated the effect of neurofeedback training (NFBT) on psychological variables and plantar pressure distribution symmetry in patients with PFP.
Thirty males with PFP were recruited for clinical trials. They were randomly divided into experimental and control groups (each group had 15 patients). The patients in the experimental group received NFBT for 12 weeks. The primary outcome was psychological variables inclusive of pain, catastrophizing, and kinesiophobia. The secondary outcome was plantar pressure distribution symmetry which was assessed in standing conditions. The covariance statistical method was used for data analysis.
After 12 weeks of NFBT, there was a significant difference in the pain (P = 0.001, ηp = 0.467), the kinesiophobia (P = 0.001, ηp = 0.459), and the catastrophizing (P = 0.011, ηp = 0.218). However, despite the slight normalization, no significant difference in plantar pressure distribution symmetry of inter-limbs foot (η = 0.113, P = 0.075), forward and backward of right foot (η = 0.120, P = 0.066), and forward and backward of left foot (η = 0.104, P = 0.088).
NFBT reduces pain intensity, kinesiophobia, and catastrophizing by modulating areas related to pain processing and cognitive. However, NFBT has a small effect on normalizing plantar pressure. Therefore, it is recommended that adding NFBT to physical rehabilitation can have a better effect on improving clinical symptoms.
有证据表明，足底压力不对称的变化与髌股关节超负荷有关，并且可能对髌股疼痛（PFP）的病因有效。心理因素，如灾难化和运动恐惧症，导致运动行为的改变，从而导致足底压力分布不对称。本研究评估了神经反馈训练（NFBT）对 PFP 患者心理变量和足底压力分布对称性的影响。
招募了 30 名男性 PFP 患者进行临床试验。他们被随机分为实验组和对照组（每组 15 名患者）。实验组患者接受 12 周的 NFBT。主要结局指标包括疼痛、灾难化和运动恐惧症等心理变量。次要结局指标为站立状态下的足底压力分布对称性。采用协方差统计方法进行数据分析。
NFBT 12 周后，疼痛（P=0.001，ηp=0.467）、运动恐惧症（P=0.001，ηp=0.459）和灾难化（P=0.011，ηp=0.218）均有显著差异。然而，尽管略有正常化，但左右脚的足底压力分布对称性差异无统计学意义（η=0.113，P=0.075），右脚前后（η=0.120，P=0.066）和左脚前后（η=0.104，P=0.088）。
NFBT 通过调节与疼痛处理和认知相关的区域，降低疼痛强度、运动恐惧症和灾难化。然而，NFBT 对正常化足底压力的作用较小。因此，建议将 NFBT 添加到物理康复中，可以对改善临床症状产生更好的效果。
