Ayık Burcu, Armağan Onur, Bakılan Fulya
Department of Physical Medicine and Rehabilitation, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Türkiye.
Turk J Phys Med Rehabil. 2025 May 22;71(2):216-225. doi: 10.5606/tftrd.2025.15971. eCollection 2025 Jun.
The aim of this study was to compare the effect of open and closed kinetic chain exercises on pain, thickness of vastus medialis (VM) and vastus medialis oblique (VMO) muscle, and VMO architecture.
The randomized single-blind prospective was conducted between January 2022 and September 2023. Thirty patients (11 males, 19 females; mean age: 37.5±8.8 years; range, 18 to 50 years) with patellofemoral pain syndrome (PFPS) were randomized into two groups. Fifteen patients in the first group (23 knees) received open kinetic chain exercises, and 15 patients in the second group (22 knees) received closed kinetic chain exercises (CKCE) as a six-week home exercise program. The following variables were measured before and after the exercise program: Visual Analog Scale , Q angle, and ultrasonographic measurements. In ultrasonographic measurements, the thickness of the VM and VMO muscles and the VMO fiber angle was evaluated.
Both groups showed statistically highly significant improvement in all evaluation parameters in inter- and intragroup comparisons (p<0.001). Before treatment, there was no statistical difference in Visual Analog Scale scores between the two groups. However, a significant decrease was observed in favor of the CKCE group after treatment (p=0.037). There was no statistically significant difference between the groups in terms of VMO, VM muscle thickness, and fiber angle changes (p=0.26, p=0.28, and p=0.28, respectively).
The thickness of the VM and VMO muscles, the angle of the VMO fibers, and the pain scores improved both exercise groups in patients with PFPS. However, CKCE proved to be superior for pain reduction. Both open and closed kinetic chain exercises can be beneficial for PFPS management, with CKCE potentially being more appropriate for patients with prominent pain.
本研究旨在比较开链运动和闭链运动对疼痛、股内侧肌（VM）和股内侧斜肌（VMO）肌肉厚度以及VMO结构的影响。
随机单盲前瞻性研究于2022年1月至2023年9月进行。30例髌股疼痛综合征（PFPS）患者（11例男性，19例女性；平均年龄：37.5±8.8岁；范围18至50岁）被随机分为两组。第一组15例患者（23个膝关节）接受开链运动，第二组15例患者（22个膝关节）接受闭链运动（CKCE）作为为期六周的家庭锻炼计划。在锻炼计划前后测量以下变量：视觉模拟评分、Q角和超声测量。在超声测量中，评估VM和VMO肌肉的厚度以及VMO纤维角度。
两组在组间和组内比较中所有评估参数均显示出统计学上的高度显著改善（p<0.001）。治疗前，两组之间的视觉模拟评分无统计学差异。然而，治疗后观察到CKCE组有显著下降（p=0.037）。两组在VMO、VM肌肉厚度和纤维角度变化方面无统计学显著差异（分别为p=0.26、p=0.28和p=0.28）。
PFPS患者的两个运动组中，VM和VMO肌肉厚度、VMO纤维角度以及疼痛评分均有所改善。然而，CKCE在减轻疼痛方面被证明更具优势。开链运动和闭链运动对PFPS的管理都可能有益，CKCE可能更适合疼痛突出的患者。
