[1]曹孝荣,张来.电疗法联合核心肌群稳定性训练治疗髌股疼痛综合征的临床研究[J].中医正骨,2022,34(09):11-16.
　CAO Xiaorong,ZHANG Lai.A clinical study of electrotherapy combined with core muscles stability training for treatment of patellofemoral pain syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(09):11-16.
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电疗法联合核心肌群稳定性训练治疗髌股疼痛综合征的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年09期
页码:
11-16
栏目:
临床研究
出版日期:
2022-09-20

文章信息/Info

Title:
A clinical study of electrotherapy combined with core muscles stability training for treatment of patellofemoral pain syndrome
作者:
曹孝荣1; 张来2
(1.浙江中医药大学,浙江杭州310053;2.宁波市鄞州区第二医院,浙江宁波315100)
Author(s):
CAO Xiaorong1; ZHANG Lai2
1.Zhengjiang chinese Medical University,Hangzhou 310053,Zhejiang,China 2.Ningbo Yinzhou No.2 Hospital,Ningbo 315100,Zhejiang,China
关键词:
膝关节;  髌骨;  髌股关节;  疼痛;  电刺激疗法;  核心肌群稳定性训练;  临床试验
Keywords:
knee joint;  patella;  patellofemoral joint;  pain;  electric stimulation therapy;  core muscle stability training;  clinical trial
摘要:
目的:观察电疗法联合核心肌群稳定性训练治疗髌股疼痛综合征(patellofemoral pain syndrome,PFPS)的临床疗效。方法:将符合要求的PFPS患者随机分为2组,每组150例。联合治疗组采用电疗法联合核心肌群稳定性训练治疗,电疗法每日1次,每周连续治疗5 d后休息2 d,在每周的第1、3、5次电疗法治疗后进行核心肌群稳定性训练,连续治疗6周; 常规治疗组仅采用电疗法治疗,治疗方法及时间同联合治疗组。分别于治疗前、治疗结束后,采用数字评价量表(numeric rating scale,NRS)评价患者膝关节疼痛程度,采用Lysholm膝关节评分标准评价膝关节功能,测量患者的膝关节主动活动度和Q角,采用三维步态训练评估系统测定患者步态周期、步幅与步速。结果:①膝关节疼痛NRS评分。治疗前,2组患者膝关节疼痛NRS评分比较,差异无统计学意义(t=-0.290,P=0.772); 治疗结束后,2组患者膝关节疼痛NRS评分均低于治疗前[(4.91±0.95)分,(1.95±0.81)分,t=19.955,P=0.000;(4.88±0.84)分,(2.99±0.80)分,t=29.038,P=0.000],联合治疗组患者膝关节疼痛NRS评分低于常规治疗组(t=11.188,P=0.000)。②Lysholm膝关节评分。治疗前,2组患者Lysholm膝关节评分比较,差异无统计学意义(t=-1.252,P=0.212); 治疗结束后,2组患者Lysholm膝关节评分均高于治疗前[(64.81±6.17)分,(85.47±6.08)分,t=-29.211,P=0.000;(63.98±5.28)分,(75.27±7.09)分,t=-15.642,P=0.000],联合治疗组患者Lysholm膝关节评分高于常规治疗组(t=-13.375,P=0.000)。③膝关节主动活动度。治疗前,2组患者膝关节主动活动度比较,差异无统计学意义(t=0.496,P=0.620); 治疗结束后,2组患者膝关节主动活动度均大于治疗前(113.82°±7.94°,129.54°±7.88°,t=-17.211,P=0.000; 114.28°±8.12°,121.37°±7.56°,t=-7.827,P=0.000),联合治疗组患者膝关节主动活动度大于常规治疗组(t=-9.163,P=0.000)。④Q角。治疗前,2组患者Q角比较,差异无统计学意义(t=-0.997,P=0.319); 治疗结束后,2组患者Q角均小于治疗前(19.38°±2.36°,16.78°±2.48°,t=9.302,P=0.000; 19.12°±2.15°,17.76°±2.29°,t=5.303,P=0.000),联合治疗组患者Q角小于常规治疗组(t=3.556,P=0.000)。⑤步态周期。治疗前,2组患者步态周期比较,差异无统计学意义(t=-1.036,P=0.301); 治疗结束后,2组患者步态周期均短于治疗前[(1.45±0.23)s,(1.21±0.16)s,t=10.491,P=0.000;(1.48±0.27)s,(1.37±0.20)s,t=4.010,P=0.000],联合治疗组患者步态周期短于常规治疗组(t=-7.651,P=0.000)。⑥步幅。治疗前,2组患者步幅比较,差异无统计学意义(t=-1.007,P=0.315); 治疗结束后,2组患者步幅均大于治疗前[(108.25±9.33)cm,(121.27±8.41)cm,t=-12.695,P=0.000;(109.28±8.36)cm,(115.33±9.52)cm,t=-5.848,P=0.000],联合治疗组患者步幅大于常规治疗组(t=5.727,P=0.000)。⑦步速。治疗前,2组患者步速比较,差异无统计学意义(t=0.719,P=0.473); 治疗结束后,2组患者步速均大于治疗前[(0.80±0.11)m·s-1,(0.95±0.13)m·s-1,t=-10.788,P=0.000;(0.79±0.13)m·s-1,(0.86±0.14)m·s-1,t=-4.487,P=0.000],联合治疗组患者步速大于常规治疗组(t=5.770,P=0.000)。结论:采用电疗法联合核心肌群稳定性训练治疗PFPS,与单纯电疗法治疗相比,更有利于缓解膝关节疼痛、改善膝关节功能和稳定性、恢复正常步态。
Abstract:
Objective:To observe the clinical outcomes of electrotherapy combined with core muscles stability training for treatment of patellofemoral pain syndrome(PFPS).Methods:Three hundred PFPS patients were enrolled in the study and were randomly divided into combination treatment group and conventional treatment group,150 cases in each group.The patients in combination treatment group were treated with electrotherapy and core muscles stability training,while the ones in conventional treatment group with electrotherapy alone.The electrotherapy was performed once a day for consecutive 6 weeks with a 2-day rest-insertion between every 2 weeks,and the core muscles stability training was conducted after the 1st,3rd and 5th electrotherapy each week for consecutive 6 weeks.Before the treatment and after the end of the treatment,the knee pain degree and knee function were evaluated by using numeric rating scale(NRS)and Lysholm knee scoring standards respectively,and the active range of motion(ROM)of knee and Q angle were measured.Furthermore,the gait cycle,stride length and gait speed were measured by three-dimensional gait training evaluation system.Results:①There was no statistical difference in knee pain NRS scores between the 2 groups before the treatment(t=-0.290,P=0.772).The knee pain NRS scores decreased in the 2 groups after the end of the treatment compared to pre-treatment(4.91±0.95 vs 1.95±0.81 points,t=19.955,P=0.000; 4.88±0.84 vs 2.99±0.80 points,t=29.038,P=0.000),and it was lower in combination treatment group compared to conventional treatment group(t=11.188,P=0.000).②There was no statistical difference in Lysholm knee scores(LKSs)between the 2 groups before the treatment(t=-1.252,P=0.212).The LKSs increased in the 2 groups after the end of the treatment compared to pre-treatment(64.81±6.17 vs 85.47±6.08 points,t=-29.211,P=0.000; 63.98±5.28 vs 75.27±7.09 points,t=-15.642,P=0.000),and it was higher in combination treatment group compared to conventional treatment group(t=-13.375,P=0.000).③There was no statistical difference in knee active ROM between the 2 groups before the treatment(t=0.496,P=0.620).The knee active ROM increased in the 2 groups after the end of the treatment compared to pre-treatment(113.82±7.94 vs 129.54±7.88 degrees,t=-17.211,P=0.000; 114.28±8.12 vs 121.37±7.56 degrees,t=-7.827,P=0.000),and it was greater in combination treatment group compared to conventional treatment group(t=-9.163,P=0.000).④There was no statistical difference in Q angle between the 2 groups before the treatment(t=-0.997,P=0.319).The Q angle decreased in the 2 groups after the end of the treatment compared to pre-treatment(19.38±2.36 vs 16.78±2.48 degrees,t=9.302,P=0.000; 19.12±2.15 vs 17.76±2.29 degrees,t=5.303,P=0.000),and it was smaller in combination treatment group compared to conventional treatment group(t=3.556,P=0.000).⑤There was no statistical difference in gait cycle between the 2 groups before the treatment(t=-1.036,P=0.301).The gait cycle shortened in the 2 groups after the end of the treatment compared to pre-treatment(1.45±0.23 vs 1.21±0.16 seconds,t=10.491,P=0.000; 1.48±0.27 vs 1.37±0.20 seconds,t=4.010,P=0.000),and it was shorter in combination treatment group compared to conventional treatment group(t=-7.651,P=0.000).⑥There was no statistical difference in stride length between the 2 groups before the treatment(t=-1.007,P=0.315).The stride length increased in the 2 groups after the end of the treatment compared to pre-treatment(108.25±9.33 vs 121.27±8.41 cm,t=-12.695,P=0.000; 109.28±8.36 vs 115.33±9.52 cm,t=-5.848,P=0.000),and it was longer in combination treatment group compared to conventional treatment group(t=5.727,P=0.000).⑦There was no statistical difference in gait speed between the 2 groups before the treatment(t=0.719,P=0.473).The gait speed increased in the 2 groups after the end of the treatment compared to pre-treatment(0.80±0.11 vs 0.95±0.13 m/s,t=-10.788,P=0.000; 0.79±0.13 vs 0.86±0.14 m/s,t=-4.487,P=0.000),and it was greater in combination treatment group compared to conventional treatment group(t=5.770,P=0.000).Conclusion:Electrotherapy combined with core muscles stability training can be more conducive to relieving knee pain,improving knee function and stability as well as restoring normal gait compared to electrotherapy alone in treatment of PFPS.

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更新日期/Last Update: 1900-01-01