《国际功能、残疾和健康分类·髌股关节疼痛》临床实践指南(二)  

Patellofemoral Pain(Ⅱ):Clinical Practice Guidelines Linked to the International Classification of Functioning,Disability and Health

作　　者：美国物理治疗协会骨科分会 王芗斌(翻译) 刘燕平(翻译) 苏娟(翻译) 巫丽媛(翻译) 陈雪玲(翻译) 徐洋(翻译) 廖麟荣(翻译) 孙扬(翻译) 韩云峰(翻译) The Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association

机构地区：[1]不详

出　　处：《康复学报》2021年第3期177-199,共23页Rehabilitation Medicine

摘　　要：美国物理治疗协会(APTA)骨科分会基于国际功能、残疾和健康分类(ICF)制定髌股关节疼痛临床实践指南。指南首先介绍了制定方法、髌股关节疼痛对应的国际疾病分类ICD-10编码及ICF相应的编码;此外,通过回顾最新的同行评议文献对证据水平进行评分,并对髌股关节疼痛相关的评估和物理治疗方案提出推荐意见及其等级说明。其内容分为3个部分:①基于损伤/功能的诊断:患病率和发生率、病理解剖特征、危险因素、诊断、功能分类(过度使用/过度负荷但不伴其他障碍、肌肉表现不足、运动协调障碍、活动障碍)、鉴别诊断;②检查:结局评测、活动受限、躯体损伤评测的方法以及信效度说明,并总结最佳实践观点;③干预方法:包括运动治疗、贴扎、支具、理疗、针刺疗法、患者教育、联合治疗等。每个部分除引用文献数据详细说明外,还有相应的总结、证据综合和临床原理、知识空白和推荐意见说明。本指南为康复临床工作者(包括康复医师和治疗师)在髌股关节疼痛的管理方面提供了整体康复方案,也为康复团队成员工作之间的衔接提供了统一的标准和认识;指南中尚未明确的问题还为今后的科研方向提供了思路,充分体现指南对临床实践的指导性和规范性的作用。The Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association(APTA)created clinical practice guidelines on patellofemoral pain(PFP)based on the International Classification of Functioning,Disability and Health(ICF).Firstly,the guidelined describes the formulation method,International Classification of Diseases(ICD)-10 codes and ICF codes corresponding to PFP.In addition,the guidelines reviewed the latest peer-review literature to grade different levels of evidence,and provided recommendations on assessment and physical therapy for patellofemoral pain with recommendation grades,which were divided into three parts:1)Impairment/function-based diagnosis:prevalence and incidence,pathoanatomical features,risk factors,diagnosis and classifications(overuse/overload without other impairment,muscle performance deficits,movement coordination deficits,and/or mobility impairments)and differential diagnosis.2)Examination:outcome measures,activity limitations,physical impairment.The information about reliability and diagnostic accuracy with test methods was elucidated correspondingly.Moreover,the best-practice point was summarized.3)Intervention:exercise therapy,taping,bracing,physical agents,needling therapies,patient education,combined interventions,etc.In each part,the detailed information of the cited literature data,summary,evidence synthesis and clinical rationales,gaps in knowledge as well as recommendations were introduced.The guidelines provided clinicians,including physiatrists and therapists,the overall rehabilitation protocol on management of PFP,also helped them link up their work between each other based on the unified standard and consensus.The gaps in knowledge enlightened future research.The guidelines fully embodied its role of guidance and standardability for clinical practice.

关 键 词：髌股关节疼痛 国际疾病分类 国际功能、残疾和健康分类 骨科部分 临床实践指南 

分 类 号：R47[医药卫生—护理学]