亚组分型个体化运动干预治疗髌股关节疼痛综合征的疗效  

Based on subgroups plot treatment of patellofemoral pain syndrome

作　　者：范志航 李强[1] 虞多多 史黎晗 罗仲流[1] 高志[1] FAN Zhihang;LI Qiang;YU Duoduo;SHI Lihan;LUO Zhongliu;GAO Zhi(Department of Knee Sport Injury, Sichuan Province Orthopedic Hospital, Chengdu 610000, China;Department of Sport Injury, Sichuan Province Orthopedic Hospital, Chengdu 610000, China;Department of Orthopaedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, China)

机构地区：[1]四川省骨科医院膝关节运动损伤科,四川成都610000 [2]四川省骨科医院运动医学科,四川成都610000 [3]成都中医药大学附属医院骨科,四川成都610000

出　　处：《西部医学》2021年第12期1821-1825,共5页Medical Journal of West China

基　　金：四川省干部保健科研课题(川干研2019-602)。

摘　　要：目的评估基于亚组分型个体化运动干预治疗髌股关节疼痛综合征(PFPS)的疗效。方法回顾分析2018年12月~2020年9月在四川省骨科医院运动医学门诊收治的185例PFPS患者,采用随机数字表法分为常规运动干预组(对照组)90例和分型亚组(实验组)95例。对照组未进行亚组分型统一给予膝周肌群力量训练进行运动干预,实验组根据6项临床测试给予亚组分型(A组:肌力强壮组31例,B组:肌力薄弱和肌紧张组32例,C组:肌力薄弱和足旋前组32例)并分别针对性干预。所有治疗周期为6周,频率每周3次。分别在治疗前后对实验组和对照组患者评估运动疼痛VAS评分,Kujala髌股关节评分(KPS),动态足底压力测试、等速肌力测定髋、膝关节屈伸向心相对峰力矩进行评估。结果治疗前对照组与实验组患者人口资料及各评估指标比较差异均无统计学意义(均P>0.05),治疗后对照组及各实验亚组在运动干预后较运动干预前均有明显疼痛改善及功能评分提高(P<0.05)。实验组在运动干预后,B组VAS评分与对照组相比差异无统计学意义(P>0.05),其余两组VAS评分及KPS评分较对照组均有明显优势(均P<0.05)。实验组中B和C亚组髋、膝关节屈伸肌相对峰力矩值与治疗前相比也显著提高(P<0.05)。结论针对性运动干预较传统膝周力量训练可提高不同类型PFPS患者的膝关节日常生活能力及运动功能,降低运动时的疼痛程度。Objective To evaluate the efficacy of targeted intervention treatment for patellofemoral pain syndrome(PFPS)according to subgroups.Methods 185 patients with PFPS treated in the sports medicine clinic of Sichuan orthopedic hospital from December 2018 to September 2020 were retrospectively analyzed.They were randomly divided into 90 cases in the routine exercise intervention group(control group)and 95 cases in the typing subgroup(experimental group).The control group was not divided into subgroups,and was uniformly given strength training of knee muscle groups for exercise intervention.The experimental group was divided into subgroups according to 6 clinical tests(group A:31 cases in strong muscle group,group B:32 cases in weak muscle strength and muscle tension group,and group C:32 cases in weak muscle strength and foot pronation group).All treatment cycles were 6 weeks and the frequency was 3 times a week.The VAS score of exercise pain,Kujala patellofemoral score(KPS),dynamic plantar pressure test,isokinetic muscle strength measurement and centripetal relative peak torque of hip and knee flexion and extension were evaluated before and after treatment.Results There were no statistically significant differences in population data and evaluation indexes between the control group and the experimental group.After 6 weeks of intervention,both VAS scores and KPS scores showed good result between control group and the experimental group(P<0.05).After intervention,the VAS scores and KPS scores of B group showed no statistically significant differences,the VAS scores and KPS scores of other groups were significantly improved compared with those before treatment(P<0.05).In the experimental groups,the flexion and extension centripetal peak torque values of hip and knee in B and C groups were also significantly increased compared with those before treatment.Conclusion PFPS patients were divided into three groups based on subcomponent types,targeted treatment designed according to subgroup characteristics improves clinical out

关 键 词：亚组分型 髌股关节疼痛综合征 运动干预 

分 类 号：R684[医药卫生—骨科学]