There is more to the knee joint than just the quadriceps:A systematic review with meta-analysis and evidence gap map of hamstring strength,flexibility,and morphology in individuals with gradual-onset knee disorders  

作　　者：Helder S.Lopes Marina C.Waiteman Liliam B.Priore Neal R.Glaviano David M.Bazett-Jones Ronaldo V.Briani Fabio M.Azevedo 

机构地区：[1]School of Science and Technology,Physical Therapy Department,Sao Paulo State University(UNESP),Presidente Prudente 19060-900,Brazil [2]Department of Kinesiology,College of Agriculture,Health and Natural Resources,University of Connecticut,Storrs,CT 06269,USA [3]School of Exercise and Rehabilitation Sciences,College of Health and Human Services,University of Toledo,Toledo,OH 43606,USA

出　　处：《Journal of Sport and Health Science》2024年第4期521-536,共16页运动与健康科学（英文）

基　　金：This work was supported by the Sao Paulo Research Foundation(FAPESP),which provided scholarships to HSL(Grant No.2021/09393-1);RVB(Grant No.2021/08644-0)and a research grant to FMA(Grant No.2020/14715-5).The financial sponsors played no role in the design,execution,analysis and interpretation of data,or the writing of the study。

摘　　要：Background:Impairments in hamstring strength,flexibility,and morphology have been associated with altered knee biomechanics,pain,and function.Determining the presence of these impairments in individuals with gradual-onset knee disorders is important and may indicate targets for assessment and rehabilitation.This systematic review aimed to synthesize the literature to determine the presence of impairments in hamstring strength,flexibility,and morphology in individuals with gradual-onset knee disorders.Methods:Five databases(MEDLINE,Embase,CINAHL,SPORTDiscus,and Web of Science)were searched from inception to September 2022.Only studies comparing hamstring outcomes(e.g.,strength,flexibility,and/or morphology)between individuals with gradual-onset knee disorders and their unaffected limbs or pain-free controls were included.Meta-analyses for each knee disorder were performed.Outcome-level certainty was assessed using the Grading of Recommendations Assessment,Development,and Evaluation,and evidence gap maps were created.Results:Seventy-nine studies across 4 different gradual-onset knee disorders(i.e.,knee osteoarthritis(OA),patellofemoral pain(PFP),chondromalacia patellae,and patellar tendinopathy)were included.Individuals with knee OA presented with reduced hamstring strength compared to pain-free controls during isometric(standard mean difference(SMD)=-0.76,95%confidence interval(95%CI):-1.32 to-0.21)and concentric contractions(SMD=-0.97,95%CI:-1.49 to-0.45).Individuals with PFP presented with reduced hamstring strength compared to painfree controls during isometric(SMD=-0.48,95%CI:-0.82 to-0.14),concentric(SMD=-1.07,95%CI:-2.08 to-0.06),and eccentric contractions(SMD=-0.59,95%CI:-0.97 to-0.21).No differences were observed in individuals with patellar tendinopathy.Individuals with PFP presented with reduced hamstring flexibility when compared to pain-free controls(SMD=-0.76,95%CI:-1.15 to-0.36).Evidence gap maps identified insufficient evidence for chondromalacia patellae and hamstring morphology across all gradual-

关 键 词：Chondromalacia patellae Knee flexors Knee osteoarthritis Patellar tendinopathy Patellofemoral pain 

分 类 号：G804.2[文化科学—运动人体科学] R684[文化科学—体育学]