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[1]曹孝榮,張來.電療法聯(lián)合核心肌群穩(wěn)定性訓練治療髕股疼痛綜合征的臨床研究[J].中醫(yī)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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電療法聯(lián)合核心肌群穩(wěn)定性訓練治療髕股疼痛綜合征的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年09期
頁碼:
11-16
欄目:
臨床研究
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:
曹孝榮1; 張來2
(1.浙江中醫(yī)藥大學,浙江杭州310053;2.寧波市鄞州區(qū)第二醫(yī)院,浙江寧波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
關鍵詞:
膝關節(jié);  髕骨;  髕股關節(jié);  疼痛;  電刺激療法;  核心肌群穩(wěn)定性訓練;  臨床試驗
Keywords:
knee joint;  patella;  patellofemoral joint;  pain;  electric stimulation therapy;  core muscle stability training;  clinical trial
摘要:
目的:觀察電療法聯(lián)合核心肌群穩(wěn)定性訓練治療髕股疼痛綜合征(patellofemoral pain syndrome,PFPS)的臨床療效。方法:將符合要求的PFPS患者隨機分為2組,每組150例。聯(lián)合治療組采用電療法聯(lián)合核心肌群穩(wěn)定性訓練治療,電療法每日1次,每周連續(xù)治療5 d后休息2 d,在每周的第1、3、5次電療法治療后進行核心肌群穩(wěn)定性訓練,連續(xù)治療6周; 常規(guī)治療組僅采用電療法治療,治療方法及時間同聯(lián)合治療組。分別于治療前、治療結束后,采用數(shù)字評價量表(numeric rating scale,NRS)評價患者膝關節(jié)疼痛程度,采用Lysholm膝關節(jié)評分標準評價膝關節(jié)功能,測量患者的膝關節(jié)主動活動度和Q角,采用三維步態(tài)訓練評估系統(tǒng)測定患者步態(tài)周期、步幅與步速。結果:①膝關節(jié)疼痛NRS評分。治療前,2組患者膝關節(jié)疼痛NRS評分比較,差異無統(tǒng)計學意義(t=-0.290,P=0.772); 治療結束后,2組患者膝關節(jié)疼痛NRS評分均低于治療前[(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],聯(lián)合治療組患者膝關節(jié)疼痛NRS評分低于常規(guī)治療組(t=11.188,P=0.000)。②Lysholm膝關節(jié)評分。治療前,2組患者Lysholm膝關節(jié)評分比較,差異無統(tǒng)計學意義(t=-1.252,P=0.212); 治療結束后,2組患者Lysholm膝關節(jié)評分均高于治療前[(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],聯(lián)合治療組患者Lysholm膝關節(jié)評分高于常規(guī)治療組(t=-13.375,P=0.000)。③膝關節(jié)主動活動度。治療前,2組患者膝關節(jié)主動活動度比較,差異無統(tǒng)計學意義(t=0.496,P=0.620); 治療結束后,2組患者膝關節(jié)主動活動度均大于治療前(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),聯(lián)合治療組患者膝關節(jié)主動活動度大于常規(guī)治療組(t=-9.163,P=0.000)。④Q角。治療前,2組患者Q角比較,差異無統(tǒng)計學意義(t=-0.997,P=0.319); 治療結束后,2組患者Q角均小于治療前(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),聯(lián)合治療組患者Q角小于常規(guī)治療組(t=3.556,P=0.000)。⑤步態(tài)周期。治療前,2組患者步態(tài)周期比較,差異無統(tǒng)計學意義(t=-1.036,P=0.301); 治療結束后,2組患者步態(tài)周期均短于治療前[(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],聯(lián)合治療組患者步態(tài)周期短于常規(guī)治療組(t=-7.651,P=0.000)。⑥步幅。治療前,2組患者步幅比較,差異無統(tǒng)計學意義(t=-1.007,P=0.315); 治療結束后,2組患者步幅均大于治療前[(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],聯(lián)合治療組患者步幅大于常規(guī)治療組(t=5.727,P=0.000)。⑦步速。治療前,2組患者步速比較,差異無統(tǒng)計學意義(t=0.719,P=0.473); 治療結束后,2組患者步速均大于治療前[(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],聯(lián)合治療組患者步速大于常規(guī)治療組(t=5.770,P=0.000)。結論:采用電療法聯(lián)合核心肌群穩(wěn)定性訓練治療PFPS,與單純電療法治療相比,更有利于緩解膝關節(jié)疼痛、改善膝關節(jié)功能和穩(wěn)定性、恢復正常步態(tài)。
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