臀部及核心肌肉群的康复训练对老年人髌股关节疼痛综合征的疗效观察

Effect of Rehabilitation Training of Hip and Core Muscle Group on Patellofemoral Pain Syndrome in the Elderly

目的探讨臀部及核心肌肉群的康复训练对老年髌股关节疼痛综合征(PFPS)患者的疼痛、功能、髋关节和膝关节肌肉强度、以及核心肌肉耐力的改善情况。方法招募2019年1月-2019年3月北京按摩医院门诊部269例髌股关节疼痛老年患者,其中符合纳入标准患者200例,按照单双号分组,单号为HIP组(6w髋关节和核心肌肉群加强康复方案)100例,双号为KNEE组(6w膝关节康复方案)100例,观察两组患者康复训练6w后VAS评分、AKPS评分、肌肉力量及核心耐力情况比较。结果两组患者基本特征无统计学差异(P>0.05);两个方案组康复训练3w,康复训练后HIP组患者LKSS评分及侧下肢支撑高于KNEE组,VAS评分低于KNEE组,组间差异有统计学意义(n=3.307,n=0.016;n=2.369,n=0.018;n=2.304,n=0.022);经过6w康复训练后HIP组和KNEE组患者LKSS评分、VAS评分及侧下肢支撑相均较治疗前有明显改善,但组间差异无统计学意义(均P>0.05);经过6w康复训练后,以下的指标髋关节外展肌、髋关节外旋肌、髋关节内旋肌、髋关节伸肌和膝关节伸肌核心耐力值均增加(均P<0.05),HIP方案组老年患者所有肌肉耐力测试都比KNEE组中改善更大,但变化无统计学意义(P>0.05);康复训练前、训练6w两组患者生活质量评分差异无统计学意义(P>0.05);训练6w后两组患者生活质量评分高于训练前,差异有统计学意义(P<0.05)。结论6w内HIP和KNEE康复方案对PFPS老年患者的关节功能及生活质量都有改善。但HIP方案比KNEE方案对关节功能及疼痛改善时间较早。

Objective To investigate the effect of rehabilitation training of hip and core muscle groups on the improvement of pain,function,hip and knee muscle strength,and core muscle endurance in the elderly with patellofemoral pain syndrome(PFPS).Methods Out of the 269 elderly with patellofemoral joint pain selected during the period from January,2019 to March,2019,200 cases met the inclusion criteria and were divided into 2 groups:HIP group and KNEE group,100 in each;cases in HIP group received enhanced rehabilitation of hip joint and core muscle groups for 6 weeks while cases in KNEE group receive rehabilitation of knee joint for 6 weeks;after the training for 6 weeks,a comparative study was made to the VAS score,AKPS score,muscle strength and core muscle endurance between the 2 groups.Results There was no statistical difference in the baseline information of the elderly between the 2 groups(P>0.05);3 weeks after rehabilitation training,the LKSS score and lateral lower extremity support phase were higher while the VAS score was lower in HIP group than those in KNEE group,the differences between the 2 groups were of statistical significance(n=3.307,n=0.016;n=2.369,n=0.018;n=2.304,n=0.022);6 weeks after the rehabilitation training,the LKSS score,the VAS score and the lower limb support phase of the cases in both groups were much improved while no difference was found between the groups(P>0.05),and the index of hip abductor,hip external rotation,and hip joint went up obviously(P<0.05);the improvement in all muscle endurance in HIP group was greater than that in KNEE group;there existed no statistical difference in the scores of life quality between the 2 group(P>0.05)before training while 6 weeks after training,the scores of life quality in both group were much higher than those before training(P<0.05).Conclusion Both enhanced rehabilitation of hip joint and core muscle groups and the rehabilitation of knee joint can obviously improve the quality of life of the elderly with PFPS while the former can lead to an early improvement.