【論文摘要】Comparing Differences of Muscle Activation During Exercise of Lower Extremity in People With Patella Femoral Pain Syndrome and Healthy: A Systematic Review and Meta-Analysis

【論文摘要】比較患有髕骨股骨疼痛症候群患者與健康人在運動時下肢肌肉活化狀態的差異：系統性文獻回顧與統合分析

陳柏睿(Po-Jui Chen) ； 陳香伶(Xiang-Ling Chen) ； 葉純妤(Chun-Yu Yeh) ； 王淳厚(Chun-Hou Wang)

《物理治療》 47卷2期 (2022/06) Pp. 148-149

https://doi.org/10.6215/FJPT.202206.P36

摘要

Background and Purpose: Patella femoral pain syndrome (PFPS) is a term for multiple condition of anterior knee pain. The pain usually be felt around patellar or retro-patellar area. PFPS usually happens in age less than 50 years old with 25% prevalence, and female is more vulnerable than male. Recent strategy of conventional treatment is focus on knee extensor and gluteal muscle which is believed to improve patellar lateral tracking and knee dynamic valgus. The purpose of our study is to figure out the differences of muscle activation during lower extremity exercise between people with PFPS and healthy people. The muscle we observed include Gluteus maximum (Gmax), Gluteus medius (Gmed), Vastus medialis oblique (VMO), Vastus lateralis (VL). Therefore, we could know about which muscle deficit may be the key factor for developing PFPS. Methods: We searched the Pubmed, Web of Science and Cochrane Library from 2000 to 2021 for studies including subjects with PFPS and without PFPS, which investigate muscle activation of lower extremity by surface electromyography (sEMG). Two reviewers appraised methodological quality using the Newcastle-Ottawa Scale. We conducted the meta-analysis with mean differences for continuous data. Results: This review included 6 low to moderate quality studies which compare differences about amplitude of Gmax, Gmed, VMO, VL and onset-timing by sEMG. There were two comparable movements which are step down and single leg squat, no significant differences was found in amplitude of Gmax, Gmed, VMO, and onset-timing between VL-Gmed, VL-VMO, VM-Gmed during both movements between groups. Only the amplitude of VL was significant higher in PFPS compare with healthy subjects (MD = 8.17, 95% CI [1.41, 14.93], p = 0.02). Conclusions: People with PFPS only tend to activate more VL than healthy people during same movement task. This may indicate that knee dynamic valgus will cause extra torque, which force VL to activate more for patellar stabilization. Clinical Relevance: This result suggests that the priority of treatment for PFPS should be more focus on regulating the alignment of lower extremity during movement task.