肌貼對於髕骨股骨疼痛患者在功能性動作的效應

Effect of Kinesio taping on functional movement in patients with patellofemoral pain

林依柔(Yi-Jou Lin)

指導教授 ： 林槐庭

高雄醫學大學/醫學院/運動醫學系碩士班/碩士(2019年)

摘要

前言：髕骨股骨疼痛患者常見問題為下肢結構排列異常與肌肉不平衡等問題，在年輕族群很常見，尤其特別容易發生在愛運動的人，且此類型的人最常在以下功能產生疼痛或受限，如走路、跑步、上下樓梯、蹲下、跳躍以及膝關節屈曲過多等，常用貼紮方法透過矯正膝與髖關節使得下肢排列正常化進而讓肌肉活化，以維持關節穩定，減少疼痛，但是是否能減少關節壓迫力與受力等問題，則需要進一步探討。
目的：探討肌貼對於髕骨股骨疼痛患者在執行日常生活功能性活動時對下肢肌肉活化與下肢關節角度的影響。
方法：本研究招募15名髕骨股骨疼痛患者與10名健康成年人，分別做無貼紮、股骨旋轉貼紮(肌貼)、Mcconnell貼紮(雷可貼)下執行六項功能性活動包括10公尺行走、10公尺跑步、上階梯、下階梯、蹲下、跳躍著地，並使用三度空間動作分析系統、表面肌電訊號測量臀中肌、股內斜肌、股外側肌、股直肌在這些動作中肌肉活化情形與其下肢髖、膝、踝關節的角度變化並使用SPSS20.0做two way ANOVA分析2(疼痛組：健康組)X3(無貼：肌貼：雷可貼)。
結果：研究結果發現，在肌貼組在功能活動期間，肌貼顯著增加跑步時臀中肌、跳躍時股直肌與股內側肌肌肉活化以及肌貼顯著增加下階梯時髖關節屈曲、減少蹲時膝內翻角度。
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結論：我們發現股骨旋轉貼法對於髕骨股骨疼痛患者的臀中肌與股內斜肌有顯著活化，對於髕骨股骨疼痛患者來說股內斜肌與臀中肌容易受到抑制產生活化減少的現象，從此結果得知，此貼法似乎對於臀中肌與股內斜肌活化是有幫助的，以下肢運動學來說，此貼法也可增加髕骨疼痛患者髖屈曲角度與膝內翻角度，這似乎可以減少下肢髖關節與膝關錯誤排列的受力，此外我們也發現肌貼似乎對於健康族群也是有幫助的，但未來如果還是要繼續進行此方面研究可以搭配一些運動訓練或者神經肌肉控制的治療去做進一步的探討。

關鍵字

肌貼 ； 股骨旋轉貼紮 ； 雷可貼 ； 下肢運動學 ； 功能性活動

並列摘要

Introduction: Patellofemoral pain syndrome (PFPS) is usually results from malalignment and muscle contraction imbalance in lower extremities structure,. It is very common in young people, especially in like sports, and this type of person is most often from pain or limitation in the following functions, such as walking, running, up stair and down stairs, squat, jumping, and excessive knee flexion, In this study, this method is a femoral rotation taping. By correcting the knee and hip joints, the lower limbs are normalized and the muscles are activated to maintain the joint stability. However, if the joint pressure and force are reduced, further research is needed explore.
Purposes: Investigate the effect of kinesiotaping on the activation of lower limb muscles and the joint angle of lower limbs in patients with PFPS who performed 10 m walking, 10 m running, up step, down step, jumping.
Method: 15 patients with PFPS were recruited and 10 healthy adults were recruited. They were performed non-taping, femoral rotation taping (kinesiotape) and Mcconnell taping (Leuko) and performed three functional activities. The 3D motion analysis system and the surface electromyography system measure the change of the muscle activation of the gluteus medius(GM), the vastus medialis oblique(VMO), the vastus lateralis(VL) , and the rectus femoris(RF) in these movements with hip and knee and ankle joint of the lower limb.
Result: The results of the study showed that the kinesiotaping had a significant increase in the activation of the GM in PFPS, and a significant increase in the activation of the VMO during jumping. For the healthy, the hip can be reduced on the up step. In the internal rotation, increase the hip flexion and external rotation when squat, in addition, Mcconnell taping can reduce the activation of the VL when walking the PFPS, reduce the hip rotation and knee flexion angle during running, Leuko can increase the hip for healthy people activation of the GM can increase the knee flexion during walking, the knee flexion when the down step, and reduce the hip flexion when jumping.
Conclusion: We found that the femoral rotation taping has significant activation of the GM and the VMO in patients with PFPS. PFPS the VMO and GM are susceptible to inhibition and activation is reduced. It is known that this method seems to be helpful for the activation of the GM and VMO. In the following kinematics, this method can increase the hip flexion and knee varus in PFPS, which seems to reduce hip and knee are malalignment. We also found Leuko can reduce the hip internal rotation and increase the knee flexion during running. In addition, we also found that the kinesiotape and Leuko tape seem to have help a healthy , but if you want to continue this research in the future, you can do some further research with some exercise training or neuromuscular control.

並列關鍵字

kinesiotaping ； femoral rotation taping ； Leuko tape ； kinematics ； functional activities

參考文獻

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2.Smith, B.E., et al., Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PloS one, 2018. 13(1): p. e0190892.

3.Crossley, K.M., et al., 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med, 2016. 50(14): p. 844-852.

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