Study On Effects Of Core Muscle Group Stability Training For Patellofemoral Pain Syndrome

Background: Patellofemoral pain syndrome(PFPS)afflicts patients because of pain and functional limitation.The main clinical manifestations include anterior,posterior and peripatellar pain,limited function of the knee joint,crepitus,and joint instability,etc.The occurrence of these symptoms are often related to activities such as up and down stairs,squatting,and sitting for a long time,which has a great impact on the quality of life for patients.Currently,there are a variety of treatments for PFPS,and the efficacy is unclear.There is no specific recommended treatment for PFPS in the clinical guidelines.Therefore,it is of certain clinical guiding significance to review the quality and efficacy of different treatment methods for PFPS.Research objectives:1.To explore effects of core muscle group stability training on patellofemoral pain syndrome by means of Sling Exercise Therapy,and to provide safe and effective treatment for patellofemoral pain syndrome from the perspective of conservative treatment.2.To review systematically effects of different treatment methods on PFPS patient and analyze quantitatively effects of functional stability training on PFPS patients.Research contents and methods:In the first part,a clinical trial was conducted to analyze the effect of a treatment on and fluencing factors on patellofemoral pain syndrome in patients diagnosed as patellofemoral pain syndrome who visited the rehabilitation department,orthopedic outpatient department and sub-centers of various groups of hospitals from July 2016 to December 2018.In this study,244 patients were selected and divided into the experimental group and the control group by different treatment methods,including 124 patients in the experimental group and 120 patients in the control group.The experimental group was treated with conventional treatment combined with sling exercise therapy,while the control group was treated with conventional treatment only.Efficacy was evaluated before treatment and at the end of 6 weeks of treatment,respectively.Evaluation indexes included visual analogue score(VAS),Lysholm knee function score,multifidus muscle thickness,and peak torque(PT)of knee flexion and extension.The second parts are systematic review and meta-analysis.Randomized controlled trials on the treatment of patellofemoral pain syndrome in Pub Med,Embase,Cochrane Library,CNKI,CBM and wanfang databases were searched by computer,and included references were also tracked.The retrieval time is from the database construction to November 2019.After literature screening,data extraction and quality review were conducted independently by 2 reviewers according to inclusion and exclusion criteria,the modified Jadad quality assessment scale was used for qualitative evaluation of PFPS treatment,and the functional stability training on PFPS was quantitatively analyzed with meta-analysis using Stata 14.0 software.Results: In the first part,244 patients were screened out in the experimental group and the control group,and the treatment before and after was completed.There was no significant difference in VAS score and Lysholm knee function score between the experimental group and the control group(P >0.05).After 6 weeks of treatment,VAS scores were lower in both groups than before treatment(P <0.05);Lysholm knee function score was increased(P <0.05).The experimental group was significantly better than the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no statistically significant differences between the experimental group and the control group in terms of the thickness of the multifidus muscle and the PT values of the flexion and extension of the knee joint(P >0.05).After 6 weeks of treatment,the measured thickness of the two groups was increased in the experimental group(P <0.05),while there was no difference in the control group before and after treatment(P >0.05),the experimental group was better than the control group,the difference was significant(P <0.05).Compared with the group before treatment,the PT value of knee flexion and extension was increased in both groups(P <0.05)and the experimental group was significantly better than the control group,the difference was statistically significant(P <0.05).In the second part,this study participants included 118 references,all treatment methods,including arthroscopic surgery,drugs,patellar sticking,patellar support,orthoses,acupuncture,vibration method,neuromuscular electrical stimulation,laser,visual feedback,the electromyographic biofeedback,technique training,physical therapy,walking,function stability,intensive training hips,knees,intensive training.The results of systematic review showed that 80 studies supported the efficacy of the experimental group which was better than that of the control group,accounting for67.8%,while another 38 studies showed that the efficacy of the experimental group was not significantly different from that of the control group,accounting for 32.2%.Among them,a total of 6 randomized controlled trials enrolling 367 patients(196 in the experimental group,171 in the control group were included on the treatment of PFPS with functional stability training.Meta-analysis results showed that compared with the control group,functional stability training could decrease the VAS score of patellofemoral pain symptoms [SMD=-0.531,95%CI(-0.978,-0.085),P=0.020],increase AKPS score[SMD=0.638,95%CI(0.078,1.197),P=0.025]Conclusions:Core muscle group stability training combined with conventional treatment is significantly better than conventional treatment for patellofemoral pain syndrome.As a classical method of core muscle group stability training,the sling exercise therapy has good operability and clinical application prospect and can be applied to the clinical treatment of patellofemoral pain syndrome.In addition,the study showed that nearly 70 percent of the treatments were more effective than the control group.Compared with the control group,functional stability training can effectively improve the pain symptoms of patients with patellofemoral pain syndrome and improve the quality of life of patients.