Clinical Study Of Proprioceptive Neuromuscular Facilitation In Treatment Of Patellofemoral Arthritis

Objective: To evaluate the efficacy of proprioceptive neuromuscular facilitation(PNF)technique and its effect on knee muscles function in patients with patellofemoral arthritis.Methods: 44 patients with patellofemoral arthritis were randomly divided into routine group and PNF group,22 cases in each group.The routine group received routine rehabilitation,including muscle training of quadriceps,gluteus medius and gluteus maximus,microwave therapy and health education.The PNF group was given PNF intervention combined with microwave therapy and health education,and the treatment cycle in both groups were 4weeks.Before and after the treatment,visual analogue scale(VAS),WOMAC function scale and Lysholm score were evaluated,the maximum strength of vastus lateralis,vastus medialis,biceps femoris and semitendinosus muscles during maximum voluntary isometric contraction(MVIC),the activation degree of each muscle and the change of co-contraction ratio(CR)during squatting and standing exercises were observed by surface electromyography(s EMG).Results: 1.There was no significant difference in all the evaluation indexes between the routine group and PNF group before treatment(P>0.05).2.VAS score: the VAS score of the two groups were lower than before treatment(P<0.01),and the VAS score of the PNF group was better than routine group(P<0.05).3.WOMAC function scale score: the score of the two groups were lower than before treatment(P<0.01),but there was no significant difference in the score after treatment between the PNF group and routine group(P>0.05).4.Lysholm score: the score of the two groups were higher than before treatment(P<0.01),but there was no significant difference in the score after treatment between the PNF group and routine group(P>0.05).5.The s EMG changes of muscles during MVIC: compared with before treatment in the same group,the MVIC value of vastus lateralis in routne group increased(P<0.05),the ratio of vastus medialis to vastus lateralis decreased(P<0.01);the MVIC values of vastus lateralis and vastus medialis in PNF group increased(P<0.01),the ratio of vastus medialis to vastus lateralis increased(P<0.05).After treatment,MVIC value of vastus medialis in PNF group was better than routine group(P<0.05),and the ratio of vastus medialis to vastus lateralis in PNF group was better than routine group(P<0.01).6.The s EMG changes of muscles squatting: compared with before treatment in the same group,the activation degree of semitendinosus in the routine group increased(P<0.01),the medial CR increased(P<0.05),and the activation degree of vastus lateralis was decreased in the PNF group(P<0.05).7.The s EMG changes of muscles during standing: compared with before treatment in the same group,the activation degree of vastus medialis in routine group decreased(P<0.05).Conclusions: Routine rehabilitation training and PNF technique can reduce the symptoms of patellofemoral arthritis.However,routine muscle strength exercise increases the activation of vastus lateralis,resulting in the imbalance of strength between vastus medialis and vastus lateralis,which is not conducive to the stability of patella movement.PNF technique can stabilize the patella movement track and relieve knee symptoms by improving the muscle strength and contraction coordination around the knee,and reducing the activation degree of vastus lateralis.