| Objective: Patella femoral pain syndrome(PFPS)is a common disease in the clinical.Some studies indicate that among the people aged between eighteen to forty-five years old,the morbidity of PFPS is about ten percent to forty percent.However,among these patients the number of women was 1.5 times of male cases.The symptoms of early PFPS is very light,and the symptoms will be relieved after having rest,so people don't pay great attention about it.If ignoring the important of the earlier symptoms of the PFPS,it will lead to the knee get serious osteoarthritis and may let the joint deformity occur,which will have serious impact on the daily life of the people.So for the prevention,treatment and delaying the development of PFPS become a major and important issue for the clinical study.The symptoms of the early PFPS are not typical,patients usually complained there is a pain at patellar weeks or under the patellar,accompanied by the symptom such as crepitation rale,suddenly weakness of the knee,when going stairs or squatting the symptom is aggravating,while the joint maybe swelling at the acute period.For recently,the causes of PFPS is still controversial,the disorder of the lower limb anatomy relationship(including the changes of the patellar tracking,an abnormal Q Angle and arch change,etc.),chronic damage of the knee,tension of muscle power around knee joint distribution inequality is considered to be the important causes of PFPS.Among them,the imbalance of the muscle strength which the most important is the strength of the vastus medialis oblique(VMO)weakness and increased vastus lateralis(VL)muscle tension is thought to be the leading cause of early PFPS influencing factors.And results in imbalance distribution of patellar activities in the process of VMO and VL muscle strength,patella and femoral stress increase between a block and tackle when the knee flexion and extension leading to the pain of the joint.The knee joint flexion and extension of,and knee pain.Therefore,it is very significance for the early PFPS patients to targeted for VMO muscle strength training,at the same time reduce the VL tension,to keep the normal activities of patellar in knee joint flexion and extension activities trajectory,rehabilitation in patients with early PFPS has the vital significance.In recent years,taping become more and more popular for the rehabilitation treatment,which can relief the pain,support and stability joints,to improvement of sensory inputs,promote the action of soft tissue function activities.Using the biomechanics of taping made the stable structure stability of patella,at the same time can promote the blood circulation,promote the joint discomfort caused by metabolic waste discharge,reduce pain,strengthen body sensory input around knee joint,stability of patellofemoral joint.The main purpose of this study is through targeted for VMO strength training,technique such as using force to reduce VL muscle tension,at the same time using the taping technology sustain patellar motion trajectory in the activities of the knee joint flexion and extension,reduce between the patella and femoral condyle in the process of knee flexion and stress of the block,in order to achieve reduce early PFPS patients of knee joint pain,the effect of delaying disease progressionMethods:The experimental study on all the patients were in diagnostic standard of patellofemoral pain syndrome,and there aren't any physical and drug therapy before they attending the researcher.The age among the patients is eighteen to forty years old.Patellofemoral joint friction test result is positive;up/ down stairs and bend your knees when motion pain for a long time will let the pain increased;there were no history of trauma,fracture and ligament reconstruction of knee joint,the meniscus repair,such as knee surgery,eliminate ligaments around the knee joint inflammation,synovial plica syndrome,knee joint diseases such as meniscus tearAccording to the above the inclusion criteria and exclusion criteria,there were forty early PFPS patients selected from the clinical of the third hospital of Hebei medical university.Get them into two groups the treatment group(Group A)and the control group(Group B).Using random method system.there are twenty persons in group A which has seven male cases and thirteen females.Ade(34.0±6.39);there are twenty persons in group B which has eight male cases and twelve females.Age(33.0±7.59)The general situation(such as age,gender,height,weight,etc.)among two groups there was no statistically significant difference(P>0.05).All patients into the group were already signed informed consent.The patients in Group B taking vastus medialis oblique muscle strength and endurance training and tractive the vastus lateralis muscles in order to reduce muscle tension.the patients in Group A using the same therapy of Group B,beyond that using taping therapy at the same time.For the physiological and biomechanical function of the taping assisted the oblique muscle of stability of patella,maintain normal activity of patella trajectory in the daily activities,three times per week,treating for four weeks.Using the VAS,the Lysholm knee functional score,Footscan gait analysis system to test the patient's expression before the treatment,after two-week treatment and after a month treatment.Results:1 There was no statistically difference of the scores of VAS between the patients of the two groups(P > 0.05);after two weeks treatment the scores of VAS of Group A has obvious improvement compare with the scores before the treatment,pain is relieved,the difference is statistically significant(P< 0.05);but the scores of VAS of Group B compared with the scores before treatment still has no obvious improvement(P>0.05).There was no statistically difference;at the result of the treatment of Group A is better than Group B.After four weeks treatment the scores of VAS of Group A and Group B both have obvious improvement compare with the scores before treatment,the pain is relieved,the difference is statistically significant(P<0.05);And the comparison between the two groups,the clinical situation of the patients in Group A has more significant improvement than Group B,the difference is statistically significant(P < 0.05);2 There was no statistically difference of Lysholm knee functional score between the patients of the two groups(P > 0.05);after two weeks treatment the Lysholm knee functional score of Group A has obvious improvement compare with the scores before the treatment,the difference is statistically significant(P< 0.05);but the Lysholm knee functional score of Group B compared with the scores before treatment still has no obvious improvement(P > 0.05);there was no statistically difference;at the result of the treatment of Group A is better than Group B.After four-week-treatment the Lysholm knee functional score of Group A and Group B both have obvious improvement compare with the score before treatment,the differences are statistically significant(P<0.05);the comparison between the two groups,Group A has more improvement than Group B of the score Lysholm knee functional test,the differences is statistically significant(P< 0.05);3 There is no statistical difference between the Group A and Group B of patients before treatment lower limb gait analysis in the supporting phase(P>0.05);after 2 weeks treatment Group A patients the lower limb gait supporting phase compared with before treatment there were obviously improved(P < 0.05),the supporting phase time extended,difference was statistically significant compared with before treatment;patients in Group B with supporting phase compared with before treatment has no obvious improvement(P>0.05),there was no statistically difference;The treatment of Group A is better than that of Group B.After four weeks two groups of patients with the supporting phase compared with before treatment each group were improved significantly(P < 0.05),obviously supporting phase support reality,statistically significant;and the comparison between the two groups,Group A,patients more significant improvements,there are statistically significant difference(P < 0.05).Conclusions:1 VMO and VL are the most important structure,maintain patellar trajectories for the oblique muscle of targeted muscle strength and endurance training,for the increase the VMO force to reduce the tension of the VL in a certain extent can alleviate the symptoms of patellofemoral joint pain syndrome.2 Application taping contast with VMO muscle strength training,can effectively alleviate the symptoms of patients with patellofemoral pain syndrome joints,release the pain of patients,improve the function of knee joint,orthodontic patients gait,effectively delay the progress of patellofemoral joint pain syndrome. |
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