| ObjectivesIn this study,PFPS patients were recruited to conduct an intervention experiment.By comparing the changes of electromyography(EMG)of the affected leg VMO and VL,the changes of pain degree and the improvement of function,the differences in efficacy of open chain exercise and closed chain exercise on patellofemoral pain syndrome were observed,so as to provide targeted exercise rehabilitation programs for clinicians treating patellofemoral pain syndrome.MethodsIn this study,there were 17 patients in the open chain group,16 patients in the closed chain group,and 14 patients in the physiotherapy group,a total of 47 patients,including 34male patients and 13 female patients.The intervention content of the three groups was as follows:A.Physical therapy:all three groups were treated with conventional ultrasound therapy,the intensity was 1.2W/cm~2,continuous wave,moving method,treatment time was10min/time,once a day,3 times a week for 6 weeks.B.Exercise therapy:the open chain group was given open chain exercise,the closed chain group was given closed chain exercise,and the physiotherapy group did not receive exercise intervention.The exercise lasted for30-40min,performed 3 times a week for 6 weeks.The indicators taken before and after the intervention were VAS score,the absolute error of proprioception of the affected leg,the comprehensive value of YBT,the electromyogram ratio of VMO to VL and the contribution rate of VMO and AKPS score.To investigate the effects of open chain and closed chain exercise on electromyography,pain relief and functional recovery of lower limbs in patients with PFPS during VMO and VL.SPSS Statistics 26 software was used for statistical analysis of the data,demographic data such as age,height and weight of the three groups of subjects were analyzed by one-way analysis of variance,qualitative data male and female composition ratio was analyzed by Chi-square test.Paired sample T test was used for the measured data within the group.Data from the intergroup experiment were measured by one-way analysis of variance,and the ratio of VMO to VL before and after intervention was tested by single sample T test.Results(1)VAS score:Before the intervention,the score of open chain group was 5.24±1.09,after the intervention was 2.82±1.07;The score of closed chain group was 5.06±2.56 before intervention and 2.56±0.96 after intervention;The score of physiotherapy group was 5.36±1.00 before intervention and 3.57±1.02 after intervention.The pain scores of the three groups decreased significantly after 6 weeks(P<0.001),and there was no significant difference between the open chain group and the closed chain group(P<0.05),but the pain scores of the open chain group decreased significantly compared with the physiotherapy group(P<0.05),and the pain scores of the closed chain group decreased significantly compared with the physiotherapy group(P<0.01).(2)Proprioception:(1)AEa:In the open chain group,the AEA was 2.86°±0.85°before intervention and 2.41°±1.27°after intervention;In the closed chain group,it was2.65±1.28°before intervention and 2.43±1.17°after intervention;In the physiotherapy group,it was 3.02±1.17°before intervention and 3.07±0.96°after intervention.(2)AEb:In the open chain group,it was 3.31±1.15°before intervention and 2.77±1.42°after intervention;In the closed chain group,it was 3.40±1.63°before intervention and 3.06±1.63°after intervention;In the physiotherapy group,it was 2.95±1.77°before intervention and 2.60±1.85°after intervention.There was no significant difference in AEa or AEb among the three groups before and after intervention(P>0.05),and there was no significant difference in AE among the three groups after intervention(P>0.05).(3)The comprehensive value of YBT in the open chain group was 93.45±9.26cm before intervention and 97.31±6.98cm after intervention.The closed chain group was 91.60±11.37cm before intervention and 98.65±8.20cm after intervention;The physiotherapy group was 89.84±13.66cm before intervention and 90.43±10.21cm after intervention.The comprehensive value of the open chain group and the closed chain group increased significantly before and after intervention(P<0.05),and the closed chain group had a very significant difference(P<0.01).However,there was no significant difference in the comprehensive value of physiotherapy group before and after intervention(P>0.05).In pairwise comparison,there was no significant difference in the comprehensive values between the open chain group and the closed chain group(P>0.05),but there was a significant difference between the open chain group and the physiotherapy group(P<0.05),and there was a significant difference between the closed chain group and the physiotherapy group(P<0.05).(4)The ratio of electromyography and the contribution rate of VMO:(1)The ratio of electromyography:before the intervention was 0.99±0.39,after the intervention was 1.13±0.42 in the open chain group;In the closed chain group,it was 1.01±0.41 before intervention and 1.25±0.42 after intervention;In the physiotherapy group,it was 1.09±0.36 before intervention and 1.00±0.42 after intervention.There was no significant difference in the ratio of physiotherapy group before and after intervention(P<0.05).The ratio of electromyography in the open chain group and the closed chain group increased,and the results were greater than"1",but there was no significant difference in the open chain group(P>0.05),and the difference of electromyography ratio in the closed chain group before and after intervention was very significant(P<0.01).There was no significant difference between the open chain group and the other two groups(P>0.05),while the closed chain group and the physiotherapy group had a very significant difference in the EMG ratio(P<0.05).(2)VMO contribution rate:Before the intervention,the open-chain group was 50.24±7.66%,after the intervention,it was 53.01±8.49%;In the closed chain group,it was 47.86±9.42%before intervention and 49.52±10.44%after intervention;In the physiotherapy group,it was51.64±9.75%before intervention and 52.90±10.12%after intervention.Among the three groups,only the contribution rate of VMO in the open chain group was significantly increased after intervention(P<0.05).However,there was no significant difference in VMO contribution rate among the three groups after intervention(P>0.05).(5)AKPS score in the open-chain group was 81.41±11.61 before intervention and 87.53±9.12 after intervention.The score of closed chain group was 82.88±7.96 before intervention and 88.19±9.81 after intervention;The score of physiotherapy group was 81.71±8.73 before intervention and 83.29±7.95 after intervention.The AKPS scores of the open-chain group and the closed-chain group were significantly different before and after intervention(P<0.01).However,there was no significant difference in physiotherapy group(P>0.05).There were no significant differences in AKPS scores among the three groups.Conclusions(1)6 weeks of closed chain exercise can significantly improve the activation level of VMO,while open chain exercise can significantly improve the muscle strength of VMO in PFPS patients.Both of the two exercise interventions can reduce knee pain and improve knee function in PFPS patients,and there is no significant difference between the two methods.(2)In the treatment of PFPS,open chain exercise and closed chain exercise can be combined with physiotherapy and proprioceptive training.Open chain motion resistance can be used in the position of hip adduction and external rotation,while closed chain motion resistance can control the knee flexion Angle of 45°.The white tape can be attached to the skin surface of VMO to give certain tactile stimulation and promote the contraction of VMO. |
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