Analysis On The Effect Of Mulligan Combined With Hip,Knee And Ankle Functional Training On Patellofemoral Joint Pain In College Students

Objective:Patellofemoral pain(PFP)is a common knee condition that is especially prevalent in physically active young adults.PFP not only has a high incidence,but also negatively affects the patient’s function,activity,and psychology.In this study,the Mulligan manipulation combined with hip,knee and ankle functional training was used to experimentally intervene in PFP patients,and to observe and analyze the improvement degree of the program on PFP patients,in order to provide new methods and ideas for the rehabilitation of PFP patients.Methods:Through screening,a total of 40 PFP patients participated in the experimental study,and were randomly divided into Mulligan dynamic joint mobilization group(M),hip,knee,ankle functional training group(F),and combined group(M+F).(1)Group M underwent dynamic joint mobilization intervention 3 times a week for a total of 6 weeks,including MWM of the patellofemoral joint and MWM of the tibiofemoral joint;(2)Group F underwent hip and knee mobilization 3 times a week for a total of 6 weeks,Ankle function training,including standing against resistance pinching the ball,knee extension against resistance in sitting position,hip abduction training,hip external rotation training,clam-style opening and closing,ankle dorsiflexion training,and elastic band relaxation;(3)M+F group in Immediately after dynamic joint loosening,functional training was performed,and the intervention program was the same as that of group M and group F.The visual analog scale(VAS)was used to evaluate the pain degree of the three groups of subjects before and after the intervention;the weighted value of the VAS was used to evaluate the clinical cure rate before and after the intervention;the anterior knee pain scale(AKPS)was used to evaluate the knee joint dysfunction before and after the intervention;Electronic joint activity ruler was used to assess the range of activity;hand-held muscle strength tester(HHD)was used to assess the muscle strength of each muscle group before and after the intervention;surface electromyography(s EMG)was used to assess the activation degree of each muscle group before and after the intervention;pain was used to assess the mental state of patients before and after the intervention Catastrophizing Scale(PCS)and Kinesiology Tampa Scale(TSK).SPSS25.0 was used to process the obtained data,the comparison between groups was conducted by one-way analysis of variance and rank sum test,and the comparison within a group was conducted by paired sample T test.P<0.05 is regarded as a significant level of difference,and P<0.01 is regarded as a very significant level of difference.Results:(1)A total of 40 subjects completed the evaluation and intervention of the whole experiment,including 13 cases in the M group,14 cases in the F group,and 13 cases in the M+F group.Before the intervention,the baseline values of the three groups of subjects had no statistical significance(P>0.05).(2)Pain assessment:(1)Compared with before intervention,the VAS scores of the three groups decreased(P<0.01).(2)Compared between groups,after 6 weeks of intervention,the VAS score of group M was lower than that of group F(P<0.01),the VAS score of group F was lower than that of group M+F(P<0.01),and the VAS score of group M was lower than that of group F(P<0.01).M+F group(P<0.01).(3)Knee joint function evaluation:(1)Compared with before intervention,the AKPS scores of the three groups were all decreased(P<0.01).(2)Comparison between groups,after 6 weeks of intervention,the AKPS score of group M was lower than that of group M+F(P<0.01),the AKPS score of group M was lower than that of group F(P<0.05),and the AKPS score of group M and F was lower than that of group M+F(P<0.01).There was no statistical difference in the evaluation(P>0.05).(4)Evaluation of joint range of motion:(1)Compared with before intervention,the ROM of ankle dorsiflexion,knee flexion,and hip adduction in the three groups were all improved(P<0.01),and the hip abduction,hip adduction,hip adduction of M+F group and F group Rotation ROM has improved.Knee valgus ROM decreased in the M+F group.(2)Compared with M+F group,except for knee valgus ROM and knee flexion ROM,other ROMs had significant differences(P<0.01,P<0.05);compared with M+F group,ankle dorsiflexion Both ROM(P<0.01)and knee flexion ROM(P<0.05)were improved,and the rest had no statistical difference;compared with group F,there were differences in knee flexion ROM and hip adduction ROM(P<0.05),and the rest There was no statistical difference.(5)Muscle strength evaluation:(1)Compared with before intervention,the muscle strength of groups F and M+F increased(P<0.01),and the muscle strength of group M showed no improvement except for knee extension muscle strength.(2)Comparison between groups,after 6 weeks of intervention,the muscle strength of group M was lower than that of group M+F(P<0.05);the muscle strength of hip abduction and extension of group M was lower than that of group M+F(P<0.05);Knee extensor strength in group F was lower than that in group M+F(P<0.05).(6)Evaluation of muscle activation:(1)Compared with before intervention,the RMS of the three groups all increased(P<0.01).(2)Comparison between groups,after6 weeks of intervention,the RMS of the M+F group was higher than that of the M group(P<0.01),and the RMS of the other muscles in the F group was higher than that of the M group except the vastus lateralis.(7)Mental state evaluation:(1)Compared with before intervention,PCS scores and TSK scores in the three groups were all decreased(P<0.01).(2)Compared between groups,after 6 weeks of intervention,the TSK score of group M was lower than that of group F(P<0.05),the TSK score of group M was lower than that of group M+F(P<0.01),and the score of PCS was lower than that of group M+F(P<0.05);TSK score and PCS score in group F were lower than those in group M+F(P<0.05).Conclusions:(1)Six weeks of dynamic joint mobilization,functional training,and dynamic joint mobilization combined with functional training have good effects on PFP patients.(2)Six weeks of hip,knee and ankle functional training can significantly improve the muscle strength,muscle recruitment,and knee joint function of PFP patients;Mulligan dynamic joint mobilization focuses more on pain,knee joint ROM and psychological state of PFP patients improvement.(3)Compared with Mulligan dynamic joint mobilization or hip,knee and ankle functional training alone,Mulligan dynamic joint mobilization combined with hip,knee and ankle functional training can better improve the dysfunction of PFP patients,improve the quality of life,and reduce the patient’s life expectancy within 6 weeks.Exercise fear and pain catastrophizing mental state.