1,721,013 research outputs found
Therapeutic Exercise and Taping in Patients with Patellofemoral Pain Syndrome: The Proximal-to-Distal Relationship between Hip and Knee
No full text背景：髕股關節疼痛患者在執行承重運動時常出現大腿內塌的情形。股骨貼紮是一新設計，用以矯正前述的動作異常。本研究目的在探討髕股關節疼痛患者與健康控制組間髖、膝關節運動學及肌肉活性，以及動態姿勢控制能力的差異；並且探討股骨貼紮的立即性效果。測試動作包括單腳半蹲與功能性單腳前伸平衡測試。
方法：16位女性髕股關節疼痛患者及8位健康女性控制組參與本實驗。測量站立腳執行單腳半蹲與平衡測試時的髖關節與髕骨三度空間運動學，及髖部臀大肌、臀中肌和大腿部股直肌的肌肉活動。記錄疼痛指數與平衡測試時的最大單腳前伸距離。計算平衡測試時髖關節與髕骨運動學的變異係數，以分析骨盆、股骨、和髕骨的穩定度。
結果：髕股關節疼痛患者在執行單腳半蹲與平衡測試時較控制組有較大的髖內收與較少的髖屈曲。且髕股關節疼痛患者在0-15度單腳半蹲時有較高程度的臀中肌活化與較少的股直肌活動。股骨貼紮可以降低疼痛、減少患者在15-30度單腳半蹲時的股直肌活動，同時將髕骨往較後、下方位移。在平衡測試中，股骨貼紮可以降低髕股關節疼痛患者的疼痛、增加單腳前伸的距離、減少髖內收，且把髕骨內旋、內移，並往較後、下方位移。另外，骨盆和股骨的內外側及上下側穩定度在股骨貼紮後也提高。
結論：股骨貼紮可以改善髕股關節運動學、降低疼痛、改善動態姿勢控制，可用來治療年輕女性髕股關節疼痛患者。Background: The phenomenon of medial collapse is commonly seen in patients with patellofemoral pain syndrome (PFPS). A femoral rotational taping is designed to correct such abnormality. The purposes of this study were to explore the hip and knee joint kinematics as well as muscle activation, and dynamic postural control between PFPS patients and controls, and to investigate the immediate effect of proximal femoral rotational taping on joint kinematics, muscle activation, postural control, and pain during a single-leg squat (SLS) and the anterior direction of the Star Excursion Balance Test (SEBT).
Methods: Sixteen female patients with PFPS, and 8 healthy female controls participated. SLS and SEBT were performed with measurement of 3-dimensional hip and patellar kinematic, and hip (gluteus maximus, Gmax and gluteus medius, Gmed) and thigh (rectus femoris, RF) muscle activation on the stance leg. Pain and maximum excursion distance from SEBT were recorded. The coefficients of variance (CV) of hip and patella kinematics during SEBT were calculated to represent the segmental stability of pelvis, femur and patella.
Results: PFPS group had increased peak hip adduction angle and decreased hip flexion compared with the control during SLS and SEBT tasks. Additionally, PFPS group exhibited significant increase of Gmed and decrease of RF activity compared with the control during initial 0-15 degrees of SLS. Application of femoral rotational taping could decrease pain and RF muscle activation during 15-30 degrees of SLS for patient group, as well as shift the patella into more posterior and inferior position. Similarly, during SEBT, femoral rotational taping could decrease pain and increase excursion distance while decreasing the peak hip adduction as well as changing patella kinematics including medial rotation/shift, and posterior/inferior shift in PFPS group. The medial-lateral and proximal-distal stability of pelvis and femur was also increased with femoral taping during SEBT.
Conclusion: Femoral rotational taping could alter patellofemoral kinematics, decrease pain, and improve dynamic postural control in treatment of young female patients with PFPS
Effect of Hip Adduction Combination with Knee Extension Exercise on Morphology of Quadriceps Muscles, Pain and Functional Outcomes in Patients with Patellofemoral Pain Syndrome
No full text背景及目的：髕股關節疼痛症候群為一臨床常見之膝關節疾病，主要原因之一乃股內斜肌失能使髕骨有不正常的外側偏移，造成髕股關節的壓迫。股內斜肌為膝關節動作時髕骨的內側動態穩定者，臨床上常用保守療法即針對股內斜肌作特定性的訓練。由於股內斜肌肌纖維起始於髖內收肌群，學者認為髖內收肌的收縮能誘發股內斜肌的活動，然而文獻除了相關的肌電圖實驗外，至今仍未有臨床試驗之研究。因此，本隨機控制試驗選用超音波儀器量測股內斜肌之肌肉型態，評估在訓練介入前後的變化，探討髖內收合併膝伸直運動訓練對髕股關節疼痛症候群患者的臨床治療效益，並且和傳統末端膝伸直運動，及控制組間作療效比較。方法：本研究徵召62位年齡小於55歲之髕股關節疼痛症候群患者，隨機分配至髖內收合併膝伸直推蹬運動訓練組、傳統末端膝伸直推蹬運動訓練組、及控制組，進行每週3次、為期8週的推蹬運動訓練，然後評估股內斜肌的肌肉型態（包括股內斜肌肌纖維角度、髕骨上緣水平位之股內斜肌截面積、及髕骨上緣水平位以下之股內斜肌體積）、膝關節視評疼痛分數（包括一般疼痛分數、最嚴重疼痛分數、及活動疼痛分數）、以及Lysholm Scale功能量表分數在介入前後之改變。結果：髖內收合併膝伸直推蹬運動及傳統末端膝伸直推蹬運動訓練組患者，經過8週運動訓練後，其髕骨上緣水平位之股內斜肌截面積、髕骨上緣水平位以下之股內斜肌體積皆有顯著進步（p< .005），然進步未較控制組顯著（p= .011~ .042）。而膝關節一般疼痛分數、最嚴重疼痛分數、活動疼痛分數、及Lysholm Scale功能量表分數除了在訓練前後有顯著進步（p< .005）外，進步亦較控制組顯著（p< .005），唯髖內收合併膝伸直推蹬運動組患者之活動疼痛分數之進步，比起控制組仍未達足夠的顯著（p= .016）。此外，兩運動組之間並無組間統計顯著差異。而股內斜肌肌纖維角度則是在訓練前後並無統計顯著差異。控制組患者之股內斜肌肌肉型態、膝關節視評疼痛分數、及Lysholm Scale功能量表分數在8週前後皆無統計顯著差異。結論：閉鎖鏈髖內收合併膝伸直推蹬運動訓練，可使髕股關節疼痛症候群患者的股內斜肌肥厚，疼痛下降，並且增加下肢功能性活動能力。然而其療效與閉鎖鏈末端膝伸直推蹬運動訓練相似。建議臨床上可以任擇一運動訓練計畫，若考量方便及實用性，則可優先選擇閉鎖鏈末端膝伸直推蹬運動。Background and purpose：Patellofemoral pain syndrome（PFPS） is a common knee disorder characterized by anterior or retropatellar pain associated with activities that load the patellofemoral joint. Previous studies reveal that the vastus medialis obliquus（VMO） is an important dynamic medial stabilizer of the patella. Insufficiency of the VMO leads to lateral shift of the patella and the increases of patellofemoral contact pressure. Thus VMO-specific training is a well-accepted clinical treatment conservatively. Hip adduction is thought to enhance VMO contraction because of its anatomic origin from hip adductors. In order to determine its training effect, we used ultrasonography as a measurement tool to examine the VMO morphology changes after hip adduction combination with knee extension exercise training compared with traditional terminal knee extension exercise training and control in patients with PFPS.
Methods：62 PFPS patients with age under 55 were recruited for the study and then randomly assigned to either one training or control group. Muscle morphology of VMO（including fiber angle, cross-sectional area on patella-base level, and volume under patella-base level）, 10 cm-visual analog scale of usual pain（VAS-U）,worst pain (VAS-W), activity pain (VAS-activity), and Lysholm Scale scores were measured before and after 8-wk leg press exercise training or control periods.
Results：Significant improvements of VMO cross-sectional area, volume, VAS-U, VAS-W, VAS-activity, and Lysholm Scale scores were found after 8-wk training in both exercise groups（p< .005）, but not in the control group. The improvements were also significantly different between the exercise and control groups（p< .005）, except for the VMO cross-sectional area and volume（p= .011~ .042）, and for the VAS-activity between the hip adduction combination with knee extension exercise and control groups（p= .016）. However, no differences were found between two exercise groups. In all three groups, no significant differences were found in VMO fiber angle throughout the experiment.
Conclusion：The results suggest that immediate effects of VMO hypertrophy, pain reduction, and functional ability improvement occurred following hip adduction combination with knee extension exercise. Treatment effects did not show significant differences between two exercise groups; therefore, therapists could choose either of these two exercise programs. Moreover, clinical practices may consider the application of leg-press exercise with terminal knee extension alone since additional equipments are not required.目錄................................................................i
表目錄.............................................................iii
圖目錄.............................................................iv
中文摘要............................................................v
英文摘要...........................................................vii
第一章、 前言..............................................1
第一節、研究背景及動機...........................................1
第二節、研究目的.................................................4
第三節、研究問題.................................................4
第四節、實驗假說.................................................4
第二章、文獻回顧...........................................5
第一節、髕股關節疼痛症候群的相關研究.............................5
第二節、股內斜肌的重要角色.......................................6
第三節、運動訓練對髕股關節疼痛症候群患者的治療效益...............7
第四節、股內斜肌與髖內收肌間的連結...............................8
第五節、髖內收運動對股內斜肌活動之影響...........................8
第六節、髕股關節疼痛症候群常用的評估工具........................13
第三章、研究方法..........................................17
第一節、研究設計................................................17
第二節、受試者..................................................17
第三節、研究使用變項定義........................................19
第四節、實驗流程................................................20
第五節、研究使用設備及工具......................................20
第六節、評估項目................................................21
第七節、運動訓練計畫............................................25
第八節、資料分析及統計..........................................28
第四章、結果.............................................29
第一節、收案流程及患者基本資料.................................29
第二節、 結果評量參數之起始組間比較.............................30
第三節、 運動訓練之影響.........................................31
第五章、討論.............................................33
第一節、運動訓練對股內斜肌肌肉型態之影響........................33
第二節、運動訓練對視評疼痛分數之影響............................36
第三節、運動訓練對Lysholm Scale功能量表分數之影響...............38
第四節、髖內收動作對股內斜肌的影響..............................39
第五節、研究限制................................................41
第六節、臨床應用................................................42
第六章、結論.............................................43
參考文獻.................................................44
附表...............................................................51
附圖...............................................................61
附件一：台灣大學醫學院附設醫院倫理委員會公文.......................81
附件二：臨床試驗受試者說明及同意書.................................82
附件三：受試者基本及相關資料評估表.................................8
The role of patellar alignment and tracking in vivo: The potential mechanism of patellofemoral pain syndrome
No full textMuscle activation of vastus medialis obliquus and vastus lateralis during a dynamic leg press exercise with and without isometric hip adduction
No full textObjectives: To investigate the effects of submaximal and vigorous isometric hip adduction on the vastus medialis obliquus (VMO) and vastus lateralis (VL) activity during the leg press exercise from 90 degrees of knee flexion until full extension. ;Design: Experimental. ;Setting: University biomechanics laboratory. ;Participants: Ten healthy male college students. ;Main outcome measures: Electromyographic (EMG) activation of VMO, VL and hip adductor longus (HAL) of the dominant leg were recorded during double leg press (LP), leg press with submaximal isometric hip adduction force (LP+), and leg press with vigorous isometric hip adduction force (LP++). The VMO, VL muscle activation, as well as the VMO/VL ratio between different leg press exercises were analyzed by MANOVA over concentric and eccentric phases, and in 15 degrees increments of knee flexion motion. The effect size was calculated. ;Results: Neither LP+ nor LP++ changed the overall VMO-VL activation patterns. Specific to knee angle, however, small to medium effect size was shown with incorporation of isometric hip adduction to the leg press exercise for VMO/VL ratio. ;Conclusion: Targeted training using the leg press exercise to the last 45 degrees of knee extension/flexion with vigorous hip adduction may be useful in promoting a greater VMO/VL ratio. (C) 2012 Elsevier Ltd. All rights reserved
Predictors of treatment response to strengthening and stretching exercise for patellofemoral pain: an examination of patellar alignment
No full text[[abstract]]Background
Closed kinetic chain and quadriceps strengthening, combined with flexibility exercises of the lower limb musculature, is a common treatment for patellofemoral pain syndrome (PFPS). The effectiveness has been well documented; however, very little is known about which factors predict treatment success.
Methods
A total of 43 female subjects with PFPS participated in an eight-week progressive leg press (LP) strengthening and stretching exercise program. A decrease of 1.5 cm on a 10 cm visual analog scale (VAS) score was used as an indicator for treatment success. The baseline patellar tilt angle difference (PTA-d) due to quadriceps contraction prior to treatment was evaluated as a predictor of treatment success. The logistic regression and receiver operating characteristics (ROC) curve analysis were performed to investigate the predictive value of PTA-d.
Results
PTA-d could significantly predict the treatment success of LP strengthening and stretching exercises. The odds ratio (OR) for having an unsuccessful outcome was 1.19 (95% confidence interval (CI), 1.03−1.39, P < 0.021) per degree increment of PTA-d. The most optimal cut-off value for the clinical discrimination of treatment success after LP strengthening and stretching exercise was − 1.5° of PTA-d (sensitivity = 0.74, specificity = 0.71). The area under the ROC curve was 0.73 (standard error = 0.08).
Conclusions
Female patients with PFPS whose quadriceps contraction reduced the lateral patellar tilt prior to LP strengthening and stretching exercise treatment are more likely to experience pain relief. It seems clinically important to check dynamic patellar tilt characteristics before treatment to aid in clinical decision making
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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