Intervention Effects Of Pillar Strength Training In Patients With Patellofemoral Pain Syndrome

Objective: This article is to study the rehabilitation effect of pillar strength training on patellofemoral pain syndrome.By comparing the change of pain degree,lower limb function and muscle activation in patients with patellofemoral pain syndrome by different intervention methods,the influence of pillar strength training on patellofemoral pain syndrome was discussed,and the differences and similarities between the intervention effects of pillar strength training and knee strength training were analyzed.In order to provide some reference for targeted exercise intervention programs for patients with patellofemoral pain syndrome in rehabilitation practice.Methods: 45 patients with PFPS were recruited.The subjects were assigned into the physical therapy group(PT,n=15),the physical therapy with knee strength training group(K+PT,n=15)and the physical therapy with pillar strength training group(P+PT,n=15).The PT group carried out physical therapy,and the K+PT group and the P+PT group carried out rehabilitation training after physical therapy.The K+PT group carried out knee strength training,and the P+PT group carried out pillar strength training.Each group had 10 times of treatments,2 days/time.Before and after treatment,Visual Pain Scale(VAS)/Kujala Anterior Knee Pain Scale(AKPS)/step-down test/ knee extensor muscle strength test/ Y-balance test/VMO and VL surface EMG test and efficacy evaluation were used to evaluate subjects’ pain degree,lower extremity function and surface electromyography(s EMG).Results: 1.Pain degree: Intra-group comparison,the VAS of the three groups decreased significantly(P<0.01,P<0.01,P<0.01);inter-group comparison,there was no significant difference in the VAS before,after intervention and changes(P>0.05).2.Lower extremity function:(1)AKPS score: Intra-group comparison,the AKPS of the three groups was significantly improved(P<0.01,P<0.01,P<0.01);inter-group comparison,the AKPS score and change value in K+PT and P+PT were higher than those in PT(P<0.05,P<0.05).(2)Step-down test: Intra-group comparison,there is no significant statistical difference in the PT(P>0.05),and the step-down test of K+PT and P+PT is significantly improved(P<0.01,P<0.01);inter-group comparison,the Step-down test and change value in K+PT and P+PT were significantly higher than those in PT(P<0.01,P<0.01).(3)Knee extension muscle strength : Intra-group comparison,the extensive knee muscle strength of the three groups was significantly improved(P<0.05,P<0.01,P<0.01);inter-group comparison,there was no significant difference in the extensive knee muscle strength of the three groups after intervention(P>0.05),but change value of the knee muscle in K+PT is significantly higher than that of PT,P+PT(P<0.01,P<0.01),and P+PT is significantly higher than that of PT(P<0.05).(4)Y balance test: Intra-group comparison,there was no significant statistical difference between PT and K+PT(P>0.05,P>0.05),and the Y balance test in P+PT was significantly improved(P<0.01);inter-group comparison,there was no significant difference in the Y balance test of the three groups after intervention(P>0.05),the change value of Y balance test in P+PT is significantly higher than that of PT and K+PT(P<0.01,P<0.05),and there is no significant difference between K+PT with PT(P>0.05).3.Muscle activation characteristics: Intra-group comparison,there is no significant statistical difference in VMO: VL after intervention in PT(P>0.05),and the K+PT and P+PT were significantly higher(P<0.01,P<0.01);inter-group comparison,the VMO: VL and change value of VMO: VL after intervention in K+PT and P+PT were significantly higher than those in PT(P<0.01,P<0.01).4.Efficacy evaluation: There is no significant difference in the evaluation of the efficacy of intervention in the three groups(P>0.05).Conclusions:1.The three intervention methods can effectively improve the pain degree of patients with patellofemoral pain syndrome,and there is no significant difference in short-term efficacy.2.Compared with physical therapy alone,adding knee strength training or pillar strength training on the basis of physical therapy can effectively improve patients’ ability of repeated flexion and extension of knee and improve the difference in activation of quadriceps femoris muscle,which has a better effect on the improvement of lower limb function.The two kinds of rehabilitation training have different emphasis on the improvement of lower limb function,knee strength training focuses on improving knee extensor muscle strength,improve the stability of knee;Pillar strength training can improve patients’ dynamic balance/postural control ability and provide better dynamic stability for lower limbs.