| Purpose:Electrical stimulation of the medial femoral muscle has been studied as a treatment for patellofemoral pain and has achieved some efficacy in relieving pain,improving lower extremity function,and increasing knee extension muscle strength,but whether it can improve the faulty movement patterns that occur during functional activities of the knee joint still needs further study and confirmation.Therefore,in this study,we investigated the differences between this comprehensive intervention program and traditional muscle training in improving pain symptoms,muscle activation,hip and knee muscle strength,knee kinematics and kinetics in patellofemoral pain patients by combining muscle electrical stimulation with plyometric training for 6 weeks to better understand the mechanisms of pain and neuromuscular control in patellofemoral pain patients.This study provides a theoretical basis for better understanding of the mechanisms of pain and neuromuscular control in patients with patellofemoral pain,and a reference for the selection of rehabilitation treatment plans for patellofemoral pain patients.Methods:The present study involved the recruitment of 46 patients with patellofemoral pain,who were randomly allocated to either a Muscle Strength Training(MST)or Muscle Strength Training combined with Electrical Muscle Stimulation(EMS)group.The intervention was conducted three times a week for a period of six weeks,with pre-and post-intervention data collected for all experimental variables.The degree of knee pain was evaluated using the visual analogue scoring scale(VAS)and anterior knee pain scale(AKPS).Isometric muscle strength of knee extension was measured using the ISOMED 2000.Knee kinematic,kinetic,and electromyographic indices during landing and jumping movements were assessed simultaneously using the Vicon motion capture system,AMTI dynamometer,and NORAXON surface electromyography system.The training effects before and after the intervention and between the two groups were evaluated using a2×2 mixed design ANOVA.The study aimed to examine the impact of the intervention on knee pain,muscle strength,and various kinematic,kinetic,and electromyographic indices associated with functional activities.Overall,the study sought to contribute to the existing literature on the mechanisms underlying patellofemoral pain and to inform the selection of optimal rehabilitation strategies for this condition.Results:(1)Pain: VAS pain scores were lower in both EMS and MST groups after the intervention than before the training,but there was no difference between the two groups;AKPS scores were greater in both EMS and MST groups after the intervention than before the intervention,and AKPS scores were greater in the EMS group than in the MST group after the intervention.(2)Muscle strength: knee extension muscle strength was greater in both EMS and MST groups after intervention than before intervention,and knee extension muscle strength was greater in EMS than MST group after intervention;hip abduction muscle strength was greater in both EMS and MST groups after intervention than before intervention,but there was no difference between the two groups.(3)Muscle activation: the mean root mean square amplitude of the medial femoral muscle in the EMS group after the intervention was greater than that before the intervention,and the mean root mean square amplitude of the medial femoral muscle in the MST group was not different compared with that before the intervention,and the mean root mean square amplitude of the medial femoral muscle in the EMS group after the intervention was greater than that in the MST group;the mean root mean square amplitude of the lateral femoral muscle in the EMS and MST groups after the intervention was not different compared with that before the intervention;the medial/lateral femoral The ratio of electromyographic activation of the medial/lateral femoral muscles in the EMS group was greater than that before the intervention,and the ratio of electromyographic activation of the medial/lateral femoral muscles in the MST group was not different compared with that before the intervention.(4)Knee kinematics: the maximum knee flexion angle during the landing jump task was greater in both the EMS and MST groups after the intervention than before the training,but there was no difference between the two groups;the maximum knee abduction angle in the EMS group after the intervention was smaller than that before the intervention,and there was no difference in the maximum knee abduction angle in the MST group compared with that before the intervention,and the maximum knee abduction angle in the EMS group after the intervention was smaller than that in the MST group;the maximum knee external rotation angle in both the EMS and MST groups after the intervention was smaller than that in the MST group.The maximum external rotation angle of the knee in both EMS and MST groups was smaller than that before the intervention,but there was no difference between the two groups.(5)Knee joint dynamics:The peak knee extension moment and the peak patellofemoral joint stress in the landing jump task were greater in the EMS and MST groups after the intervention than before the training,but there was no difference between the two groups;the peak knee abduction moment and the peak knee external rotation moment in the landing jump task were smaller in the EMS and MST groups after the intervention than before the training,but there was no difference between the two groups.Conclusion:Both electrical muscle stimulation combined with plyometric training and plyometric alone can alleviate knee pain,improve knee extension and influence knee biomechanical characteristics during landing and jumping movements.In contrast to plyometric training alone,electrical stimulation of the medial femoral muscle combined with plyometric training of the lower extremity was more advantageous in improving knee pain,increasing knee extension muscle strength and reducing knee abduction angle,which may be related to its ability to effectively balance medial and lateral femoral muscle activation,enhance neuromuscular control of the lower extremity and improve patellar trajectory. |
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