اثر تقویت عضلات ابداکتور و چرخاننده های خارجی مفصل ران بر درد، قدرت و کینماتیک اندام تحتانی مبتلایان به درد کشککی رانی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

2 استاد، گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

3 گروه بیومکانیک ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

چکیده

مقدمه و اهداف
هدف از مطالعه حاضر بررسی تاثیر تقویت عضلات ابداکتور و چرخاننده ­های خارجی مفصل ران بر درد، قدرت عضلات ران و کینماتیک اندام تحتانی در مبتلایان به درد کشککی رانی و مقایسه اثر این تمرینات در زنان و مردان می­باشد.
مواد و روش ­ها
35 فرد مبتلا به درد کشککی رانی به صورت تصادفی در چهار گروه زن و مرد تجربی و زن و مرد شاهد جای گرفتند. گروه ­های تجربی به مدت 12 هفته و هر هفته 3 جلسه تمرینات تقویتی عضلات ابداکتور و چرخاننده ­های خارجی مفصل ران با استفاده از تراباند را دریافت کردند. بر گروه­ های شاهد هیچ ­گونه مداخله تمرینی اعمال نشد؛ این گروه ­ها جهت مطالعه اثر متغیر مستقل در گروه ­های تجربی با گروه­های تجربی مقایسه گردیدند. درد توسط مقیاس دیداری درد، قدرت عضلات مفصل ران توسط دینامومتر دستی و کینماتیک اندام تحتانی با استفاده از تحلیل ویدئویی قبل و بعد از مداخله بررسی گردید. نمونه­ ها شامل افراد مبتلا به درد کشککی رانی بودند که درد در هر دو و یا یک زانو داشتند؛ در صورت دوطرف بودن درد، تمرینات به صورت دوطرفه و بر هر دو اندام تحتانی انجام می­گرفت، اما اندازه­ گیری­ ها فقط از اندام تحتانی که بیشتر درد داشت، صورت می­ پذیرفت. در صورت مساوی بودن درد در هر دو زانو، داده ­ها فقط از اندام تحتانی برتر جمع ­آوری می­ گردید. جهت تجزیه­ و تحلیل آماری از تحلیل واریانس برای اندازه ­های مکرر از نرم ­افزار SPSS استفاده گردید.
یافته­ها
یافته­های تحقیق حاضر نشان داد که پس از مداخله، در گروه­های تجربی درد کاهش یافت (0/000=P) و قدرت عضلات ابداکتور (در زنان 0/000=P و در مردان 0/03=P) و عضلات چرخاننده­های خارجی (در زنان 0/024=P و در مردان 0/000=P) افزایش یافت. بهبود قابل ملاحظه­ای در والگوس دینامیک زانو در اسکات یک­پایی (در زنان 0/018=P و در مردان 0/017=P) و میزان افتادگی لگن سمت مقابل در پایین آمدن از پله تنها در زنان (0/04=P) در گروه تجربی مشاهده شد. هیچ­گونه تفاوت قابل توجهی در میزان اثر تمرینات بین مردان و زنان مشاهده نگردید (0/05<P).
نتیجه­ گیری
نتایج تحقیق کنونی نشان داد تقویت عضلات مفصل ران می­تواند درد افراد مبتلا به درد کشککی رانی را کاهش، قدرت عضلات را افزایش و کینماتیک اندام تحتانی را در صفحه حرکتی فرونتال تغییر دهد و این می­تواند مکانیسم اثر این مداخله بر علائم درد کشککی رانی باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Effect of hip abductor and external rotator muscles strengthening on pain, hip muscles strength, and lower extremity kinematics in patients with patellofemoral pain

نویسندگان [English]

  • Narjes Jamali 1
  • Khalil Khayambashi 2
  • Shahram Lenjannejadian 3
  • Hamed Esmaeili 3
1 PhD Candidate of Sport Sciences, University of Isfahan, Isfahan, Iran
2 PhD,Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
3 PhD, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
چکیده [English]

Background and Aims: The aim of the current study was to investigate the effect of hip abductor and external rotator muscles strengthening exercises on pain, muscle strength, and lower extremity kinematics in people with patellofemoral pain (PFP).
Materials and Methods: A total of 35 patients with PFP were randomly assigned into exercise and control groups. The exercise group received abductor and external rotator strengthening exercises with thera-band 3 times per week for 12 weeks. The control groups did not receive any training intervention. Then, the two groups were compared to study the effect of independent variable on the experimental group. Pain (VAS), hip muscle strength (handheld dynamometer), and lower extremity kinematics (video analysis) were assessed at baseline and post-intervention. Participants included patients with bilateral or unilateral patellofemoral pain; if pain was bilateral, exercises were performed bilaterally on both lower extremities but measurements were performed only on the lower extremity which was more painful; whenever the pain in both knees was equal, data were collected only from the superior lower extremity.
Repeated measures ANOVA was applied using SPSS to assess the effects of the exercises on measured variables.
Results: Pain decreased significantly in exercise group from baseline to post-intervention (P=0.000). Hip abductor muscles strength (women, P=0.000 and men, P=0.003) and external rotator muscles strength  (women, P=0.024 and men, P=0.000) increased significantly in exercise group after 12 weeks of strengthening program. There was a significant improvement in dynamic knee valgus during single-legged squat (women, P=0.018 and men, P=0.017) and contralateral pelvic drop during stair descending just in women (P=0.04) in exercise group. There were no significant differences between men and women in the effect of exercises on the variables studied (P>0.05).
Conclusion: According to the results, hip strengthening can decrease pain, increase muscle strength, and change kinematics in the frontal plane movement patterns of the lower extremity, which can possibly be the mechanism of effect of this intervention on PFP symptoms. According to findings of the present study, it might be concluded that gender-specific rehabilitation program is not needed in patients with PFP.

کلیدواژه‌ها [English]

  • Patellofemoral pain
  • Lower extremity kinematics
  • Dynamic knee valgus angle

مراجع

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دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 9، شماره 2
تیر 1399
صفحه 79-92

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سابقه مقاله

  • تاریخ دریافت: 05 شهریور 1398
  • تاریخ بازنگری: 12 شهریور 1398
  • تاریخ پذیرش: 15 شهریور 1398
  • تاریخ اولین انتشار: 01 تیر 1399

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