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The patellofemoral pain syndrome (PPS) is characterized by anterior knee pain and poor patellar kinetics. In this review, we focus on primary PPS. Several local factors are known to provoke knee pain (subchondral bony disorders, retraction of the lateral retinaculum, inflammation of the infrapatellar adipose pad). Furthermore, proximal factors involving the hip and pelvis as well as distal factors involving the ankle and foot explain the impact on lower limb mechanics, for instance on single-stance squat. In the 1980s, the gold standard management strategy for PPS was to strengthen the vastus medialis in order to counter lateral subluxation of the patella during knee flexion. More recently, with improved techniques for neuromuscular biomechanical investigations, several publications propose reinforcing the hip abductor muscles for PPS. This offers a more global approach by correcting the posture of the entire lower limb to provide relief from this difficult-to-treat complex syndrome. Strengthening the hip abductors (gluteus medius) appears to be the best way to eliminate the single-stance lower limb postural failure leading to several musculoskeletal disorders. This new approach to rehabilitation is a validated evidence-based therapeutic strategy. 相似文献
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E. Laboute V. Vignerot P.L. Puig P. Trouve R. Ferrand E. Verhaeghe 《Journal de Traumatologie du Sport》2018,35(4):210-217
Introduction
After anterior cruciate ligament (ACL) ligamentoplasty, muscular recovery is often compared to asymmetries in monopodal length jumps, but rarely to functional exercises with vertical displacements. The objective of this study is to analyze these asymmetries and to determine the correlations with the muscular force.Material and methods
We included 12 athletes who had an ACL isolated ligamentoplasty. We performed a 2D videographic analysis of functional exercises with vertical displacements (knee up, heel-buttock, repeated vertical monopodal jump, squat jump). We also performed a concentric measurement of isokinetic muscle strength of the quadriceps and hamstrings on a Biodex device at a rate of 90°/s and 240°/s. And we looked for correlations between videographic asymmetries and muscle strength asymmetries.Results
The reproducibility of video analysis is very good. Muscle strength deficit of the quadriceps is strongly correlated with the difference between the hip heights during the squat jump (maximum values: r = 0.70 and amplitudes: r = 0.85) as well as with the amplitude of angle knee during the squat jump (r = 0.71). There is asymmetry of hip height for repeated monopodal jump and squat jump with a smaller vertical ascent on the injured side. And the knee joint on the injured side is less mobile than on the healthy side during knee up (P = 0.01), repeated jumps (P = 0.04) and squat jump (P = 0.01).Conclusion
The quadriceps muscle strength deficit is correlated with asymmetries during squat jump. The vertical ascent of the hip is lower on the injured side than on the healthy side when jumping. The knee of the injured side is less mobile than the healthy side, and is the most affected joint. 相似文献8.
Berna P Bagan P Renard C Auquier M Remond A Riquet M 《Revue de pneumologie clinique》2008,64(3):129-132
MATERIALS AND METHODS: Thirty-one patients underwent stent placement between June 1998 and October 2006 for superior vena cava obstruction. The initial effectiveness of the metallic stent therapy and the follow-up results were studied at one, six and 12 months. PURPOSE: We retrospectively studied the utility of metallic stent placement for the treatment of malignant superior vena cava obstruction in 31 patients (SVCO) on the basis of long-term follow-up data. RESULTS: The initial clinical success rate was 100% (31 out of 31), the primary clinical patency rate was 93% (26 out of 28) at six months. The obstruction rate of the stent was 7% (two out of 28) at six months. There was no additional stent used for recurrence. At 12 months, 27 out of 31 patients were deceased in whom there was no recurrence of SVCO until death. CONCLUSION: Stent therapy is an effective treatment for SVCO. Adjuvant therapy must to be evaluated in association with stent therapy. 相似文献
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