疼痛缓解:良好质量的证据证实开链和闭链运动在减轻疼痛方面同样有效。[67]Irish SE, Millward AJ, Wride J, et al. The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. J Strength Cond Res. 2010;24:1256-1262.http://www.ncbi.nlm.nih.gov/pubmed/20386128?tool=bestpractice.com[68]Bennell K, Duncan M, Cowan S, et al. Effects of vastus medialis oblique retraining versus general quadriceps strengthening on vasti onset. Med Sci Sports Exerc. 2010;42:856-864.http://www.ncbi.nlm.nih.gov/pubmed/19997004?tool=bestpractice.com[69]Stiene HA, Brosky T, Reinking MF, et al. A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1996;24:136-141.http://www.ncbi.nlm.nih.gov/pubmed/8866272?tool=bestpractice.com[70]Witvrouw E, Lysens R, Bellemans J, et al. Open versus closed kinetic chain exercises for patellofemoral pain: a prospective, randomized study. Am J Sports Med. 2000;28:687-694.http://www.ncbi.nlm.nih.gov/pubmed/11032226?tool=bestpractice.com[71]Wijnen LC, Lenssen AF, Kuys-Wouters YM, et al. McConnell therapy versus Coumans bandage for patellofemoral pain: a randomised pilot study. Ned Tijdschr Fysiother. 1996;(special issue):12-17.[72]Gaffney K, Fricker P, Dwyer T, et al. Patellofemoral joint pain: a comparison of two treatment programmes. Excel. 1992;8:179-189.[73]Smith TO, Bowyer D, Dixon J, et al. Can vastus medialis oblique be preferentially activated? A systematic review of electromyographic studies. Physiother Theory Pract. 2009;25:69-98.http://www.ncbi.nlm.nih.gov/pubmed/19212898?tool=bestpractice.com
证据 B 疼痛缓解及关节功能:有中等质量的证据认为髌骨带有助于缓解疼痛,提高关节功能。然而亦有研究认为两者无差别。[63]Timm KE. Randomized controlled trial of Protonics on patellar pain, position, and function. Med Sci Sports Exerc. 1998;30:665-670.http://www.ncbi.nlm.nih.gov/pubmed/9588606?tool=bestpractice.com[64]Miller MD, Hinkin DT, Wisnowski JW. The efficacy of orthotics for anterior knee pain in military trainees: a preliminary report. Am J Knee Surg. 1997;10:10-13.http://www.ncbi.nlm.nih.gov/pubmed/9051172?tool=bestpractice.com[65]Lun VM, Wiley JP, Meeuwisse WH, et al. Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome. Clin J Sport Med. 2005;15:235-240.http://www.ncbi.nlm.nih.gov/pubmed/16003037?tool=bestpractice.com 系统评价或者受试者>200名的随机对照临床试验(RCT)。疼痛缓解及关节功能:有中等质量的证据认为髌骨带有助于缓解疼痛,提高关节功能。然而亦有研究认为两者无差别。[63]Timm KE. Randomized controlled trial of Protonics on patellar pain, position, and function. Med Sci Sports Exerc. 1998;30:665-670.http://www.ncbi.nlm.nih.gov/pubmed/9588606?tool=bestpractice.com[64]Miller MD, Hinkin DT, Wisnowski JW. The efficacy of orthotics for anterior knee pain in military trainees: a preliminary report. Am J Knee Surg. 1997;10:10-13.http://www.ncbi.nlm.nih.gov/pubmed/9051172?tool=bestpractice.com[65]Lun VM, Wiley JP, Meeuwisse WH, et al. Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome. Clin J Sport Med. 2005;15:235-240.http://www.ncbi.nlm.nih.gov/pubmed/16003037?tool=bestpractice.com
证据 B 疼痛缓解:中等质量的证据证实矫形支具可改善疼痛症状。[75]Johnston LB, Gross MT. Effects of foot orthoses on quality of life for individuals with patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2004;34:440-448.http://www.ncbi.nlm.nih.gov/pubmed/15373007?tool=bestpractice.com[76]Eng JJ, Pierrynowski MR. Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome. Phys Ther. 1993;73:62-68.http://www.ncbi.nlm.nih.gov/pubmed/8421719?tool=bestpractice.com[77]Hossain M, Alexander P, Burls A,et al. Foot orthoses for patellofemoral pain in adults. Cochrane Database Syst Rev. 2011;(1):CD008402.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008402.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/21249707?tool=bestpractice.com[78]Barton CJ, Munteanu SE, Menz HB, et al. The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review. Sports Med. 2010;40:377-395.http://www.ncbi.nlm.nih.gov/pubmed/20433211?tool=bestpractice.com 系统评价或者受试者>200名的随机对照临床试验(RCT)。疼痛缓解:中等质量的证据证实矫形支具可改善疼痛症状。[75]Johnston LB, Gross MT. Effects of foot orthoses on quality of life for individuals with patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2004;34:440-448.http://www.ncbi.nlm.nih.gov/pubmed/15373007?tool=bestpractice.com[76]Eng JJ, Pierrynowski MR. Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome. Phys Ther. 1993;73:62-68.http://www.ncbi.nlm.nih.gov/pubmed/8421719?tool=bestpractice.com[77]Hossain M, Alexander P, Burls A,et al. Foot orthoses for patellofemoral pain in adults. Cochrane Database Syst Rev. 2011;(1):CD008402.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008402.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/21249707?tool=bestpractice.com[78]Barton CJ, Munteanu SE, Menz HB, et al. The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review. Sports Med. 2010;40:377-395.http://www.ncbi.nlm.nih.gov/pubmed/20433211?tool=bestpractice.com
证据 B 疼痛缓解:中等质量的证据证实锻炼比不进行锻炼可减轻髌股关节疼痛。[63]Timm KE. Randomized controlled trial of Protonics on patellar pain, position, and function. Med Sci Sports Exerc. 1998;30:665-670.http://www.ncbi.nlm.nih.gov/pubmed/9588606?tool=bestpractice.com[60]Clark DI, Downing N, Mitchell J, et al. Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis. 2000;59:700-704.http://ard.bmj.com/content/59/9/700.longhttp://www.ncbi.nlm.nih.gov/pubmed/10976083?tool=bestpractice.com[81]McMullen W, Roncarati A, Koval P. Static and isokinetic treatments of chondromalacia patella: a comparative investigation. J Orthop Sports Phys Ther. 1990;12:256-266.http://www.jospt.org/doi/pdf/10.2519/jospt.1990.12.6.256http://www.ncbi.nlm.nih.gov/pubmed/18796869?tool=bestpractice.com 系统评价或者受试者>200名的随机对照临床试验(RCT)。疼痛缓解:中等质量的证据证实锻炼比不进行锻炼可减轻髌股关节疼痛。[63]Timm KE. Randomized controlled trial of Protonics on patellar pain, position, and function. Med Sci Sports Exerc. 1998;30:665-670.http://www.ncbi.nlm.nih.gov/pubmed/9588606?tool=bestpractice.com[60]Clark DI, Downing N, Mitchell J, et al. Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis. 2000;59:700-704.http://ard.bmj.com/content/59/9/700.longhttp://www.ncbi.nlm.nih.gov/pubmed/10976083?tool=bestpractice.com[81]McMullen W, Roncarati A, Koval P. Static and isokinetic treatments of chondromalacia patella: a comparative investigation. J Orthop Sports Phys Ther. 1990;12:256-266.http://www.jospt.org/doi/pdf/10.2519/jospt.1990.12.6.256http://www.ncbi.nlm.nih.gov/pubmed/18796869?tool=bestpractice.com
证据 C 疼痛缓解:目前有低质量的证据支持在缓解髌股关节疼痛方面萘普生比安慰剂更有效。然而有研究发现NSAID与安慰剂在缓解疼痛方面无显著差异。[50]Suter E, Herzog W, De Souza K, et al. Inhibition of the quadriceps muscles in patients with anterior knee pain. J Appl Biomech. 1998;14:360-373.[51]Bentley G, Leslie IJ, Fischer D. Effect of aspirin treatment on chondromalacia patellae. Ann Rheum Dis. 1981;40:37-41.http://ard.bmj.com/content/40/1/37.longhttp://www.ncbi.nlm.nih.gov/pubmed/7008711?tool=bestpractice.com[52]Marchese A, Cherubini M, Forte R. Laser therapy versus pharmacological in anterior knee pain. La Riabilitazione. 1998;31:189-198. 系统评价或者受试者>200名的随机对照临床试验(RCT)。疼痛缓解:目前有低质量的证据支持在缓解髌股关节疼痛方面萘普生比安慰剂更有效。然而有研究发现NSAID与安慰剂在缓解疼痛方面无显著差异。[50]Suter E, Herzog W, De Souza K, et al. Inhibition of the quadriceps muscles in patients with anterior knee pain. J Appl Biomech. 1998;14:360-373.[51]Bentley G, Leslie IJ, Fischer D. Effect of aspirin treatment on chondromalacia patellae. Ann Rheum Dis. 1981;40:37-41.http://ard.bmj.com/content/40/1/37.longhttp://www.ncbi.nlm.nih.gov/pubmed/7008711?tool=bestpractice.com[52]Marchese A, Cherubini M, Forte R. Laser therapy versus pharmacological in anterior knee pain. La Riabilitazione. 1998;31:189-198.
证据 C 疼痛缓解:有低质量的证据证明髌骨带结合锻炼比单独锻炼更有效。然而有研究认为两者无差别。[58]Whittingham M, Palmer S, Macmillan F. Effects of taping on pain and function in patellofemoral pain syndrome: a randomized controlled trial. J Orthop Sports Phys Ther. 2004;34:504-510.http://www.ncbi.nlm.nih.gov/pubmed/15493518?tool=bestpractice.com[59]Kowall MG, Kolk G, Nuber GW, et al. Patellar taping in the treatment of patellofemoral pain: a prospective randomized study. Am J Sports Med. 1996;24:61-66.http://www.ncbi.nlm.nih.gov/pubmed/8638755?tool=bestpractice.com[60]Clark DI, Downing N, Mitchell J, et al. Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis. 2000;59:700-704.http://ard.bmj.com/content/59/9/700.longhttp://www.ncbi.nlm.nih.gov/pubmed/10976083?tool=bestpractice.com 系统评价或者受试者>200名的随机对照临床试验(RCT)。疼痛缓解:有低质量的证据证明髌骨带结合锻炼比单独锻炼更有效。然而有研究认为两者无差别。[58]Whittingham M, Palmer S, Macmillan F. Effects of taping on pain and function in patellofemoral pain syndrome: a randomized controlled trial. J Orthop Sports Phys Ther. 2004;34:504-510.http://www.ncbi.nlm.nih.gov/pubmed/15493518?tool=bestpractice.com[59]Kowall MG, Kolk G, Nuber GW, et al. Patellar taping in the treatment of patellofemoral pain: a prospective randomized study. Am J Sports Med. 1996;24:61-66.http://www.ncbi.nlm.nih.gov/pubmed/8638755?tool=bestpractice.com[60]Clark DI, Downing N, Mitchell J, et al. Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis. 2000;59:700-704.http://ard.bmj.com/content/59/9/700.longhttp://www.ncbi.nlm.nih.gov/pubmed/10976083?tool=bestpractice.com
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