足矫具对髌股骨疼痛症候群有最小的效果


  May 30, 2008 (印第安纳波里) — 少有高质量的证据证实足矫具是髌股骨疼痛症候群(PFPS)的最佳治疗方式;澳洲昆士兰大学健康与复健科学院的博士候选人Natalie Collins在美国运动医学会第55届年会中表示,最近有关最佳治疗方式的研究发现,单用足矫具对PFPS的效果有限。
  
  共有179名研究对象(56%为女性、 57%有双侧 PFPS),随机分派到以下四组之一:平底便鞋(安慰组) (n= 44);足矫具 (n= 46);物理治疗计画(n= 45);足矫具加上物理治疗(n= 44),研究为期12个月,在第6、12、52周进行治疗效果的初级测量。
  
  第6周时,相较于安慰组,足矫具加上物理治疗、以及物理治疗有明显较大的改善,这些发现维持到第12周;在第6和12周时,单用足矫具组和安慰组的差距很小。
  
  Collins小姐表示,在第52周时,任何组别之间都没有差异;我们预期在矫具组有较多的不同。
  
  试验过程中,改善最大的是足矫具加上物理治疗组,这一组的脚痛也最小,但在第52周时,各组的疼痛程度相当。
  
  Collins小姐指出,足矫具在短期(6周)内比安慰组有效,足矫具加上物理治疗组的长期和短期效果类似,足矫具、物理治疗、以及并用方式在6周时都优于安慰组;她表示,足矫具加上物理治疗在PFPS的短期治疗效果有限,无法证实有额外的好处。
  
  会议主席、俄亥俄州立大学家庭医学助理教授James Borchers医师表示,治疗 PFPS是一个多面向的问题,事实是你证实一些可以帮助病患恢复的事情,我不认为我们可以分辨哪里些病患能从这些介入方式中获利。
  
  美国运动医学会(ACSM)第55届年会:摘要747。发表于2008年5月29日。

Foot Orthoses Have Minimal Effect on Patellofemoral Pain Syndrome

By Laura Gater
Medscape Medical News

May 30, 2008 (Indianapolis, Indiana) — There is little high-quality evidence to confirm that foot orthoses are the best treatment for patellofemoral pain syndrome (PFPS). A recent study to determine the best method of treatment found that foot orthoses alone had minimal effect on PFPS, according to Natalie Collins, PhD candidate, from the School of Health and Rehabilitation Sciences, University of Queensland, in Brisbane, Australia, who presented the findings here at the American College of Sports Medicine 55th Annual Meeting.

The 179 study participants (56% of whom were female and 57% of whom had bilateral PFPS) were randomly allocated to 1 of 4 groups: flat-shoe (placebo) inserts (n?= 44); foot orthoses (n?= 46); a proven physical therapy program (n?= 45); or foot orthoses plus physical-therapy (n?= 44). The study lasted 12 months. The primary measures of perceived treatment effect were assessed at 6, 12, and 52 weeks.

At 6 weeks, there were significantly greater improvements with foot orthoses plus physical therapy and physical therapy alone than with placebo inserts; these findings were maintained at 12 weeks. There were smaller differences between the foot-orthoses-alone group and placebo group at 6 and 12 weeks.

"At 52 weeks, there were no differences between any of the groups. We expected more of a difference in orthoses," said Ms. Collins.

Over the course of the trial, the biggest improvement was in the foot orthoses plus physical therapy group. The least foot pain was also found in this group, although the pain leveled out at 52 weeks in all groups.

Ms. Collins pointed out that foot orthoses were more effective than placebo inserts in the short term (6 weeks), and that foot orthoses plus physical therapy had similar short-term and long-term effects. Foot orthoses, physical therapy, and the combined approach were superior to placebo inserts over 6 weeks. Adding foot orthoses to physical therapy had minimal effect in the short-term management of PFPS, she said, and provided no additional benefit.

"Treating PFPS is a multifaceted problem. The fact that you are providing something, anything, is helping people to recover. I don't know that we've identified which patient will benefit from which intervention," said session chair James Borchers, MD, an assistant professor of family medicine at Ohio State University in Columbus.

American College of Sports Medicine (ACSM) 55th Annual Meeting: Abstract 747. Presented May 29, 2008.

    
相关报导
ASCM 2009:运动改善髌骨疼痛
2009/6/4 下午 02:50:00

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