簡易檢索 / 詳目顯示

回結果列表
研究生： 陳宜伶
Chen, Yi-Ling
論文名稱： 下肢矯正性貼紮對於患有髕股關節痛籃球員之立即效益
Immediate Effects of Hip Corrective Taping on Basketball Players with Patellofemoral Pain
指導教授： 蔡一如
Tsai, Yi-Ju
學位類別： 碩士
Master
系所名稱： 醫學院 - 物理治療學系
Department of Physical Therapy
論文出版年： 2014
畢業學年度： 102
語文別： 英文
論文頁數： 40
中文關鍵詞： 髕股關節痛 、矯正性貼紮 、疼痛 、動作模式
外文關鍵詞： Patellofemoral pain, hip corrective taping, pain, movement patterns
相關次數： 點閱：116  下載：8 
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報

    • 背景與目的：髕股關節痛好發於運動員，有多種不同的原因與此種疼痛的產生有關。一般認為髕骨的過度外傾在動作時會造成不正常的髕骨活動軌跡，進而使關節面間的壓力升高，影響軟骨及附近組織。近年來學者發現，在承重情況下，股骨內轉可能是造成髕骨外傾更重要的因素。許多研究也已證實髕股關節疼痛的患者在髖關節的動作學上有不同於正常人的模式。患者在動作時可能產生過多的髖關節內收及內轉動作，此現象可能與患者臀肌力量不足以及神經動作控制上的缺失有關。先前研究指出，使用髖關節穩定護具提供髕股關節痛患者在髖關節上外展及外轉的力量，有助於降低患者在動作時的疼痛，以及達到髖關節動作的矯正效果。然而，護具對於需要執行大量大幅度下肢動作的籃球運動員來說，穿戴上過於厚重不便，因此本篇研究利用肌內效貼布，嘗試提供髕股關節痛球員在髖關節上外轉及外展的矯正力量，來觀察球員們的疼痛及動作模式是否改變。方法：共12名有髕股關節痛的籃球員及14名健康籃球員參與此次實驗，以動作分析系統觀察兩組間動作的不同，以及使用下肢矯正之肌內效貼布對疼痛球員的動作學所產生的影響。動作任務包括模擬球員平常動作的上籃單腳跳以及靜態的單腳蹲動作。結果：髕股關節痛球員在上籃動作表現了比健康球員更多的膝蓋外轉動作，身體質量中心較為接近髖關節中心，然而髖關節的動作模式並無差異。單腳蹲的動作兩組在動作學上沒有差異。在貼上肌內效貼布之後，髕股關節痛球員在上籃跳時的膝蓋外轉減少，單腳蹲時，貼布使球員的疼痛降低，髖關節內轉也有減少的情形。結論：肌內效貼布對籃球員在動作時的模式矯正及疼痛控制上有一定的作用，臨床上可用於減少髕股關節痛球員的不適，對球員在傷害的預防上也有益處。

    Background and Purpose: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder on athletes. The etiology was feathering multi-factorial. Femur internal rotation was proved to contribute in patella lateral laterization position in patients with PFPS. Excessive hip adduction and internal rotation during various tasks were recognized in patients with PFPS and associated with the increased stress of patellofemoral joint. Therefore, hip movement control can be an important issue when making management decision. Hip stabilization brace was proved to be effective in pain reduction, decreasing hip internal rotation and improving posture stability. Kinesio taping has been applied in the upper extremity for movement correction. However, whether applying Kinesio taping is able to correct the movement patterns of the lower extremity during weight bearing activities remains unknown. Therefore, the purpose of this study was to investigate the immediate effects of hip corrective taping on hip and knee movements during lay-up jump and single-leg squat in basketball players with PFPS. Methods: 12 basketball players (10 males, 2 females) with PFPS and 14 healthy (10 males, 4 females) player were asked to perform lay-up jump and single-leg squat with and without corrective taping. Whole body kinematics and ground reaction forces were recorded using Vicon 3D motion analysis system (200Hz) and an AMTI force plate (1000Hz). The primary objectives of corrective taping in this study were to limit hip adduction and internal rotation and provide guidance of hip abduction and external rotation during tasks. Thus, kinesio tape was applied from 3 cm below medial tibia epicondyle to 3 cm above ipsilateral anterior superior iliac crest spirally with maximal tension. Results: The PFPS group showed greater knee external rotation than healthy players (10.23° v.s. 4.88°) but no significant differences in hip joint kinematic during lay-up jump. However, distance between center of mass and hip joint center in PFPS group was shorter than control group. In terms of taping effects, for lay-up jump task at initial contact, the angle of knee external rotation was significantly decreased after taping. (10.24° vs. 8.02°, p = 0.038). For single-leg squat task, hip internal rotation was significantly decreased (7.94° vs. 4.72°, p = 0.050). A trend of decreased hip adduction were also observed (11.45° vs. 10.16°, p = 0.059). Conclusions: Corrective taping applied in this study may have the effects of decreasing hip adduction and internal rotation in basketball players with PFPS during both static and dynamic tasks. Clinical Relevance: The results of current study provided evidence for corrective taping in basketball players with PFPS to limit hip movement patterns associated with increased patellofemoral joint stress. Clinically this taping method may be beneficial for the other populations with PFPS.

    List of Contents 中文摘要 I Abstract II 誌謝 IV List of Contents V List of Tables VII List of Figures VIII Chapter 1. Introduction 1 1.1. Background and Research Purposes 1 1.2. Hypothesis 2 Chapter 2. Literature Review 4 2.1. Epidemiology of patellofemoral pain syndrome 4 2.2. Biomechanics of patellofemoral joint 4 2.3. Etiology of patellofemoral pain syndrome 6 2.3.1. Patellofemoral pain syndrome is featuring with multifactorial etiology 6 2.3.2. Osseous structure abnormality 7 2.3.3. Muscle function deficiency 8 2.3.4. Neuromuscular control during dynamic tasks on patients with PFPS 10 2.4. Management of PFPS 10 2.4.1. Focus on patellar tracking and distal segment of lower extremity 10 2.4.2. Management focus on the control of hip joint 11 Chapter 3. Methods 13 3.1. Subjects 13 3.2. Instruments 13 3.2.1. Motion analysis system 13 3.2.2. Markers application 14 3.3. Procedure 14 3.3.1. Experiment protocol 14 3.3.2. Task 15 3.3.3. Hip corrective taping 15 3.4. Data reduction and analysis 16 3.4.1. Joint angle 16 3.4.2. The distance between center of mass and lower extremity joint centers 16 3.5. Statistics analysis 17 Chapter 4. Results 18 4.1. Differences between PFPS and control groups 18 4.1.1. Subjects characteristics 18 4.1.2. Kinematics differences between control group and pain group in lay-up jump 18 4.2. Taping effect 19 4.2.1. Kinematics change after taping application in PFPS group in lay-up jump 19 Chapter 5. Discussion 20 5.1. Kinematic difference between PFPS and controls 20 5.2. The effect of correction taping on PFPS subjects 21 5.3. Conclusion 23 5.4. Limitation 23 References 24 Appendix I. 40 List of Tables Table 1. Basic data of control and pain group 31 Table 2. Hip, knee angle and distance between COM and hip and knee joint center control and pain group at initial contact 31 Table 3. Hip and knee angle at maximal ground reaction force 32 Table 4. Peak hip and knee angle in ground phase of lay-up jump 32 Table 5. Peak distance of COM and hip or knee joint center between control and PFPS group 33 Table 6. Peak hip and knee angle in ground phase between control and pain group of single-leg-squat 33 Table 7. Peak distance between COM and HJC and KJC of control and PFPS group in single-leg-squat 34 Table 8. Initial contact angle and distance between pre-taping and taping condition 34 Table 9. Hip and knee angle at maximal vertical ground reaction force between pre-taping and taping condition in pain group 35 Table10. Peak hip and knee angle and distance between pre-taping and taping condition 35 Table 11. Maximal distance of COM and hip or knee joint center between pre-taping and taping condition 36 Table 12. Visual analogy scale of pre-taping and taping condition 37 Table 13. Peak hip and knee angle between pre-taping and taping condition in single-leg squat 37 Table 14. Peak distance of hip and knee joint center to center of mass between pre-taping and taping condition in single-leg-squat 37 List of Figures Figure 1. Possible etiology of PFPS 38 Figure 2. Lay-up jump illustration 38 Figure 3. Hip corrective taping 39

    1. Plug-In Gait Model Details. Available at: Accessed
    2. Agur AM, Dalley AF. Grant's atlas of anatomy. Lippincott Williams & Wilkins; 2009.
    3. Baldon Rde M, Nakagawa TH, Muniz TB, Amorim CF, Maciel CD, Serrao FV. Eccentric hip muscle function in females with and without patellofemoral pain syndrome. Journal of athletic training. 2009;44:490-496.
    4. Blackburn JT, Padua DA. Influence of trunk flexion on hip and knee joint kinematics during a controlled drop landing. Clinical biomechanics. 2008;23:313-319.
    5. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scandinavian journal of medicine & science in sports. 2010;20:725-730.
    6. Boling MC, Padua DA, Alexander Creighton R. Concentric and eccentric torque of the hip musculature in individuals with and without patellofemoral pain. Journal of athletic training. 2009;44:7-13.
    7. Boling MC, Padua DA, Marshall SW, Guskiewicz K, Pyne S, Beutler A. A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort. The American journal of sports medicine. 2009;37:2108-2116.
    8. Caylor D, Fites R, Worrell TW. The relationship between quadriceps angle and anterior knee pain syndrome. The Journal of orthopaedic and sports physical therapy. 1993;17:11-16.
    9. Chen Y-J, Powers CM. The Dynamic Quadriceps Angle: A Comparison of Persons with and without Patellofemoral Pain. Michigan, U.S.A.: 2008.
    10. Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Bmj. 2008;337:a1735.
    11. Cowan SM, Bennell KL, Hodges PW. Therapeutic patellar taping changes the timing of vasti muscle activation in people with patellofemoral pain syndrome. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. 2002;12:339-347.
    12. Cowan SM, Crossley KM, Bennell KL. single-leg squat. British journal of sports medicine. 2009;43:584-588.
    13. Crossley K, Cowan SM, Bennell KL, McConnell J. Patellar taping: is clinical success supported by scientific evidence? Manual therapy. 2000;5:142-150.
    14. Csintalan RP, Schulz MM, Woo J, McMahon PJ, Lee TQ. Gender differences in patellofemoral joint biomechanics. Clinical orthopaedics and related research. 2002;260-269.
    15. DeHaven KE, Lintner DM. Athletic injuries: comparison by age, sport, and gender. The American journal of sports medicine. 1986;14:218-224.
    16. Dierks TA, Manal KT, Hamill J, Davis IS. Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. The Journal of orthopaedic and sports physical therapy. 2008;38:448-456.
    17. Dolak KL, Silkman C, Medina McKeon J, Hosey RG, Lattermann C, Uhl TL. Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial. The Journal of orthopaedic and sports physical therapy. 2011;41:560-570.
    18. Duffey MJ, Martin DF, Cannon DW, Craven T, Messier SP. Etiologic factors associated with anterior knee pain in distance runners. Medicine and science in sports and exercise. 2000;32:1825-1832.
    19. Dutton M. Orthopaedic examination, evaluation & intervention. McGraw Hill Professional; 2004.
    20. ElKhatib RS, ElNegmy EH, Salem AH, Sherief AA. Kinesio arm taping as prophylaxis against the development of Erb’s Engram. Journal of Advanced Research. 2013;4:485-491.
    21. Eng JJ, Pierrynowski MR. Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome. Physical therapy. 1993;73:62-68; discussion 68-70.
    22. GonzáLez-Iglesias J, Fernandez-De-Las-Penas C, Cleland J, Huijbregts P, Gutiérrez-Vega MDR. Short-term effects of cervical kinesio taping on pain and cervical range of motion in patients with acute whiplash injury: a randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2009;39:515-521.
    23. Hanten WP, Schulthies SS. Exercise effect on electromyographic activity of the vastus medialis oblique and vastus lateralis muscles. Physical therapy. 1990;70:561-565.
    24. Heino Brechter J, Powers CM, Terk MR, Ward SR, Lee TQ. Quantification of patellofemoral joint contact area using magnetic resonance imaging. Magnetic resonance imaging. 2003;21:955-959.
    25. Herrington L, Nester C. Q-angle undervalued? The relationship between Q-angle and medio-lateral position of the patella. Clinical biomechanics. 2004;19:1070-1073.
    26. Holmes Jr SW, Clancy Jr WG. Clinical classification of patellofemoral pain and dysfunction. Journal of Orthopaedic & Sports Physical Therapy. 1998;28:299-306.
    27. Horton MG, Hall TL. Quadriceps femoris muscle angle: normal values and relationships with gender and selected skeletal measures. Physical therapy. 1989;69:897-901.
    28. Huberti H, Hayes W. Patellofemoral contact pressures. J Bone Joint Surg A. 1984;66:715-724.
    29. HUNGERFORD DS, BARRY M. Biomechanics of the patellofemoral joint. Clinical orthopaedics and related research. 1979;144:9-15.
    30. Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. The Journal of orthopaedic and sports physical therapy. 2003;33:671-676.
    31. Jamison ST, Pan X, Chaudhari AM. Knee moments during run-to-cut maneuvers are associated with lateral trunk positioning. Journal of biomechanics. 2012;45:1881-1885.
    32. Kase K, Wallis J, Kase T, Association KT. Clinical therapeutic applications of the Kinesio taping methods. Kinesio Taping Assoc.; 2003.
    33. Kaya E, Zinnuroglu M, Tugcu I. Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clinical rheumatology. 2011;30:201-207.
    34. Kneeshaw D. Shoulder taping in the clinical setting. Journal of bodywork and movement therapies. 2002;6:2-8.
    35. LaBella C. Patellofemoral pain syndrome: evaluation and treatment. Primary care. 2004;31:977-1003.
    36. Lee SP, Souza RB, Powers CM. The influence of hip abductor muscle performance on dynamic postural stability in females with patellofemoral pain. Gait & posture. 2012;36:425-429.
    37. Lee TQ, Anzel SH, Bennett KA, Pang D, Kim WC. The influence of fixed rotational deformities of the femur on the patellofemoral contact pressures in human cadaver knees. Clinical orthopaedics and related research. 1994;69-74.
    38. Lee TQ, Morris G, Csintalan RP. The influence of tibial and femoral rotation on patellofemoral contact area and pressure. The Journal of orthopaedic and sports physical therapy. 2003;33:686-693.
    39. Levinger P, Gilleard W. Tibia and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking. Gait & posture. 2007;25:2-8.
    40. Levinger P, Gilleard W, Coleman C. Femoral medial deviation angle during a one-leg squat test in individuals with patellofemoral pain syndrome. Physical Therapy in sport. 2007;8:163-168.
    41. Magee DJ. Orthopedic physical assessment. Elsevier Health Sciences; 2013.
    42. Messier SP, Davis SE, Curl WW, Lowery RB, Pack RJ. Etiologic factors associated with patellofemoral pain in runners. Medicine and science in sports and exercise. 1991;23:1008-1015.
    43. Nakagawa TH, Moriya ET, Maciel CD, Serrao FV. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. The Journal of orthopaedic and sports physical therapy. 2012;42:491-501.
    44. Nakagawa TH, Muniz TB, Baldon Rde M, Dias Maciel C, de Menezes Reiff RB, Serrao FV. The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study. Clinical rehabilitation. 2008;22:1051-1060.
    45. Nguyen A-D, Boling MC, Levine B, Shultz SJ. Relationships between lower extremity alignment and the quadriceps angle. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine. 2009;19:201.
    46. Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. British journal of sports medicine. 2011;45:691-696.
    47. Owings TM, Grabiner MD. Motor control of the vastus medialis oblique and vastus lateralis muscles is disrupted during eccentric contractions in subjects with patellofemoral pain. The American journal of sports medicine. 2002;30:483-487.
    48. Piva SR, Goodnite EA, Childs JD. Strength around the hip and flexibility of soft tissues in individuals with and without patellofemoral pain syndrome. The Journal of orthopaedic and sports physical therapy. 2005;35:793-801.
    49. Pollard CD, Sigward SM, Powers CM. Gender differences in hip joint kinematics and kinetics during side-step cutting maneuver. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. 2007;17:38-42.
    50. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. The Journal of orthopaedic and sports physical therapy. 2003;33:639-646.
    51. Powers CM. Patellar kinematics, part I: the influence of vastus muscle activity in subjects with and without patellofemoral pain. Physical therapy. 2000;80:956-964.
    52. Powers CM, Chen PY, Reischl SF, Perry J. Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot & ankle international. / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society. 2002;23:634-640.
    53. Powers CM, Landel R, Perry J. Timing and intensity of vastus muscle activity during functional activities in subjects with and without patellofemoral pain. Physical therapy. 1996;76:946-955; discussion 956-967.
    54. Ramappa AJ, Apreleva M, Harrold FR, Fitzgibbons PG, Wilson DR, Gill TJ. The effects of medialization and anteromedialization of the tibial tubercle on patellofemoral mechanics and kinematics. The American journal of sports medicine. 2006;34:749-756.
    55. Selkowitz D, Souza R, Powers C. Effect of femoral strapping on lower extremity kinematics and pain response in females with patellofemoral pain. First International Patellofemoral Pain Syndrome Research Retreat, Baltimore, MD. 2009;
    56. Souza DR, Gross MT. Comparison of vastus medialis obliquus: vastus lateralis muscle integrated electromyographic ratios between healthy subjects and patients with patellofemoral pain. Physical therapy. 1991;71:310-316; discussion 317-320.
    57. Souza RB, Draper CE, Fredericson M, Powers CM. Femur rotation and patellofemoral joint kinematics: a weight-bearing magnetic resonance imaging analysis. The Journal of orthopaedic and sports physical therapy. 2010;40:277-285.
    58. Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. The Journal of orthopaedic and sports physical therapy. 2009;39:12-19.
    59. Starkey C. Injuries and illnesses in the national basketball association: a 10-year perspective. Journal of athletic training. 2000;35:161-167.
    60. Tang SF, Chen CK, Hsu R, Chou SW, Hong WH, Lew HL. Vastus medialis obliquus and vastus lateralis activity in open and closed kinetic chain exercises in patients with patellofemoral pain syndrome: an electromyographic study. Archives of physical medicine and rehabilitation. 2001;82:1441-1445.
    61. Thomee R, Augustsson J, Karlsson J. Patellofemoral pain syndrome: a review of current issues. Sports Med. 1999;28:245-262.
    62. Tiberio D. The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. The Journal of orthopaedic and sports physical therapy. 1987;9:160-165.
    63. Tyler TF, Nicholas SJ, Mullaney MJ, McHugh MP. The role of hip muscle function in the treatment of patellofemoral pain syndrome. The American journal of sports medicine. 2006;34:630-636.
    64. Utting MR, Davies G, Newman JH. Is anterior knee pain a predisposing factor to patellofemoral osteoarthritis? The Knee. 2005;12:362-365.
    65. Ward SR, Powers CM. The influence of patella alta on patellofemoral joint stress during normal and fast walking. Clinical biomechanics. 2004;19:1040-1047.
    66. Ward SR, Terk MR, Powers CM. Patella alta: association with patellofemoral alignment and changes in contact area during weight-bearing. The Journal of bone and joint surgery. American volume. 2007;89:1749-1755.
    67. Whittingham M, Palmer S, Macmillan F. Effects of taping on pain and function in patellofemoral pain syndrome: a randomized controlled trial. The Journal of orthopaedic and sports physical therapy. 2004;34:504-510.
    68. Willson JD, Binder-Macleod S, Davis IS. Lower extremity jumping mechanics of female athletes with and without patellofemoral pain before and after exertion. The American journal of sports medicine. 2008;36:1587-1596.
    69. Willson JD, Davis IS. Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands. Clinical biomechanics. 2008;23:203-211.
    70. Willson JD, Davis IS. Lower extremity strength and mechanics during jumping in women with patellofemoral pain. Journal of sport rehabilitation. 2009;18:76-90.
    71. Willson JD, Davis IS. Utility of the frontal plane projection angle in females with patellofemoral pain. Journal of Orthopaedic & Sports Physical Therapy. 2008;38:606-615.
    72. Willson JD, Kernozek TW, Arndt RL, Reznichek DA, Scott Straker J. Gluteal muscle activation during running in females with and without patellofemoral pain syndrome. Clinical biomechanics. 2011;26:735-740.
    73. Willy RW, Davis IS. The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. The Journal of orthopaedic and sports physical therapy. 2011;41:625-632.
    74. Wilson NA, Press JM, Koh JL, Hendrix RW, Zhang LQ. In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. The Journal of bone and joint surgery. American volume. 2009;91:558-566.
    75. Winslow J, Yoder E. Patellofemoral pain in female ballet dancers: correlation with iliotibial band tightness and tibial external rotation. Journal of Orthopaedic & Sports Physical Therapy. 1995;22:18-21.
    76. Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic risk factors for the development of anterior knee pain in an athletic population a two-year prospective study. The American journal of sports medicine. 2000;28:480-489.
    77. Witvrouw E, Werner S, Mikkelsen C, Van Tiggelen D, Berghe LV, Cerulli G. Clinical classification of patellofemoral pain syndrome: guidelines for non-operative treatment. Knee Surgery, Sports Traumatology, Arthroscopy. 2005;13:122-130.
    78. 蔡忠穎. 比較螺旋式貼紮法及向內貼紮法對於髕股疼痛症候群之效果 [thesis]. 國立陽明大學; 2005.

    下載圖示 校內：立即公開
    校外：2015-09-05公開
    QR CODE