Additionofhipexercisestotreatmentofpatellofemoralpainsyndrome:Ameta-analysis

摘要： AIM:Todetermineiftheadditionofhip-strengtheningexercisesdecreasespainandimprovesfunctioninpatientswithpatellofemoralpainsyndrome.METHODS:Theauthorscompletedasystematicreviewsearchingeightdatabases(i.e.,PubMed,Cochrane,CINHAL,MEDLINE,SportsDiscus,EMBASE,APTAHookedonEvidence,andPEDro).Twoindependentreviewersscreenedandexcludedstudiesiftheydidnotmeetthefollowinginclusioncriteria:subjectshadaprimarydiagnosisofpatellofemoralpainsyndrome(PFPS),interventiongroupincludedhip-strengtheningexercises,controlgroupincludedatraditionalphysicaltherapyintervention,studyincludedoutcomemeasuresofpainand/orfunction,studyusedarandomizedcontrolledtrialdesign,PEDroscorewas≥7,andstudywaspublishedinapeer-reviewedjournal.Primaryoutcomemeasuresweresubjectivescalesofpainandfunction.Thesemeasureswereconvertedtostandardizedmeandifference[effectsize(ES)],andarandom-effectsmodelwasusedtocalculatetheoverallES.RESULTS:Twohundredeighty-threestudieswerescreenedforinclusioninourmeta-analysis.Ninestudiesweredeemedsuitablefordataextractionandanalysis.Atotalof426subjectswereusedintheninestudies.Overall,therewasasignificantpositiveeffectofhip-strengtheningexercisesonmeasuresofpainandfunctioninsubjectswithPFPS(ES=0.94,P=0.00004).NoneoftheindividualstudieshadanegativeES,withstudyESrangingfrom0.35to2.59.Becauseofthehighdegreeofbetween-studyvariance(I2=76%;Q=34.0,P<0.001),subgroupmeta-analysesandmeta-regressionswereperformed.Noneofthepotentialmoderatorvariablesthatwereinvestigated(e.g.,outcometype,hipregiontargeted,durationoftreatment)couldexplainasignificantamountofthebetween-studyvarianceinES(P≥0.23).CONCLUSION:Overall,theadditionofhip-strengtheningexercisestotraditionalphysicaltherapyproducedgreaterimprovementsinmeasuresofpainandfunction. （共7頁）