{"title":"膝伸肌神经肌肉功能在有和没有髌股疼痛的个体中的性别差异。","authors":"Sungwan Kim, Neal R Glaviano, Jihong Park","doi":"10.1177/19417381231209318","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Impaired knee extensor neuromuscular function has been frequently observed in individuals with patellofemoral pain (PFP); however, few researchers have aimed to understand the influence of sex on knee extensor neuromuscular function in this pathological population. The authors aimed to determine whether there are differences in knee extensor neuromuscular function between sexes in individuals with and without PFP.</p><p><strong>Hypothesis: </strong>Women with PFP would exhibit greater deficits in knee extensor neuromuscular function than men with PFP, compared with sex-matched individuals without PFP.</p><p><strong>Study design: </strong>Cross-sectional, case-control study.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Methods: </strong>A total of 110 individuals were classified into 4 groups: women with PFP (n = 25); men with PFP (n = 30); women without PFP (n = 25); and men without PFP (n = 30). Knee extensor strength (isometric peak torque [PT]), activation (central activation ratio), early, late, and total phase rate of torque development (RTD<sub>0-100</sub>, RTD<sub>100-200</sub>, and RTD<sub>20-80%</sub>), and endurance (isokinetic average PT) were assessed using an isokinetic dynamometer. Group differences were assessed using a 2-way multivariate analysis of variance (sex by PFP).</p><p><strong>Results: </strong>Both women and men with PFP exhibited lower knee extensor strength, activation, early, late, and total phase RTD, and endurance versus sex-matched individuals without PFP (<i>P</i> < 0.05 for all comparisons). Women with PFP exhibited lower early phase (7.91 ± 2.02 versus 9.78 ± 2.43 N·m/s/kg; <i>P</i> < 0.01; Cohen <i>d</i> = 0.83), late phase (5.34 ± 1.02 versus 7.28±2.28 N·m/s/kg; <i>P</i> < 0.01; Cohen <i>d</i> = 1.37), and total phase (7.40 ± 2.57 versus 8.72 ± 2.57 N·m/s/kg; <i>P</i> = 0.03; Cohen <i>d</i> = 0.51) RTD than men with PFP.</p><p><strong>Conclusion: </strong>Compared with sex-matched pain-free individuals, women with PFP displayed lower RTD than men with PFP. Clinicians should note that among individuals with PFP, women are more likely to experience a greater impairment in their knee extensor torque-generating capacity than men.</p><p><strong>Clinical relevance: </strong>Additional treatment strategies that effectively improve the ability to rapidly generate torque should be developed and implemented, especially when treating women with PFP.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"1000-1008"},"PeriodicalIF":2.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531066/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sex Differences in Knee Extensor Neuromuscular Function in Individuals With and Without Patellofemoral Pain.\",\"authors\":\"Sungwan Kim, Neal R Glaviano, Jihong Park\",\"doi\":\"10.1177/19417381231209318\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Impaired knee extensor neuromuscular function has been frequently observed in individuals with patellofemoral pain (PFP); however, few researchers have aimed to understand the influence of sex on knee extensor neuromuscular function in this pathological population. The authors aimed to determine whether there are differences in knee extensor neuromuscular function between sexes in individuals with and without PFP.</p><p><strong>Hypothesis: </strong>Women with PFP would exhibit greater deficits in knee extensor neuromuscular function than men with PFP, compared with sex-matched individuals without PFP.</p><p><strong>Study design: </strong>Cross-sectional, case-control study.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Methods: </strong>A total of 110 individuals were classified into 4 groups: women with PFP (n = 25); men with PFP (n = 30); women without PFP (n = 25); and men without PFP (n = 30). Knee extensor strength (isometric peak torque [PT]), activation (central activation ratio), early, late, and total phase rate of torque development (RTD<sub>0-100</sub>, RTD<sub>100-200</sub>, and RTD<sub>20-80%</sub>), and endurance (isokinetic average PT) were assessed using an isokinetic dynamometer. Group differences were assessed using a 2-way multivariate analysis of variance (sex by PFP).</p><p><strong>Results: </strong>Both women and men with PFP exhibited lower knee extensor strength, activation, early, late, and total phase RTD, and endurance versus sex-matched individuals without PFP (<i>P</i> < 0.05 for all comparisons). Women with PFP exhibited lower early phase (7.91 ± 2.02 versus 9.78 ± 2.43 N·m/s/kg; <i>P</i> < 0.01; Cohen <i>d</i> = 0.83), late phase (5.34 ± 1.02 versus 7.28±2.28 N·m/s/kg; <i>P</i> < 0.01; Cohen <i>d</i> = 1.37), and total phase (7.40 ± 2.57 versus 8.72 ± 2.57 N·m/s/kg; <i>P</i> = 0.03; Cohen <i>d</i> = 0.51) RTD than men with PFP.</p><p><strong>Conclusion: </strong>Compared with sex-matched pain-free individuals, women with PFP displayed lower RTD than men with PFP. Clinicians should note that among individuals with PFP, women are more likely to experience a greater impairment in their knee extensor torque-generating capacity than men.</p><p><strong>Clinical relevance: </strong>Additional treatment strategies that effectively improve the ability to rapidly generate torque should be developed and implemented, especially when treating women with PFP.</p>\",\"PeriodicalId\":54276,\"journal\":{\"name\":\"Sports Health-A Multidisciplinary Approach\",\"volume\":\" \",\"pages\":\"1000-1008\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531066/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sports Health-A Multidisciplinary Approach\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/19417381231209318\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SPORT SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sports Health-A Multidisciplinary Approach","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19417381231209318","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/17 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
背景:膝关节伸肌神经肌肉功能受损在髌骨股痛(PFP)患者中经常观察到;然而，很少有研究人员旨在了解性别对这一病理人群中膝关节伸肌神经肌肉功能的影响。作者的目的是确定在有和没有PFP的个体中，膝关节伸肌神经肌肉功能是否存在性别差异。假设:与没有PFP的性别匹配个体相比，患有PFP的女性会比患有PFP的男性表现出更大的膝关节伸肌神经功能缺陷。研究设计:横断面、病例对照研究。证据等级:四级。方法:110例患者分为4组:女性PFP患者(n = 25);PFP患者(n = 30);无PFP的女性(n = 25);无PFP的男性(n = 30)。膝关节伸肌强度(等距峰值扭矩[PT])、激活(中枢激活比)、扭矩发展的早期、晚期和总阶段速率(RTD0-100、RTD100-200和RTD20-80%)和耐力(等速平均PT)使用等速测力仪进行评估。采用双向多变量方差分析(PFP为性别)评估组间差异。结果:与没有PFP的性别匹配个体相比，患有PFP的女性和男性均表现出膝关节伸肌力量、激活、早期、晚期和全期RTD以及耐力(所有比较P < 0.05)。PFP女性表现出较低的早期期(7.91±2.02 vs 9.78±2.43 N·m/s/kg);P < 0.01;Cohen d = 0.83)，晚期(5.34±1.02 vs 7.28±2.28 N·m/s/kg);P < 0.01;Cohen d = 1.37)，总相(7.40±2.57 vs 8.72±2.57 N·m/s/kg);P = 0.03;Cohen d = 0.51) RTD高于PFP患者。结论:与性别匹配的无痛个体相比，女性PFP患者的RTD低于男性PFP患者。临床医生应该注意到，在患有PFP的个体中，女性比男性更有可能经历更大的膝关节伸肌扭矩产生能力的损害。临床相关性:应制定和实施额外的治疗策略，有效提高快速产生扭矩的能力，特别是在治疗PFP妇女时。
Sex Differences in Knee Extensor Neuromuscular Function in Individuals With and Without Patellofemoral Pain.
Background: Impaired knee extensor neuromuscular function has been frequently observed in individuals with patellofemoral pain (PFP); however, few researchers have aimed to understand the influence of sex on knee extensor neuromuscular function in this pathological population. The authors aimed to determine whether there are differences in knee extensor neuromuscular function between sexes in individuals with and without PFP.
Hypothesis: Women with PFP would exhibit greater deficits in knee extensor neuromuscular function than men with PFP, compared with sex-matched individuals without PFP.
Study design: Cross-sectional, case-control study.
Level of evidence: Level 4.
Methods: A total of 110 individuals were classified into 4 groups: women with PFP (n = 25); men with PFP (n = 30); women without PFP (n = 25); and men without PFP (n = 30). Knee extensor strength (isometric peak torque [PT]), activation (central activation ratio), early, late, and total phase rate of torque development (RTD0-100, RTD100-200, and RTD20-80%), and endurance (isokinetic average PT) were assessed using an isokinetic dynamometer. Group differences were assessed using a 2-way multivariate analysis of variance (sex by PFP).
Results: Both women and men with PFP exhibited lower knee extensor strength, activation, early, late, and total phase RTD, and endurance versus sex-matched individuals without PFP (P < 0.05 for all comparisons). Women with PFP exhibited lower early phase (7.91 ± 2.02 versus 9.78 ± 2.43 N·m/s/kg; P < 0.01; Cohen d = 0.83), late phase (5.34 ± 1.02 versus 7.28±2.28 N·m/s/kg; P < 0.01; Cohen d = 1.37), and total phase (7.40 ± 2.57 versus 8.72 ± 2.57 N·m/s/kg; P = 0.03; Cohen d = 0.51) RTD than men with PFP.
Conclusion: Compared with sex-matched pain-free individuals, women with PFP displayed lower RTD than men with PFP. Clinicians should note that among individuals with PFP, women are more likely to experience a greater impairment in their knee extensor torque-generating capacity than men.
Clinical relevance: Additional treatment strategies that effectively improve the ability to rapidly generate torque should be developed and implemented, especially when treating women with PFP.
期刊介绍：
Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals.
Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS).
The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor.
Topics include:
-Sports Injury and Treatment
-Care of the Athlete
-Athlete Rehabilitation
-Medical Issues in the Athlete
-Surgical Techniques in Sports Medicine
-Case Studies in Sports Medicine
-Images in Sports Medicine
-Legal Issues
-Pediatric Athletes
-General Sports Trauma
-Sports Psychology
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