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  • Patellofemoral Joint Pain 2013 Consensus - Rayner & Smale PDF

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    Itai Izhak
    20 vues3 pages

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    Patellofemoral joint pain 2013 consensus — Rayner & Smale.pdf

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    20 vues3 pages

    Patellofemoral Joint Pain 2013 Consensus - Rayner & Smale PDF

    Transféré par

    Itai Izhak

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 3

    1.8.

    2016

    Patellofemoraljointpain2013consensus

    Patellofemoraljointpain2013consensus
    AresearchretreatwasheldinVancouverin2013coveringtheresentresearchforpatellofemoraljointpain
    (PFJP).Thereweremanyinterestingpointsmadeinthisconsensusstatementcoveringboththepastand
    currentliterature.Theysummarisedthefindingsofthisresearchretreatintothefollowingcategories.The
    mainpointswhichcaughtmyattentionhavebeenlistedbelow.
    NaturalhistoryandlocalfactorsaffectingPFJP
    Evidenceregardingtheprevalenceandincidenceamongstsportingpopulationsandotherpatientgroups
    islacking.Itremainstobethoughtthatitismostprevalentintheadolescentpopulationandeffectsgirls
    morethanboys.
    "AlthoughitispossiblethatthereisaphenotypeofPFPthatgoesontodevelopPFOA,thereisno
    evidencetosupportthisview"(Witvrouw,etal.,2014,p.2).
    ManypeoplethinkthatthelateralcompartmentofthePFJismorepronetoosteoarthritis(OA)however,
    researchisnowimmergingthatthemedialcompartmentisofteninvolved.Furtherresearchshould
    regardingthemechanismsandriskfactorsforbothmedialandlateralPFJOA.
    "Patellaaltaandabnormaltrochleamorphologywereassociatedwithcartilagedamageandbonemarrow
    lesions(BMLs)"(Witvrouw,etal.,2014,p.2).
    QangleisnotassociatedwithincreasedriskofdevelopingPFJP.
    "Thereislimitedevidencethatavarietyoflocalstructurescontributetonociception(andpotentiallypain)
    inPFP.TheseincludetheinfrapatellarfatpadinPFP,increasedwatercontentinsubchondralpatellar
    boneinathletesandBMLsinPFOA.Thereisnonewevidencethattheretinaculum,whichwaspreviously
    acommonlycitedsofttissueproblem,contributestonociception"(Witvrouw,etal.,2014,p.2).

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    1.8.2016

    Patellofemoraljointpain2013consensus

    (Cleland,2005,p.286)
    TrunkanddistalfactorsaffectingPFJP
    Alterationsintrunkandhipbiomechanics,includingincreasedhipadductionandinternalrotation,are
    oftennotedinwomenbutnotmen.Rehabmayneedtobesexspecific.
    TheeffectofcontralateralhipmechanicsonPFJPisunclear.
    Hipextensionmusclemomentsisnotedtobeloweranddemonstratelessenduranceontheeffectedside
    duringrunning.
    GluteusmediushasalsobeendemonstratedtobeweakeronthesidewithPFJPduringrunning.
    Weaknessinkneeextensormuscleshasbeendemonstratedinwalking(notrunning)inPFJP.
    PatientswithPFJPareoftenobservedtohaveincreasedhindfooteversionandincreasedtibialinternal
    rotationduringwalking,whichmayprovideabiomechanicallinkbetweenfootmechanicsandkneepain.
    "ThecontributionoftheglutealmusclesandquadricepstoPFPhasbeenwellstudiedinwomen.
    However,theinfluenceofothermuscles(theirstrength,activation,endurance)suchasthehamstring,hip
    adductoranddistalmusclessuchastheposteriortibialisandintrinsicfootmusclesneedtobe
    investigated.Studiesarealsoneededinmen(withandwithoutPFP)tocharacterisetheroleofall
    muscles"(Witvrouw,etal.,2014,p.3).
    Innovationsinrehabilitationofpeoplewithpatellofemoraljointpain
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    1.8.2016

    Patellofemoraljointpain2013consensus

    "Therapeuticexercisesfocusedonstrengtheningposterolateralhipmusclesreducepainandimprove
    functionwhenperformedalone,orincombinationwithmultimodaltherapy"(Witvrouw,etal.,2014,p.3).
    "Movementfeedbackinterventionsduringtreadmillrunningmaychangemovementpatternsofpeople
    withPFPduringweightbearingactivitiesandthesekinematicadjustmentsmayreducePFPsymptoms.
    However,increasinghipabductorandkneeextensormusclestrengthdoesnotaffectalteredlower
    extremitykinematicsassociatedwithPFP"(Witvrouw,etal.,2014,p.3).
    Andafinalpointtoconsiderinclinicalpracticeisthatpain(theprimaryproblem)shouldbemeasuredacross
    multipledomainsincludingphysical,psychological,functional/qualityoflife,kinesiophobiaandemotional
    state,toclearlyunderstandthefunctionalimpactandprovidepatientspecificandgoaldrivenrehabilitation.
    Sian
    References
    Witvrouw,E.,Michael,J.C.,Joshua,J.S.,Brian,N.,David,M,BJ.,etal.(2014).Patellofemoralpain:
    consensusstatementfromthe3rdInternationalPatellofemoralPainResearchRetreatheldinVancouver,
    September2013.BritishJournalofSportsMedicine,48,411414.
    Cleland,J.(2005).Orthopaedicclinicalexamination:anevidencebasedapproachforphysicaltherapists.
    WBSaundersCo.

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