Publication:

肌內效貼紮技術對髕股骨疼痛症候群下肢生物力學的影響與分析

在所有膝關節運動傷害中，髕股骨疼痛症候群是常見傷害之一。許多學者認為髕股骨疼痛症候群發生機制是由於髕骨與股骨間滑動軌跡出現異常，導致髕骨軟骨與股骨間磨損而疼痛。日本Kase博士發明肌內效貼紮，強調透氣舒適且不影響競技動作表現，近年來已逐漸受到運動員喜愛與重視，然而現今少有研究討論肌內效貼紮對髕股骨疼痛症候群下肢生物力學效應。目的：在階梯測試中，分析五種肌內效貼紮狀態(髕骨矯正貼紮、髖外展貼紮、支持足弓貼紮、合併貼紮與無貼紮)對髕股骨疼痛症候群受試者下肢運動學參數、肌電學特性與疼痛治療效益的影響。方法：利用三維動作分析系統觀察貼紮對髖關節外展角度、膝關節屈曲角度、膝關節旋轉角度、膝關節外翻角度、股四頭肌角度與舟狀骨下墜距離的影響，使用肌電圖觀察貼紮對股內斜肌與股外側肌的肌電比值與收縮反應時間差的影響，另外用視覺疼痛量表評估貼紮的治療效益。結果：肌內效貼紮可以降低階梯測試時的股內斜肌收縮反應延緩現象，甚至可以使股內斜肌比股外側肌提早收縮。推測影響機制可能是肌內效貼紮手法提供髕骨機械效應與增加髂脛束柔軟度，以改變髕骨滑動軌跡，使降低股內斜肌收縮反應時間的延緩。建議臨床工作人員擬定髕股骨疼痛運動員的復健治療計畫時，加入髖關節與足踝關節的評估檢查，再針對不同症狀給予不同的貼紮設計，以穩定髕骨滑動軌跡，降低髕股骨關節磨損疼痛機率。

Patellofemoral pain syndrome is one of the most common knee sports injuries. The mechanism of patellofemoral pain syndrome is the abnormal tracking between patella cartilage and femur, resulting in joint wear and pain. Kinesio taping, invented by Dr. Kase, has the nature of breathable comfort and might not affect the competitive performance of the athletes. Numerous athletes have paid attention on the use of the kinesio taping in recent years. However, little is known about the biomechanical effect of the kinesio taping. Purpose: The purpose of this study was to investigate the effect of kinesio taping (patellar corrective taping, hip abductor taping, support foot-arch taping, combined taping and no taping) on kinematics, electromyographic (EMG) characteristics and treatment effect of patellofemoral pain syndrome during stair trials. Methods: The motion analysis system was used, and the hip and knee kinematics, quadriceps angle and navicular drop were analyzed. The vastus medialis obliquus (VMO) / vastus lateralis (VL) EMG ratio and delayed onset time of VMO were calculated. Visual analogue scale was measured to evaluate taping treatment effect. Results: Kinesio taping could reduce the delayed onset time of VMO in stair trials. VMO onset occurred earlier than VL after the use of kinesio taping. It might be due to the mechanical effect of the taping on patella and the increasing iliotibial band flexibility. It might also change the tracking between patella and femur and reduce the delayed onset time of VMO. Conclusion: This study suggested that the assessments of the hip and foot are recommended when the clinicians evaluate the patellofemoral pain syndrome. Different taping is suggested in different causes of the patellofemoral pain syndrome to maximally stabilize patellar tracking and decrease pain.