Purpose

The purpose of this study was to examine how attentional focus during training influences the effects of a 6-week hip-knee strength training program on pain, function, strength, and kinematics in males and females with Patellofemoral pain (PFP).

Methods

Seventy-five males and females with PFP were randomly allocated to a group that trained with an internal focus (n = 25), a group that trained with an external focus (n = 25), or a control group (n = 25). All patients completed testing before (baseline) and after (posttest) the 6-week period. The primary outcome was pain, assessed by Visual Analog Scale (VAS). The secondary outcomes were function, hip muscles strength and lower extremity kinematics, assessed by Kujala Questionnaire, handheld dynamometer and a 2-D motion capture, respectively. All outcomes were measured at the baseline and after the 6-week intervention. Analysis of covariance was used to compare posttest outcomes among the groups while accounting for group differences in baseline performance.

Results

The hip-knee strengthening exercises resulted in improved knee valgus (ES(95 % CI) = 0.43(0.26 to 0.75), p = 0.03), and external rotator strength (ES(95 % CI) = 0.51(0.12 to 0.78), p = 0.03) for males and females who trained with an external compared to internal focus.

Conclusions

Our findings indicate that males and females with PFP may benefit from completing a hip-knee strengthening training program with an external focus vs. an internal focus. Physical therapists and clinicians should consider using instructions that promote an external focus when implementing hip-knee strengthening training programs with PFP patients. This result could be strengthened or re-enforced by larger studies with longer follow up.

中文翻译：

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内部和外部焦点对pain股股骨疼痛患者的步态运动表现出相似的影响：一项随机对照试验

目的

这项研究的目的是检验训练期间的注意力集中程度如何对6个月髋膝力量训练计划对Pat骨股骨痛（PFP）的男性和女性的疼痛，功能，力量和运动学的影响。

方法

七十五名患有PFP的男性和女性被随机分配到以内部重点训练的组（n = 25），以外部重点训练的组（n = 25）或对照组（n = 25）。所有患者在6周的时间之前（基线）和之后（后测）均完成了测试。主要结果是通过视觉模拟量表（VAS）评估的疼痛。次要结果是功能，髋部肌肉力量和下肢运动学，分别由Kujala问卷，手持测功器和二维运动捕捉评估。所有结果均在基线和干预后6周进行测量。协方差分析用于比较各组之间的测试后结果，同时说明各组在基线表现方面的差异。

结果

髋膝关节加强锻炼可改善膝外翻（ES（95％CI）= 0.43（0.26至0.75），p = 0.03）和外旋肌力量（ES（95％CI）= 0.51（0.12至0.78）， p = 0.03）对于使用外部焦点训练而不是内部焦点训练的男性和女性。

结论

我们的研究结果表明，患有PFP的男性和女性可能会受益于完成一个以外部关注点与内部关注点为重点的髋关节强化训练计划。物理治疗师和临床医生在对PFP患者实施髋关节膝盖强化训练计划时，应考虑使用能够引起外界关注的指导。较大的研究和更长时间的随访可以增强或加强这一结果。