RESUMEN
OBJECTIVE: To compare different types of rehabilitation for anterior knee pain. DESIGN: Prospective, randomized, blinded, and controlled study of 64 participants with anterior knee pain. SETTING: Outpatient rehabilitation clinic and testing laboratory. PARTICIPANTS: Participants were assigned in randomized fashion to three rehabilitation groups: traditional home rehabilitation (n = 20); physical therapy (n = 21); and home rehabilitation with a modified vastus medialis obliquis (VMO) specific straight leg raise (Muncie method; n = 23). INTERVENTIONS AND MAIN OUTCOME MEASURES: Clinical data was obtained at 0, 2, 6, and 12 weeks. Cybex testing was performed at 0, 6, and 12 weeks. RESULTS: Clinical outcome for the Muncie method indicated a statistically significant improvement in subjective pain and functional impairment ratings. Cybex testing in patients using the Muncie method demonstrated a statistically significant improvement in pain-free isometric contractions and maximum voluntary contraction. There were no significant differences between traditional home therapy and physical therapy. CONCLUSION: Findings suggest that the Muncie method results in improved clinical outcome at a lower cost than traditional home and physical therapy and possibly improved VMO/quadriceps muscle balance. Patients with anterior knee pain may benefit from applying the Muncie method in a home therapy program.
Asunto(s)
Artralgia/rehabilitación , Articulación de la Rodilla/fisiopatología , Adulto , Análisis de Varianza , Artralgia/etiología , Artralgia/fisiopatología , Análisis Costo-Beneficio , Terapia por Ejercicio/economía , Terapia por Ejercicio/métodos , Femenino , Estudios de Seguimiento , Servicios de Atención de Salud a Domicilio/economía , Humanos , Contracción Isométrica/fisiología , Masculino , Contracción Muscular/fisiología , Músculo Esquelético/fisiopatología , Estudios Prospectivos , Rango del Movimiento Articular/fisiología , Método Simple Ciego , Resultado del TratamientoRESUMEN
A 20-year-old female college cross-country runner developed chest pain and dyspnea that increased with running. A chest radiograph revealed a right-side pleural effusion, and a ventilation-perfusion scan indicated a probable pulmonary embolism. The diagnosis was left-side pulmonary emboli. Testing for genetic risk factors was negative, leaving oral contraceptive use as the likely cause of the condition. The patient was treated with anticoagulant drugs and discontinuation of oral contraceptives, and was allowed to resume running gradually. Discussion covers genetic and other risk factors, anticoagulation therapy, and return to play.