体外冲击波治疗慢性髂胫束摩擦综合征的疗效及其髋膝关节运动学特征分析OA

Objective To investigate the effects of extracorporeal shock wave therapy(ESWT)on the kinematic parameters of hip and knee joints in patients with chronic iliotibial band friction syndrome(ITBS),and to verify its biomechanical improvement effect through three-dimensional gait analysis.Methods A total of 30 patients meeting the inclusion criteria were enrolled and received ES-WT twice a week for 4 weeks(energy density:2 bar;frequency:10 Hz).Symptoms and functions were evaluated using the Visual An-alogue Scale(VAS)and the Lower Extremity Functional Scale(LEFS),before treatment,immediately after treatment and 4 weeks after treatment.A three-dimensional gait analysis system was used to quantify selected hip and knee kinematic parameters,including hip ad-duction angle,hip internal rotation angle,knee flexion angle,and knee internal rotation angle.Results After treatment,the VAS score decreased from 5.20±1.00 at baseline to 2.53±1.25(P<0.001),and the LEFS score increased from 45.10±6.47 to 55.33±8.72(P<0.001),and the improvements persisted at the 4-week follow-up(VAS:1.53±1.38;LEFS:69.87±8.03;both P<0.001).Three-dimensional gait analysis showed that the hip adduction angle decreased from 14.60°±1.19° to 9.87°±0.97° immedi-ately after treatment and further improved to 12.63°±2.11° at 4-week follow-up(P<0.001).The hip internal rotation angle decreased from 7.17°±1.66° to 5.90°±2.09° and was maintained at 6.17°±1.88°(P<0.05).For knee flexion angle,values increased during initial contact from 15.27°±0.83° to 16.53°±2.00° and during peak stance from 43.70°±3.35° to 46.93°±3.70°(both P<0.005).The knee internal rotation angle decreased from 8.57°±0.77° to 6.77°±1.59°(P<0.001).Conclusions ESWT can significantly al-leviate pain,improve lower-limb function,and help correct abnormal gait patterns by optimizing hip and knee kinematic parameters in patients with chronic ITBS.