Relationship between bilateral quadriceps angle and anterior knee pain and its association with knee injury in long distance runners (original) (raw)
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https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.9\_Sep2017/IJHSR\_Abstract.02.html, 2017
Background: Anterior knee pain (patellofemoral pain syndrome) is a very common problem that poses difficult diagnostic and therapeutic problems. It accounts for up to 74% of knee pain experienced by adolescents participating in sports, with prevalence of 15% in females and 12% in males. Although etiology and pathogenesis of patellofemoral pain syndrome are poorly understood, many predisposing factors suggest an underlying genetic, developmental, or familial abnormality. Various clinical tests have been used to diagnose anterior knee pain but data regarding validity are scarce and inconclusive. Q-angle is the most common test done to identify and treat anterior knee pain. The objective of this study is to evaluate quadriceps angle (Q angle) in patients with anterior knee pain in our setup. Materials and Methods: A descriptive study was undertaken at Tribhuvan University Teaching Hospital (TUTH), Kathmandu. One hundred patients with symptomatic anterior knee pain presenting to Orthopaedics OPD or Sports Clinic of the Department of Orthopaedics, TUTH, who could meet the inclusion criteria were taken up for the study. Results: Total124 symptomatic knees of 100 patients (55 male and 45 females) were evaluated. Mean Q-angle was 15.57 degrees; Mean Q-angle of symptomatic knees was 16.62 degree (male-14.55, female-19.05) and 13.84 degrees of asymptomatic knee (male-12.65, female-15.39). Mean q-angle in female was 17.71 degree and in male was 13.81degree. Conclusions: Q-angle was significantly high in females and symptomatic knee with anterior knee pain. The relationship between Q-angle and knees with anterior knee pain was statistically significant (P-0.001).
The Relationship of Quadriceps Angle and Anterior Knee Pain
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
Anterior Knee Pain (AKP) or Patella Femoral Pain Syndrome (PFPS) is defined by mild aching pain localised around peripatellar area which aggravate by physical activities like climbing stairs, squatting, jumping, running and/or by sitting with the knees flexed for prolonged periods of time [1]. It accounts for 25% of all knee pain encountered in sports medicine clinics [1]. It is commonest diagnoses among young, physically active populations, affects 25% athletes, with >70% of them between age of 16 and 25-year-old. This respond well to physiotherapy but has high incidence of relapse in two-thirds which leads to activity modification and long medical treatment [2]. The main anatomical structures responsible for AKP are subchondral bone, synovium, retinaculum, skin, muscle/tendon, and nerve. These structures may be affected by many factors, including systemic disease, but in orthopaedic, the most common reasons for AKP are patellofemoral malalignment, overuse and trauma [3]. A common tool used to assess such patellar malalignment is the Q-angle [4]. Various studies suggest that there is a significant association between AKP and Q-angle [5-9]. Most of the studies done are from western population who have body morphology and physical activities different from Southeast Asian population, and hence its validity in present population is largely unknown. So in this prospective comparative study, authors have tried to find the relationship between AKP and Q-angle and the normal range of Q-angle in Nepalese population.
International journal of sports physical therapy, 2013
There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount of running performed. Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe. A 10 week study was conducted including healthy, novice runners. At baseline foot posture was evaluated using the foot posture index (FPI) and the Q-angle was measured. Based on the FPI and Q-angle, right and left feet / knees of the runners were categorized into exposure groups. All participants received a Global Positioning System watch to allow them to quantify running volume and were instructed to run a minimum of two times per week in a conventional, neutr...
Comparison of Quadriceps Q-Angle Values of Soccer Players and Wrestlers
Journal of Education and Training Studies, 2019
The aim of this study is to compare according to different positions the mean right and left knee Q angle of footballers and wrestlers. In this study, found the female soccer and wrestlers mean age 20.51 ± 3.47 years, height 165.43 ± 4.82 cm, weight 58.23 ± 5.18 kg. Male soccer and wrestlers has with mean age 21.30 ± 3.45 years, height 173.28 ± 5.45 cm, weight 65.66 ± 5.73 kg. One-way ANOVA, Student t, and Duncan post hoc test were used for statistical analysis. In this study, found that the mean right and left knee Q angles of male athletes were 15.08 ± 1.79° and 14.49 ± 1.82° for the standing position, 14.26 ± 1.84° and 13.29 ± 1.82° for the supine position.The mean right and left knee Q angles of Female athletes were 18.11 ± 1.32° and 17.90 ± 1.35° for the standing position, 17.52 ± 1.36°and 16.82 ± 1.29° for the supine position. In this study, were found abnormal results. The difference between the Q angle values of footballers and wrestlers was found to be statistically signifi...
Cureus, 2023
Background: The quadriceps angle, commonly known as the Q-angle, is the angle formed between the vectors of the pull of the quadriceps muscle and the patellar tendon. The literature varies in terms of the values of Q angles measured by various researchers. It is well appreciated that the normal Q-angle should fall between 12° and 20°, with males being at the lower end of this range and females having higher measurements. An increase in Q-angle beyond the normal range has been associated with knee extensor dysfunction leading to patellar instability. Keeping in mind the clinical and biomechanical importance of the Q-angle, the aim of this study was to compare and establish the range of the Q-angle in healthy individuals and evaluate its variations with respect to age, weight, height, gender, dominant side, and femoral bicondylar distance. These observations will be helpful for sports therapists in understanding the evaluation of Q-angle in athletes as a prognostic value for probable knee pathologies that may appear in the future. Methods: The current study was conducted at a tertiary care center, and a total of 100 healthy adults between the ages of 18 and 35 were enrolled in the study (50 males and 50 females), following which their Q-angles, bicondylar distances, and femur lengths were measured. Individuals with any lower limb injury that resulted in a ligamentous, muscular, or bony defect; any spinal or neurological injury; any diagnosed knee disorder, such as a fracture, acute or chronic knee pain, patellar dislocation, or prior orthopaedic surgery in the lower extremities, were excluded from the study. Data were analyzed using paired t-tests, independent sample t-tests, ANOVA, and Pearson correlation coefficients. Result and conclusion: The mean Q-angle in males was found to be 11.14° ± 1.9° on the right side and 10.84°± 1.86° on the left side. In females, it was found to be 13.68° ± 1.87° on the right side and 13.61° ± 2.04° on the left side. Among males, right and left Q-angles showed significant positive correlations with height, weight, BMI, right femur length, left femur length, right bicondylar distance, and left bicondylar distance (p<0.05). The highest correlation was found between weight and BMI. Among females, the right Q-angle showed significant positive correlations with weight and BMI (p<0.05). The highest correlation was found with weight.
Influence of Q-angle on Lower-Extremity Running Kinematics
Journal of Orthopaedic & Sports Physical Therapy, 2000
Study Design: Two-group posttest-only comparison. Objective: To assess the influence of the Q-angle on the 3-dimensional lower-extremity kinematics during running. Background: An excessive Q-angle has been implicated in the development of knee injuries by altering the lower-extremity locomotion kinematics. Previous investigations using 2dimensional analyses during walking did not support this hypothesis. Methods and Measures: We hypothesized that individuals with Q-angles more than 15" would display an increase in reatfoot eversion and tibial internal rotation during running. Thirty-two nonimpaired subjects (men: n = 16, mean age = 22 + 3 years; women: n = 16, mean age = 23 5 3 years) ran over ground, and 3-dimensional kinematic data were collected from the right lower extremity. Subjects with a Q-angle of 15" or less comprised the 1ow-Q-angle group, whereas those with Q-angles of more than 15" comprised the high-Q-angle group. Segment and joint maximum angles and the times when the maxima occurred during stance were measured. Results: The Q-angle magnitude did not increase the maximum segment or joint angles during running. The groups displayed similar maximum angles for rearfoot eversion (low Qangle,-15.5 t 5.0"; high Q-angle,-15.6 + 6.6") and tibial internal rotation (low Q-angle,-8.8 + 4.8"; high Q-angle,-6.8 t 5.1"). The high-Q-angle group (39.5 t 16.3%) achieved maximum tibial internal rotation later in the stance phase than the 1ow-Q-angle group (28.8 t 10.7%). Conclusions: In support of the previous investigations involving Q-angle influences on kinematics, our study did not reveal any differences between groups in maximum joint or segment angles. The kinematic information did reveal that the high-Q-angle group displayed an increase in time to maximum tibial intemal rotation. The impact of this single factor on producing knee injury is unknown.
Quadriceps cross-sectional area changes in young healthy men with different magnitude of Q angle
Journal of Applied Physiology, 2008
Knee pain and dysfunction have been often associated with an ineffective pull of the patella by the vastus medialis (VM) relative to the vastus lateralis (VL), particularly in individuals with knee joint malalignment. Such changes in muscular behavior may be attributed to muscle inhibition and/or atrophy that precedes the onset of symptoms. The aim of this study was to investigate possible effects of knee joint malalignment, indicated by a high quadriceps (Q) angle (HQ angle >15°), on the anatomic cross-sectional area (aCSA) of the entire quadriceps and its individual parts, in a group of 17 young asymptomatic men compared with a group of 19 asymptomatic individuals with low Q angle (LQ angle <15°). The aCSA of the entire quadriceps (TQ), VM, VL, vastus intermedius (VI), rectus femoris (RF), and patellar tendon (PT) were measured during static and dynamic magnetic resonance imaging (MRI) with the quadriceps relaxed and under contraction, respectively. A statistically significa...
Quadriceps Femoris Angle of Elite and Non-Elite Athletes in Olympic Style Weightlifting
Khyber Medical University Journal, 2022
the power of quadriceps muscular. Moreover, it is also reported that Q-angle is affected by many factors such as gender, dominant foot use, the type of sports and training years and that sports comprising a great number of quadriceps trainings might be associated with lower 10 Q-angle values. In studies including individuals into different types of sports, it is reported that Q-angle is correlated with parameters like femur length, thigh girth, calf circumference, pelvic width 11,12 and training years. Some studies refer that right-left Q-angle develop 4,10,12-14 asymmetrically whereas some 15 other studies report no asymmetry. The observed Q-angle asymmetry is reported to be related to knee injuries in 16 different athletic activities. This study aims to find out Q-angle values of elite weightlifting (EWL) athletes and non-elite weightlifting (non-EWL) athletes in Olympic style weightlifting and to compare Q-angle value findings with some physical parameters such as high length, thigh girth, lower leg length, calf girth, pelvic width along with other parameters like leg force, training years, the number of weekly trainings, athletic performance. o the Q-angle exceeds 15-20 , it is thought to increase knee extensor mechanism dysfunction and patellofemoral pain as it also increases the tendency for lateral 5 patella mal-position. Unusual increases in the value of Q-angle are can cause changes in neuromuscular control, extreme stress on joints owing to change in the knee-joint movement plane and 6,7 low athletic performance. In some studies, it is reported that Q-angle is correlated with knee joint and muscular 1-3 to the center of the tibial tubercle. Qangle is frequently used to define relations between athletic injuries and physical factors, besides, it is a primary 4 indicator of tendency to injuries. When
Study of Variation in Quadriceps Angle in Healthy Individuals
2018
DOI: 10.21276/sjams.2018.6.6.26 Abstract: Quadriceps angle is defined as the angle formed by the vector for the combined pull of the quadriceps f muscle and the patellar tendon. The aim of the study was to analyse the effect of age and gender on quadriceps angle. A cross-sectional study was conducted in 600 healthy individuals. Subjects with any present or past history of trauma, degenerative disorders, structural deformity, inflammatory condition of bilateral lower extremities and spine were excluded. Quadriceps angle was measured using goniometric method in supine lying position bilaterally. Of the 600 participants, 300 were males and 300 females. There was a statistically significant negative correlation (r = -0.232, p = 0.000) between age and right limb quadriceps angle. Also, it was observed that women have greater value quadriceps angle than men in both right (p = 0.000) and left limb (p = 0.000). The present study showed that there was an inverse relationship between age and ...
2021
Background: Nowadays many young active females are diagnosed with anterior knee pain or patellofemoral pain disorder. Q angle is an essential parameter to check the alignment of the patella within the quadriceps muscle. Higher Q angle may cause patellofemoral pain which may lead to patellar subluxation. Previous studies supports that there is a decrement in Q angle during maximal isometric quadriceps contraction. Thus, the purpose of this study is to evaluate Q angle value among young females in both supine and standing. Method: 66 subjects participated in this study who have no significant history of any knee pathology. The Q angle was measured in relaxed state of quadriceps and during isometric contraction with knee in full extension on right and left side in both supine and standing. The Q angle was measured using universal goniometer. Data was collected from each subject and analyzed using SPSS software 28.00. Results: The result of this study shows that there was a significant ...