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Background: The Q angle has a major impact on the lower limb's static alignment in the frontal plane; also, the lever-arm distance between the hip and knee joint centers also changes the hip abductor muscles' ability to produce torque. An association between Q angle and hip muscle strength has been investigated in different population. However, the relationship between Q angle and hip abductor muscle strength in early knee osteoarthritis has not been investigated. Therefore, the objective of the study was to investigate the correlation between Q angle and hip abductor muscle strength in patients with initial stage of knee osteoarthritis (OA). Study design: This is a correlation study. Methodology: Fifty-four involved OA knee among 32 patients (26 female and 6 male), with mean age of 49.38 ± 5.68 years, were included in the study. The Q angle was measured by universal goniometer, and the hip abductor muscle strength was measured by a hydraulic handheld dynamometer. Results: Spearman's correlation coefficient test showed that Q angle is significantly (weak negative) correlated (r = − 0.31; p < 0.05) with hip abductor muscle strength, in patients with knee osteoarthritis. Conclusion: There is a correlation between Q angle and hip abductor muscle strength in patients with knee OA. So, with the decrease in hip abductor, muscle strength may lead to increase in Q angle, which may be a factor responsible for early-stage degenerative changes in knee OA. [ABSTRACT FROM AUTHOR]

Abstract Background The Q angle has a major impact on the lower limb’s static alignment in the frontal plane; also, the lever-arm distance between the hip and knee joint centers also changes the hip abductor muscles’ ability to produce torque. An association between Q angle and hip muscle strength has been investigated in different population. However, the relationship between Q angle and hip abductor muscle strength in early knee osteoarthritis has not been investigated. Therefore, the objective of the study was to investigate the correlation between Q angle and hip abductor muscle strength in patients with initial stage of knee osteoarthritis (OA). Study design This is a correlation study. Methodology Fifty-four involved OA knee among 32 patients (26 female and 6 male), with mean age of 49.38 ± 5.68 years, were included in the study. The Q angle was measured by universal goniometer, and the hip abductor muscle strength was measured by a hydraulic handheld dynamometer. Results Spearman’s correlation coefficient test showed that Q angle is significantly (weak negative) correlated (r = − 0.31; p

Background:Anterior knee pain (AKP) is a common condition, especially among physically active adults who present a clinical challenge. Patellar malalignment is thought to be an important cause. Measuring quadriceps (Q) angle significant test used in the assessment of patellar alignment and hence used in the assessment of AKP. Objectives:To assess the relationship between AKP and Q angle among ample Iraqi patients. Materials and Methods:The right and left Q angles of 100 participants were measured using a universal goniometer. The participants were divided into three groups: controls, patients with left AKP (LAKP), and patients with right AKP (RAKP). The relationship between Q angles and different groups was tested using appropriate statistical tests. Results:The left Q angles for males measure 14.1 ± 1.9 in controls, 17.7 ± 1.6 in LAKP cases and 16.1 ± 1.8 in RAKP cases, and for the females 16.1 ± 1.8 in controls, 18.1 ± 1.8 in LAKP cases and 17.1 ± 2.5 in RAKP cases. The right Q angles for males measure 15.6 ± 2.2 in controls, 15.1 ± 2.7 in LAKP cases and 19 ± 1.6 in RAKP cases, and for the females were 17.7 ± 2.4 in controls, 17.9 ± 2.2 in LAKP cases and 19.9 ± 2 in RAKP cases. Both Q angles (right and left) were greater in females than in males and both were greater in cases than in controls. Conclusion:The study concluded that there is a significant association between AKP and quadriceps femoris angle measurement in both genders. Therefore, clinical and/or radiological demonstration of quadriceps angle can be used as a means for initial detection of AKP.

Copyright of Journal of Sport & Recreation Researches is the property of Journal of Sport & Recreation Researches and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Sport Science (MJSS) is the property of Mediterranean Journal of Sport Science (MJSS) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/Aims: The quadriceps angle, which depicts the quadriceps muscle's mechanical effect on the knee, is frequently used as an assessment metric when diagnosing a variety of knee-related issues. Smartphone goniometer applications have clinical assessment capabilities that can be used instead of the universal goniometer. The aim of this study was to analyse the criterion validity and inter- and intra-rater reliability of a smartphone goniometer application for measuring the quadriceps angle. Methods: A total of 50 typically healthy women were included in this study. The quadriceps angle was evaluated with the universal goniometer as the gold standard and the Angulus smartphone goniometer application on each participant. The intraclass correlation coefficient and 95% confidence intervals were used to analyse reliability, while the standard error of the mean was used to calculate precision. Bland-Altman plots and 95% limits of agreement were used to establish the levels of agreement between the smartphone goniometer application and the universal goniometer. The Pearson correlation coefficient was used to quantify the smartphone goniometer application criterion validity in comparison to the universal goniometer. Results: The smartphone goniometer application had good intra-rater reliability (intraclass correlation coefficient 0.99; 95% confidence interval 0.96–1) and inter-rater reliability (intraclass correlation coefficient 0.98; 95% confidence interval 0.94–1). A strong and significant correlation was found between the universal goniometer and the smartphone goniometer application, showing good criterion validity (r=0.99; 95% confidence interval 0.98–0.99; P=0.006). Conclusions: The use of the smartphone goniometer application to measure the quadriceps angle was valid and demonstrated excellent intra- and inter-rater reliability levels. Implications for practice: The smartphone goniometer application can be used in clinical practice as a valid and reliable quadriceps angle measurement tool. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to investigate the effect of 6 weeks of core stability exercises in the trunk area on lower limb alignment and lower and upper limb function in Kyokushin athletes. Methods: The statistical sample of the research included 30 female Kyokushin players aged 14-18 years, who were randomly divided into two experimental and control groups. The control group performed common Kyokushin exercises and the experimental group performed core stability exercises for 6 weeks. Analysis of covariance (ANCOVA) and paired t-tests were used to compare between groups and within groups. Results: The results of the paired t-test showed a significant effect of training programs on changes in upper and lower limb function in both experimental and control groups (P≤0.05); however, a significant difference was observed between the pre-test and post-test in both control and experimental group. The test was not observed in the Q angle (P>0.05). The results of ANCOVA test showed that after controlling the effect of the pre-test, a significant difference was observed in lateral jump (P≤0.05) between the experimental and control groups. However, no difference was observed between the two groups in the changes of closed kinetic chain upper extremity stability test (CKCUEST), square jump, and Q angle (P>0.05). Conclusion: Considering the nature of Kyokushin and the research results, it is suggested that people working in Kyokushin do not feel the need for core stability exercises separately.

Objective: To investigate the effects of body mass index (BMI), quadriceps angle (Q0) and pes planus on walking age in children with Down syndrome (DS) and typically developing peers. Methods: Bodyweight, height and Q0 were measured and footprints were obtained in 50 children with DS and 50 typically developing children (control), ages between 2-6 years. BMI and Staheli index (SI) were calculated. Results: The mean walking age was 26±8 months in the DS group and 12±2 months in the control group (p

Purpose: This study was conducted to investigate the effect of 6 weeks of core stability exercises in the trunk area on lower limb alignment and lower and upper limb function in Kyokushin athletes. Methods: The statistical sample of the research included 30 female Kyokushin players aged 14-18 years, who were randomly divided into two experimental and control groups. The control group performed common Kyokushin exercises and the experimental group performed core stability exercises for 6 weeks. Analysis of covariance (ANCOVA) and paired t-tests were used to compare between groups and within groups. Results: The results of the paired t-test showed a significant effect of training programs on changes in upper and lower limb function in both experimental and control groups (P≤0.05); however, a significant difference was observed between the pre-test and post-test in both control and experimental group. The test was not observed in the Q angle (P>0.05). The results of ANCOVA test showed that after controlling the effect of the pre-test, a significant difference was observed in lateral jump (P≤0.05) between the experimental and control groups. However, no difference was observed between the two groups in the changes of closed kinetic chain upper extremity stability test (CKCUEST), square jump, and Q angle (P>0.05). Conclusion: Considering the nature of Kyokushin and the research results, it is suggested that people working in Kyokushin do not feel the need for core stability exercises separately. [ABSTRACT FROM AUTHOR]

Aim and background: Genuvarum is a common complication among girls aged 12-16 years. This study aimed to investigate the effect of eight weeks of NASM and Theraband correction exercises on balance and kinematic variables of the knee in girls aged 16-12 years with suffering pain due to genuvarum. Material and Methods: The research sample includes 30 of these individuals who were randomly selected and then randomly divided into three groups of 10 controls (age: 14.20 ± 1.31 years, height: 1.59 ± 0.059). M, weight: 54.80 ± 7.61, BMI: 21.26 ± 2.19 kg / m2), Theraband group (age: 14.70 ± 0.94 years, height: 1.61 ± 0.06 M, weight: 54.40 ± 4.37 kg, BMI: 21.51 ± 1.23 kg / m2) and NASM group (age: 14.71 ± 1.16 years, height: 1.66 ± 0.053 M, weight: 56.70 ± 4.47 kg, BMI: 20.52 ± 0.87 kg / m2). In this study, a balance was assessed using the Walking on the balance wood test. Also, the distance between the inner condyle of the femur and the Q angle was measured using a caliper and a goniometer, respectively. After evaluating the variables, the subjects were divided into three groups of control and training, and each training group performed the training program for 8 weeks and 3 sessions per week. The control group also performed their daily activities and physiotherapy at Arman Clinic during this period. In this study, the normality of the distributions was investigated using the Shapiro-Wilk test. To test the research hypotheses under normal conditions, ANCOVA analysis of covariance (between groups) and correlated T (within groups) were used. SPSS software version 26 was used in this study. Results: The results of this study showed that applying 8 weeks of NASM and Theraband training program in addition to increasing the balance was effective on improving the distance between the condylar and the Q angle (P = 0.001). In the field of comparison between the two training groups, except for the Q angle (P = 0.001), the balance variable and the distance between the condyles were not found (P ≥ 0.05). Conclusion: In general, the results of the present study show the effect of both NASM and Theraband training programs on balance and improvement of knee kinematic variables; 1- The distance between the inner condyle of the femur, 2- Q angle has been effective. Based on this, it seems that the use of these two training programs in this community can lead to desirable results and shows the importance of using these exercises (especially NASM) in girls suffering genuvarum. [ABSTRACT FROM AUTHOR]

Background and Objectives: Anterior cruciate ligament (ACL) injuries occur as a result of the deterioration of the static and dynamic stability of the knee. One of the structures involved in providing static stability is the patellofemoral angle (Q angle). The aim of this study was to investigate the relationships between Q angle, pelvis diameter, lower extremity length, and foot posture index (FPI) in patients who had undergone ACL reconstruction (ACLR) with the semitendinosus/gracilis (ST/G) technique on both the operated and non-operated sides. Materials and Methods: Twenty-five male recreational athletic patients between the ages of 18 and 35 who had undergone semitendinosus/gracilis (ST/G) anterior cruciate ligament reconstruction at least 6 months earlier were included in the study. Femur length, lower extremity length, pelvis diameter, and Q angle measurements, total foot posture index (FPI) scores, and single leg hop (SLH) and triple hop distance (THD) test results were determined on the operated and non-operated sides. Results: When the findings of the patients were evaluated statistically between the operated and non-operated sides, no significant differences were found in Q angle, femur length, and lower extremity length (p > 0.05). In terms of FPI scores, a significant difference was found only in the inversion/eversion of the calcaneus (CALC) parameter (p < 0.05). When the single hop test (SLHT) results were evaluated statistically on the operated and non-operated sides, the results were in favor of the non-operated side (p < 0.05). In the correlation analysis conducted for both the operated and non-operated sides, positive and significant correlations were found only between SLH and THD (p < 0.05). No significant difference was found in the other parameters. Conclusions: The fact that ST/G ACLR 6th month post-operative findings revealed similar results in Q angle, lower extremity length, and total FPI scores between the operated and non-operated sides showed that the 6-month process did not cause a difference in these parameters. However, it was found that the operated sides showed lower findings compared to non-operated sides for SLHTs, although these findings were within normal ranges in terms of the limb symmetry index. [ABSTRACT FROM AUTHOR]

Introduction: Evaluating the mechanical-anatomical alignment and angles of the knee joint is crucial for athletes. We aimed to analyse the relationship between lower extremity bone alignment and the importance of the Q angle (QA) in male athletes., Methods: We included 38 male professional football athletes without any alignment or varus-valgus deformity who actively played football in various football clubs in Istanbul. This study was conducted using quantitative research methods within the scope of a cohort study design and employed a correlational survey method. A health specialist at the orthopaedic outpatient clinic of the Haseki Training and Research Hospital, Istanbul, evaluated the participants' lower extremity bone alignment using standing anteroposterior radiographs and assessed the QA using the goniometric measurement method. The anatomical lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA) and QA data were analysed to assess lower extremity straightness., Results: Significant relationships between the right and left leg aLDFA, MPTA and QA values of the participants' lower extremity mechanical axis values and between the aLDFA and right leg QA values ( r  = 0.380, p  = 0.019) were found. These relationships were attributed to the difference between proximal and distal alignments of the lower extremities. The correlation between QA and certain mechanical alignment parameters was due to unilateral and bilateral symmetrical arrangements of the lower extremities., Conclusions: The parameters of lower extremity mechanical-anatomical alignment are considered preliminary indicators of relationships among sports injuries, structural factors and predisposition to such injuries. Individual differences in the angular values of mechanical-anatomical alignment and the application of different methods for determining these angles have revealed some uncertainties. We determined the mechanical axis data of football athletes who predominantly used their lower extremities using the most reliable methods and examined the relationship among the right and left leg aLDFA, MPTA and QA values. We believe that our findings provide insights and guidance for experts in the field., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abstract Background Multiple lower limb joint involvement is one of the most common and debilitating musculoskeletal conditions, while the complaints from both heel and knee pain are considered the most frequent. For that reason, in this cross-sectional study, the association between heel pain (HP) and early knee osteoarthritis (EKOA) was investigated; the most painful site and side of HP, the prevalence, and risk factors for disabling HP in patients with EKOA were identified. Results Bilateral HP (56%) and posterior HP (54%) were found to be the most prevalent complaints, and 66% of patients reported the HP to be non-disabling. There was a very high positive statistically significant correlation between the Manchester Foot Pain Disability Index (MFPDI) and both the Health Assessment Questionnaire (HAQ) and the total Western Ontario and McMaster University Osteoarthritis (WOMAC) score (p ≤ 0.001), while there was a high negative statistically significant correlation between MFPDI and quadriceps angle of the most affected knee (p = 0.002). A higher total WOMAC score (OR 1.077, 95% CI 1.014 to 1.145) significantly increases the risk of developing disabling HP, while wearing 2–3-cm heels during the past month was found to be protective against the development of disabling HP (odds ratio < 1). Conclusion Disabling HP was present in a third of patients with EKOA and HP, and it was associated with flat shoe wear as well as a high total WOMAC score. Also, it had a statistically significant correlation with varus knee mal-alignment. Furthermore, decreased functional ability in the presence of HP was found to lead to significant disability. Moreover, a striking finding in this study was the longer mean duration of HP compared to the duration of knee symptoms.

Purpose: Genu valgum deformity a common lower extremity deformity. The weakness of the lower limb muscles followed by the internal rotation of the femur and external rotation of the tibia, shift the gravitational pull to the outside of the knee. This lower limb alignment deformity could increase the distance of ankle medial malleolus and the Q angle. Therefore, the present study aimed to investigate the effect of TheraBand training on the Q angle and distance of ankle medial malleolus in individuals with genu valgum deformity. Methods: This was a quasi-experimental study with a pre-test and post-test and control group design. The study population consisted of girls in the age range of 9-13 years with genu valgum deformity. The study subjects were randomly divided into the experimental (n=15) and control (n=15) groups. The experimental group participated in TheraBand exercises for 8 weeks and 3 sessions per week. However, the control group received no training during this period. Before and after 8 weeks, the Q angle and distance of ankle medial malleolus were measured by goniometers and coulis, respectively. Analysis of Covariance (ANCOVA) was used to analyze the collected data in SPSS. The significance level was considered at 0.05. Results: The obtained statistical results suggested that TheraBand training significantly decreased the Q angle and the distance of ankle medial malleolus in the explored subjects with genu valgum deformity (P=0.001 & P=0.04, respectively). However, no significant difference was observed in the control group. Conclusion: The obtained data revealed that TheraBand training could improve the genu valgum position. Therefore, this training protocol could be implemented to improve the deformity in this population.

Patellofemoral or anterior knee pain is a common cause of medical evaluation around the globe. It affects one in four individuals and is more frequent in females. It is considered a multifactorial disease in which conservative management must focus on the alterations found in the physical exam and radiologic images. Recurrence is high, as 39-40% of the patients continue with symptoms in one year of follow-up. Surgical management should be considered when symptoms persist after six months of conservative measures and when evident malalignments are identified. This article aims to establish and summarize the possible causes, involve the importance of the physical examination and the radiologic images suggested, as to consider the different treatment options that may be used to treat such a frequent and irregular pathology., Competing Interests: The authors declare no conflict of interest

Copyright of Mediterranean Journal of Sport Science (MJSS) is the property of Mediterranean Journal of Sport Science (MJSS) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Q-angle is defined as the acute angle formed by the vectors for combined pull of the quadriceps femoris muscle and the patellar tendon. This study aimed to investigate the variations in Q angle with respect to race. Moreover, this study performed ultrasound to evaluate of the thickness of articular cartilage covering the medial and lateral femoral condyle in volunteers with an increased Q angle. The study included 487 Jordanian and 402 Malaysians with age range 18-23 years. Moreover, the study included 30 participants aged between 18 and 22 years, with a total of 15 volunteers with Q >14° and 15 patients with Q ≤14°. Both Q angle and condylar distance were measured by well-trained medical practitioners according to a well-established protocol. The thickness of articular cartilage covering the medial and lateral femoral condyle of the femoral bone was measured using ultrasound. Regardless of race, Q angle was greater in females. Furthermore, Q angle was significantly greater in Arab volunteers compared to Malay volunteers. Q angle significantly increase with increasing condylar distance in both races. Finally, the statistical analysis showed a significantly reduced thickness of articular cartilage on both medial and lateral femoral condyle (P = 0.05) in the Q >14° group. Multiple factors including race and condylar distance and even the articular cartilage of femoral condyle should be considered during the examination and management of knee fractures and condylar diseases. [ABSTRACT FROM AUTHOR]

Background and Objectives: Anterior cruciate ligament (ACL) injuries occur as a result of the deterioration of the static and dynamic stability of the knee. One of the structures involved in providing static stability is the patellofemoral angle (Q angle). The aim of this study was to investigate the relationships between Q angle, pelvis diameter, lower extremity length, and foot posture index (FPI) in patients who had undergone ACL reconstruction (ACLR) with the semitendinosus/gracilis (ST/G) technique on both the operated and non-operated sides. Materials and Methods: Twenty-five male recreational athletic patients between the ages of 18 and 35 who had undergone semitendinosus/gracilis (ST/G) anterior cruciate ligament reconstruction at least 6 months earlier were included in the study. Femur length, lower extremity length, pelvis diameter, and Q angle measurements, total foot posture index (FPI) scores, and single leg hop (SLH) and triple hop distance (THD) test results were determined on the operated and non-operated sides. Results: When the findings of the patients were evaluated statistically between the operated and non-operated sides, no significant differences were found in Q angle, femur length, and lower extremity length (p > 0.05). In terms of FPI scores, a significant difference was found only in the inversion/eversion of the calcaneus (CALC) parameter (p < 0.05). When the single hop test (SLHT) results were evaluated statistically on the operated and non-operated sides, the results were in favor of the non-operated side (p < 0.05). In the correlation analysis conducted for both the operated and non-operated sides, positive and significant correlations were found only between SLH and THD (p < 0.05). No significant difference was found in the other parameters. Conclusions: The fact that ST/G ACLR 6th month post-operative findings revealed similar results in Q angle, lower extremity length, and total FPI scores between the operated and non-operated sides showed that the 6-month process did not cause a difference in these parameters. However, it was found that the operated sides showed lower findings compared to non-operated sides for SLHTs, although these findings were within normal ranges in terms of the limb symmetry index.

This study was carried out to determine the relation between patellofemoral (Q) angle differences and static equilibrium, flexibility and take-off force in young and veteran volleyball players. To the study 20 young males with an average age of 18 ± 00, 19 young females with a mean age of 18 ± 73, 21 veteran males with a mean age of 49 ± 04, 20 veteran females with a mean age of 48 ±70 who are registered players in Muğla Provincial Directorate of Youth and Sports, a total of 80 athletes voluntarily participated. The height, body weight, right and left leg Q angles in standing and laying, balance, flexibility and vertical take-off measurements were performed in the research group respectively. The statistical evaluation of the obtained data was done in SPSS 21.00 package program on a personal computer. In the data with normal distribution, the parametric statistical methods were used. While the analysis of variance (ANOVA) test was used for intergroup comparisons, the Tukey test was used for multiple comparisons, and the correlation level was used to determine the relationship between the variables and the significance level was taken as p lt;0.05. According to the findings, there were significant differences between the Q angles, balance, flexibility, and take-off values of the participants (p lt;0.01). Also, there was a positive relationship between Q angle values and elasticity values in standing and laying position, and a negative relationship between balance and take-off force values (p lt;0.05). As a result: Q angle values of volleyball players were examined and it was seen that the difference between groups has resulted from gender; the difference between young and veteran volleyball players was not statistically significant. As the Q angle increased, the increase in the elasticity values and the decrease in the balance and splash values were determined. In this respect, Q angle differences are thought to be related to lower extremity performances of young and veteran volleyball players.

Background: Quadriceps angle or Q angle is an index of the vector for the combined pull of extensor mechanisms and patellar tendon. It is a clinical measurement for knee and patella alignment. It is not a static but rather a dynamic consequence to the muscle mechanics, leg loading, and foot and leg position. Therefore in present study we assessed whether change of body position i.e. standing and supine position affects the Q angle measurement. Aims and Objectives: Present study aimed at finding whether there are any variations in Q angle in standing and supine position. Objectives of the study were to measure Q angle in supine position and standing position. We intended to assess the variations in the Q angle with change of body position. Methods: In this cross sectional analytical study, we assessed female participants between age group of 18-25 years, in supine and standing position, Q angle was measured in both the positions. Sample size was 100. Results: The results showed statistically significant increase in Q angle in standing position as compared with the supine position (p

Objective: The purpose of this study was to investigate the effect of Kinesio Taping method and corrective exercise on Genu Varum and knee kinematics in adolescent soccer players. Methods: The present study was a quasi-experimental study with pretest-posttest design. The sample consisted of 30 soccer players with mean age of 16.66 ± 2.32 years with genu varum. Participants took part in this study voluntarity and were randomly divided into three groups including: corrective exercise, tapping and control groups. Q-angle and knee deformity were measured by caliper and universal goniometer. Gait analysis was measured by two cameras with 50 fps. The distance between internal epicondyl and Q angle was measured before and after 8 weeks of taping. Results: The results showed that in Kinesio Taping group there was significant decrease on distance of internal epicondyl (p=0.001) and a significant increase on Q angle (p

Background: Osteoarthritis (OA) is the most frequent cause of disability in the India, with the medial compartment of the knee being most commonly affected. Osteoarthritis of knee joint is common musculoskeletal problem now days in Indian population. It is most disabling in day to day activities of life. Purpose: Due to Osteoarthritis of knee joint, multiple changes occur in structure in and around knee joint. Due to these structural changes, biomechanics of knee joint is altered, which in turn leads to secondary changes in muscles, ligaments and other soft tissues also. So, energy cost of walking increases. Objective: Objective of this study is to correlate Q angle, tibial torsion and leg heel alignment in OA knee patients. Setting: Different physiotherapy centres of Surat city Method: Co relational study was done in Surat city. Selection of OA knee patients was done as per selection criteria. Subjects were explained about the study. Informed consent forms were signed by the patient and/or relatives. Subjects selected by purposive sampling were assessed. Participants: Total 63 male and female OA knee patients Outcome measure: Q angle, Tibial torsion & Leg heel alignment Results: Data were entered in Microsoft Excel for Microsoft Windows. Descriptive analysis and corelational test was applied by SPSS version 20 for Microsoft Windows. Moderate positive correlation was found between Q angle & Tibial torsion, between Tibial Torsion & Leg heel alignment, between Leg heel alignment & Q angle. Conclusion: These findings may suggest that Q angle, Tibial torsion & Leg heel alignment are moderate positively correlated in OA knee joint. So any change in any of above three values may alter values of other remaining values. [ABSTRACT FROM AUTHOR]

Context: Structural and coronal-plane-alignment characteristics of the lower limb are frequently cited as factors contributing to knee pathologies. Objective: The purpose of this study was to determine the accuracy and reliability characteristics of a digital-photographic-goniometric method (DPGM) of measurement for 2-dimensional (2D) coronal-plane lower limb measurements of the quadriceps (Q) angle, tibiofemoral (TF) angle, and femur length in human participants adopting a self-selected- or Rombergstance position. Design: Reliability study. Setting: University motion-analysis laboratory. Participants: A convenience sample of 20 healthy young adult men and women. Main Outcome Measures: Intraclass correlation coefficients (ICCs), 95% confidence intervals, and standard error of the measurements. Results: Intratester- and intertester-reliability coefficients for the Q angle (ICCs .458-845 and .257-737) were consistently lower than those for the TF angle (ICCs .627-904 and .700-839) or femur length (ICCs .867-958 and .866-.944). Q angles were also significantly larger (13.4%) in the Romberg- vs self-selected-stance position (P < .001) and larger (20.2%) in the left limb than the right limb. Conclusions: The DPGM has the potential to produce accurate and reliable measurements of selected 2D lower limb measures. However, the reliability characteristics depend on the ability of the testers to correctly and repeatably landmark the anatomical sites used to define the measurements of interest and might be influenced by other factors such as the stance position adopted, the complexity of the variable (ie, number of anatomical landmarks and segments), and the size of the captured image. Further investigation of these latter factors is warranted. [ABSTRACT FROM AUTHOR]

Context: Hip-muscle weakness might be associated with impaired biomechanics and postures that contribute to lower extremity injuries. Objective: To examine relationships between hip-muscle strength, Q angle, and foot pronation. Design: Correlational study. Setting: Academic laboratory. Participants: 33 healthy adults. Main Outcome Measures: Maximal isometric hip abduction (Abd), adduction (Add), external-rotation (ER) and internal-rotation (IR) strength; Q angle of the knee; and longitudinal arch angle of the foot. We analyzed Pearson product-moment (r) correlation coefficients between the Abd/Add and ER/IR force ratios, Q angle, and longitudinal arch angle. Results: The hip Abd/Add force ratio was correlated with longitudinal arch angle (r = .35, P = .025). Conclusions: Reduced strength of the hip abductors relative to adductors is associated with increased pronation at the foot. Clinicians should be aware of this relationship when examining patients with lower extremity impairments. [ABSTRACT FROM AUTHOR]

Background: The newly defined angle, quadriceps-patella angle (QPA), reflects the combined force transmitted to the patella by the quadriceps muscles and patellar tendon. An increase in QPA may correlate with an increased force on the patella, which is significant in diagnosing patellofemoral instability and pain syndrome. In our study, we examined how various angles and pathologies vary depending on lateral patellar tilt angle (LPTA). QPA and patellar malalignment was investigated. Thus, the importance of understanding patellar malalignment and the research gap., Methods: Three hundred and fifty patients who underwent knee magnetic resonance imaging (MRI) examinations were included. The cross-sectional study conducted retrospectively between the years of 2018-2020 in a tertiary care outpatient clinic. Shapiro-Wilk normality, Chi-square, Mann-Whitney- U , Spearman correlation and receiver operating characteristic (ROC) curve analysis, statistical tests used for analysis. The patellar tendon length, patellar height, tibial tubercle-trochlear groove distance (TT-TG), patella angle, trochlear sulcus angle, trochlear groove depth (TGD), medial trochlea length (MT), lateral trochlea length (LT), medial trochlear/lateral trochlear length ratio (MT/LT), LPTA, patella-patellar tendon angle (PPTA), QPA, Insall-Salvati index (ISI), medial trochlear inclination (MTI), lateral trochlear inclination (LTI) were among these measurements. In addition, we aim to reveal whether there is a significant relationship between two important angles LPTA and QPA. Whether there is a significant increase in the development of chondromalacia for the patient group with LPTA >5°. We examined how the frequency of chondromalacia changes in the patient group with LPTA >5°., Results: Two hundred and seventy seven patients included in the study and many measurements were performed on MRI. Fad-pad edema was found to be significantly higher in the group with LPTA <5° (P=0.046). TT-TG distance was significantly higher, TGD and MT were significantly lower in patients with higher LPTA (P=0.001, P=0.002 and P=0.017, respectively). A low level of significant positive correlation was found between QPA and patellar tendon length. There is no significant difference between QPA and PPTA angles between the groups with LPTA <5° and >5° (P=0.503, P=0.188). In the ROC analysis performed to determine the cut-off value, the LPTA value ≤14.2° which significantly predicted the presence of fad-pad edema, had the highest sensitivity and specificity [sensitivity: 76.71%, specificity: 39.90%, area under the curve (AUC): 0.588, P=0.024]., Conclusions: QPA is independent from many angles of the knee and does not change significantly. As the patellar tendon length increases, QPA angle also increases. In patients with abnormal LPTA, the frequency of TT-TG distance and chondromalacia increased, while TGD and MT decreased. Patients with a low LPTA can be more carefully examined for chondromalacia and fad-pad edema in clinical and MRI examination., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1592/coif). The authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Running causes overuse injuries and ITBS (Iliotibial band syndrome) is one of the most common injury. Risk factors of ITBS includes ITB tightness, abductor weakness and biomechanical differences. People using treadmill without ruling out faulty biomechanics leads to ITBS. Objectives: i) To find the causative factor for ITBS among treadmill runners. ii) To find out the impact of ITBS in functional activities among treadmill runners. Methodology: 120 samples fulfilling the selection criteria were included. Age, lateral knee pain, speed of running, number of days running per week, since how many months, for how many minutes were collected. Participants with lateral knee pain were assessed using NCT (Noble compression test). Subjects were assessed with hip abductor strength test, NPT (Navicular position test), TT test (tibial torsion test) and Q angle measurement. Common cause for ITBS among treadmill runners was evaluated. Participants were screened for their functional activity using the LEFS (lower extremity functional scale) and scored accordingly. Result: Mean age calculated is 27.88±3.91 yrs, running since 12.08±5.82 months, for 23.58±4.91 minutes, 4.06±0.8 days a weeks, with a speed of 6.75±0.57 m/sec. 40.83% of the subjects had ITBS due to hip abductor weakness, 15.83% of the subjects had a FF(flat feet) and int.TT while 14.17 % had int.TT. Increased Q angle and ext.TT was found in 9.17%. 5 % had hip abductor weakness and increased Q angle whereas 2.5% of the subjects had all the four components present. The mean score obtained by all the subjects with ITBS in the LEFS scale is 63.12±5.33. Conclusion: Study concludes that hip abductor weakness alone is the major cause of ITBS among treadmill runners. FF and int.TT being second most important cause. Mean score of ITBS in LEFS scale is 63.12±5.33 [ABSTRACT FROM AUTHOR]

BACKGROUND: Changes in postural stability may be a reason for injuries in individuals who have altered musculoskeletal alignment. Q angle (QA) has shown to be a predictor for lower extremity injuries. However, the relationship between balance and QA has not been investigated in young adults. OBJECTIVE: The aim of the study was to investigate the relationship between QA and balance in young adults. METHODS: Ninety participants performed the single leg stance test (SLST) and Star Excursion Balance Test (SEBT) to assess static and dynamic balance, respectively. QA was measured using a manual goniometer. Participants were divided into low, normal and high QA groups. RESULTS: The relationship between SLST and QA was not statistically significant in both eyes opened and closed condition (r = - 0.030, p = 0.782; r = 0.031, p = 0.774; respectively). SLST scores did not differ among the three groups in both eyes opened and closed condition (p = 0.781, p = 0.790; respectively). QA significantly correlated with lateral, posterolateral directions and sum score of SEBT (r = 0.240, p = 0.023; r = 0.269, p = 0.010; r = 0.210, p = 0.047). The comparisons among the low, normal and high Q angle groups' SEBT scores showed that balance performance in lateral direction was poorer in low QA group (p = 0.027). CONCLUSIONS: The results of the study showed that QA and dynamic balance have a significant relationship. To reduce musculoskeletal injury risk, the dynamic balance should be assessed in young adults who have lower QA. [ABSTRACT FROM AUTHOR]

• Lateral open wedge distal femur osteotomy. • With MPFL and MCL reconstruction. • Tibial tuberosity medialization realignment procedure. • This procedure can improve irreducible patellar dislocation in valgus knee. The high rate of recurrence in patellar dislocation treatment, requires a more comprehensive action, this is due to causes not only single but often multifactorial, including problems with static stability, dynamic stability or both. 1st case: A-39-years-old male, complain of irreducible right patella dislocation with valgus knee and already done soft tissue procedure for patella dislocation. Long-leg radiographs of the right leg showed 18° valgus mechanical angle. 2nd case: A-26-years-old obese female, complain of dislocation of left patella and history of surgery for dislocation at 5 years old. Long-leg radiographs of the right leg showed 11° valgus mechanical angle. After knowing the cause of the patellar dislocation from history taking, physical and supporting examination, we performed lateral open wedge distal femoral osteotomy also MPFL and MCL reconstruction, and tibial tuberosity medialization osteotomy. There is improvement mean score in Tegner Lysholm Knee Scoring system and IKDC Scoring at 6 months after surgery. Lateral open wedge distal femur osteotomy combine with MPFL and MCL reconstruction and tibial tuberosity medialization realignment procedure can be successfully done for improve irreducible patellar dislocation in valgus knee, from clinical and radiological evaluation have good outcome after surgery. [ABSTRACT FROM AUTHOR]

Purpose: Hamstring muscle is a two-jointed muscle, which is attached to the pelvis at one end and to tibia at the other. Contractures of the hamstring muscles affect the position of proximal and distal joints. The present study aims to compare the value of quadriceps angle (‘Q angle’) and tibial torsion among Premier League Futsal players with and without hamstring tightness. Methods: In this expost facto study, 30 male players, aged 18 to 25 years old, were non-randomly and purposefully selected as subjects. They were assigned to two 15-member groups, one containing players with hamstring tightness and the other without hamstring tightness. The goniometer was used to check the hamstring muscle tightness and measure the Q angle and tibial torsion. Independent t-test was used to analyze the data at a significance level of 0.05. SPSS version 21.0 was used for statistical analysis. Results: According to the findings of the present study, there was a significant difference in the value of Q angle and tibial torsion between the healthy athletes and group with hamstring tightness (P≤0.05). Conclusion: To prevent injuries in Futsal players with hamstring muscles tightness, special attention should be paid to the Q angle and tibial torsion.

Introduction: Anterior Knee Pain (AKP) is a very common symptom that poses a difficult diagnostic and therapeutic problem. Abnormal patellar alignment is described to be one of the causes. A common tool to assess patellar malalignment is the quadriceps angle (Q-angle). Aim: To evaluate the relationship between Q-angle and AKP. Materials and Methods: A total of 100 patients with AKP were included in this prospective, comparative observational study who qualified the inclusion criteria. Another group consisting of 100 subjects without AKP were kept as control. Along with demographic details, Q-angle was measured in both groups in standing position using universal goniometer and compared using standard statistical tests. Results: A total of 122 knees in 100 cases (52 Females and 48 Males) and 100 knees of 100 control group (50 Female and 50 Male) were evaluated with mean age 25.5 years in case and 25.4 years in control group (p>0.05). The mean duration of AKP was 7.13 months (ranging from 2-24 months). Left knees were involved in 40 cases, right knees in 38 cases and both knees in 22 cases. The mean Q-angle among men, women and all participants in the case group were 15.2°, 20.4° and 17.9° respectively. In the normal control group, the angles were 12.2°, 16.3° and 14.3° respectively. All these difference in case and control group were statistically significant. Conclusion: The individual with AKP have large Q-angle than asymptomatic individual.

Anterior Cruciate Ligament (ACL) injuries are a prevalent concern in athletic population, particularly among female athletes who are disproportionately affected. The increased incidence of ACL injuries in females is attributed to a combination of anatomical, physiological, and biomechanical factors that influence knee stability. This review comprehensively explores these contributing factors, highlighting gender-specific anatomical differences such as wider pelvis, increased quadriceps (Q) angle, and steeper tibial slopes, all of which predispose females to greater knee valgus during dynamic activities. Furthermore, hormonal influences and greater ligament laxity are discussed as physiological contributors to increased ACL injury risk. Biomechanical factors such as reduced knee flexion, increased knee valgus, and altered muscle activation patterns further amplify the risk of ACL tears in female athletes. Despite extensive research, gaps remain in the understanding of how these factors interact and influence injury susceptibility. This article is focussed on the critical points in the current literature, analyzing key risk factors, and identifying future research directions that can inform more effective prevention strategies. A better understanding of these factors will ultimately contribute to reducing the incidence of ACL injuries among female athletes and improving long-term strength and stability of knee joint., Competing Interests: Competing interests: All authors have read the manuscript and declare no conflict of interest. No writing assistance was utilized in the production of this manuscript.

Introduction: Anterior Knee Pain (AKP) is a very common symptom that poses a difficult diagnostic and therapeutic problem. Abnormal patellar alignment is described to be one of the causes. A common tool to assess patellar malalignment is the quadriceps angle (Q-angle). Aim: To evaluate the relationship between Q-angle and AKP. Materials and Methods: A total of 100 patients with AKP were included in this prospective, comparative observational study who qualified the inclusion criteria. Another group consisting of 100 subjects without AKP were kept as control. Along with demographic details, Q-angle was measured in both groups in standing position using universal goniometer and compared using standard statistical tests. Results: A total of 122 knees in 100 cases (52 Females and 48 Males) and 100 knees of 100 control group (50 Female and 50 Male) were evaluated with mean age 25.5 years in case and 25.4 years in control group (p>0.05). The mean duration of AKP was 7.13 months (ranging from 2-24 months). Left knees were involved in 40 cases right knees in 38 cases and both knees in 22 cases. The mean Q-angle among men, women and all participants in the case group were 15.2°, 20.4° and 17.9° respectively. In the normal control group, the angles were 12.2°, 16.3° and 14.3° respectively. All these difference in case and control group were statistically significant. Conclusion: The individual with AKP have large Q-angle than asymptomatic individual. [ABSTRACT FROM AUTHOR]

Summary Objective Use logistic regression to determine a mathematical model which is able to predict injuries in aerobic gymnastics (AG) athletes, according to certain anthropometric characteristics. Subjects and methods In total, 73 athletes were recruited, of whom 51 were gymnasts and 22 were athletes from other sports. The independent variables were anthropometric characteristics of both lower extremities. The dependent variable was injury at the end of the season. Results The statistical model indicated that the effect of the Q angle on the likelihood of injury varies depending on the weight of the gymnast. An excessive Q angle is an anthropometric factor that may predispose to injury, especially the left Q angle. Conclusion Studies that analyze anthropometric characteristics can contribute to understanding what variables or parameters may cause injuries in athletes. Thus, in the future, intervention strategies could be developed and the onset of certain injuries could be prevented. [ABSTRACT FROM AUTHOR]

This aim of this study is to observe the differences in foot posture and the angle of the knee according to different physical activities. Seventy-eight football players and 72 swimmers were recruited, and in each case a foot posture analysis, based on the foot posture index (FPI), was conducted and the Q angle of the knee was determined. The following mean values were obtained for the lower extremities: in the swimmers, FPI 6.45 ± 2.04 and Q angle 15.38º ± 3.79º. In the footballers, FPI 2.23 ± 1.72 and Q angle 13.16º ± 1.36º. There were statistically significant differences (p < 0.001) between the two groups. The swimmers presented a foot posture with a tendency towards pronation, and a Q angle with a tendency towards valgus, while the results for the footballers were within the normal range. [ABSTRACT FROM AUTHOR]

There is a campaign called "manspreading". The campaign which started to draw attention to men's making passengers uncomfortable by sitting with open legs in public transportation, attracted too much attention. When we glance through communal living spaces, we see men mostly sitting with their legs open. Can there be a morphological background of this sitting position? Basically, the pelvis of men and women are different from each other. Angulus subpubicus is bigger in women. In women, the femur head is located to lateral due to excess angulus subpubicus. However, the lower end of femur has to direct to medial to adjust with tibial condyle, that is, it gets closer to midline. Anteversion angle of acetabulum is higher in women. Anteversion with a higher angle means more anteriorly located acetabulum. That is, both femurs have to be more located to the midline. In women, the collodiaphyseal angle and femur neck length is smaller than men. Both of these situations cause femurs to be located close to the midline. Q angle which is used in the assessment of the mechanic and situation of knee joint is higher in women. High Q angle means that femur lower ends are close to the midline. Due to anatomical differences listed above, women's femurs are located closer to the midline, while the femurs of men are located more laterally. This difference is also reflected in the way they sit. [ABSTRACT FROM AUTHOR]

Introduction. TPatellofemoral pain may be caused by an increase of the pressure of the joint surfaces in the patella and the femur, and, as a consequence, a premature abrasion of joint cartilage. The aim of the study was an ultrasonographic evaluation and comparison of articular cartilage of the femur condyles between the limbs in patients with an elevated Q angle. Methods. The total of 13 women aged 35--45 years with the Q angle exceeding 15° took part in the research. The measurement of the Q angle was carried out with a goniometer. The thickness of joint cartilage was measured with the ultrasound scanner HoNdA HS-2200. Shapiro-Wilk test for normality was applied. The variance test ANoVA for independent samples allowed to evaluate the differences of the measured parameters. The Bonferroni test was applied for multiple comparison. Results and conclusions. The analysis did not depict any statistically significant differences in the thickness of cartilage of the lateral condyle (p = 0.83) or the medial condyle (p = 0.12), or in the Q angle (p = 1.00) between the right and left limb. The changes in thickness of the joint cartilage covering the lateral and medial condyles occurred symmetrically in both limbs. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the effects of knee and foot alignments on the risk of falling. Patients and methods: Between April 2016 and December 2016, a total of 74 individuals (24 males, 50 females; mean age 32.2±4.9 years; range 18 to 65 years) were included in the study. The knee Q angle and Chippaux-Smirak Index (CSI), Arch Index, and foot progression angle (FPA) evaluated by pedobarography were used for the assessment of the lower extremity alignment. The fall risk was evaluated by the Fall Index, Fourier 56 Index (F56), and Stability Index. Results: The fall index was found to be correlated with the Q angle, CSI, the Arch index, and FPA (p<0.05). Q angle, Arch Index, and FPA which were explained 40% of the variance of the fall index. The Q angle was correlated with F56 and the stability index at the most position (p<0.05). The CSI was correlated with the F56 and the stability index at two and three positions, respectively (p<0.05); however, the Arch Index and FPA were not correlated with the F56 and Stability Index at any of the eight positions (p>0.05). According to the categorical regression analysis, the Q angle was the most effective on the F56 and Stability Index. Conclusion: Our study results suggest that lower extremity malalignment increases the risk of falling. We believe that the risk of falling can be decreased by the reduction of these malalingments and, thus, mortality and morbidity associated with the fall can be reduced as well. [ABSTRACT FROM AUTHOR]

Purpose: An increased lateral quadriceps vector has been associated with lateral patellar dislocation. Surgical correction of this increased vector through tibial tubercle medialization is often recommended when the quadriceps vector is "excessive". This can be evaluated by physical examination measurements of Q-angle and/or tubercle sulcus angle (TSA), as well as the magnetic resonance imaging (MRI) measurement of tibial tubercle-trochlear groove (TT-TG) distance. This study examined the relationship between three objective measurements of lateral quadriceps vector (TT-TG, Q-angle, TSA). A secondary goal was to relate lateral patellar tilt to these measurements.Methods: Consecutive patients undergoing patellofemoral stabilization surgery from 9/2010 to 6/2011 were included. The Q-angle and TSA were measured on intra-operative physical examination. The TT-TG and patellar tilt were measured on MRI. TSA, Q-angle, and patellar tilt were compared to TT-TG using Pearson correlation coefficient.Results: The study cohort included 49 patients, ages 12-37 (mean 23.2); 62% female. The Pearson correlation coefficients showed (+) significance (p < 0.01) between the TT-TG and both TSA and Q-angle. Tilt and TT-TG were (+) non-significantly correlated. Despite positive correlations of each measurement with TT-TG, there is not uniform intra-patient correlation. In other words, if TT-TG is elevated for a patient, it does not guarantee that all other measurements, including tilt, are elevated in that individual patient.Conclusion: The TT-TG distance has significant positive correlation with the measurements of TSA and Q-angle in patients undergoing surgery for patellofemoral instability. The clinical relevance is that the variability within individual patients demonstrates the need for considering both TSA and TT-TG before and during surgical intervention to avoid overcorrection with a medial tibial tubercle osteotomy.Level Of Evidence: Diagnostic study, Level III. [ABSTRACT FROM AUTHOR]