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Yıl 2025, Cilt: 11 Sayı: 2, 61 - 68, 30.04.2025

Musa Eymir , Nihat Demirhan Demirkıran , Bayram Ünver , Mehmet Erduran

https://doi.org/10.31459/turkjkin.1626497

Öz

Proje Numarası

none

Kaynakça

  • Abdullah, S. S., & Rajasekaran, M. P. (2022). Do Weight-Bearing Knee Digital Radiographs Help to Track the Severity of OA? Indian J Orthop, 56(4), 664-671. doi:10.1007/s43465-021-00560-w
  • Almeida, G. P., Silva, A. P., França, F. J., Magalhães, M. O., Burke, T. N., & Marques, A. P. (2016). Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop, 51(2), 181-186. doi:10.1016/j.rboe.2016.01.010
  • Belchior, A. C. G., Arakaki, J. C., Bevilaqua-Grossi, D., Reis, F. A., & Carvalho, P. T. C. (2006). Effects in the Q angle measurement with maximal voluntary isometric contraction of the quadriceps muscle. Rev Bras Med Esporte, 12, 6-10. doi:10.1590/S1517-86922006000100002
  • Chevidikunnan, M. F., Al Saif, A., Pai, H., & Mathias, L. (2015). Comparing goniometric and radiographic measurement of Q angle of the knee. Asian Biomed, 9(5), 631-636. doi:10.5372/1905-7415.0905.433
  • de Vet, H. C., Terwee, C. B., Ostelo, R. W., Beckerman, H., Knol, D. L., & Bouter, L. M. (2006). Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change. Health Qual Life Outcomes, 4, 54. doi:10.1186/1477-7525-4-54
  • Devan, M. R., Pescatello, L. S., Faghri, P., & Anderson, J. (2004). A prospective study of overuse knee injuries among female athletes with muscle imbalances and structural abnormalities. J Athl Train, 39(3), 263-267.
  • Draper, C. E., Chew, K. T., Wang, R., Jennings, F., Gold, G. E., & Fredericson, M. (2011). Comparison of quadriceps angle measurements using short-arm and long-arm goniometers: correlation with MRI. PM&R, 3(2), 111-116. doi:10.1016/j.pmrj.2010.10.020
  • Driban, J. B., Harkey, M. S., Barbe, M. F., Ward, R. J., MacKay, J. W., Davis, J. E., Lu, B., Price, L. L., Eaton, C. B., Lo, G. H., & McAlindon, T. E. (2020). Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review. BMC Musculoskelet Disord, 21(1), 332. doi:10.1186/s12891-020-03367-2
  • Ekim, A. A., Hamarat, H., & Musmul, A. (2017). Relationship between q-angle and articular cartilage in female patients with symptomatic knee osteoarthritis: ultrasonographic and radiologic evaluation. Arch Rheumatol, 32(4), 347-352. doi:10.5606/ArchRheumatol .2017.6145
  • Eymir, M., Unver, B., & Karatosun, V. (2024). Reliability, concurrent validity, and minimal detectable change of the hand-held dynamometry for the assessment of knee muscle strength in patients with revision total knee arthroplasty. Arch Phys Med Rehabil, 105(1), 34-39. doi:10.1016/j.apmr.2023.05.002
  • Eymir, M., Yuksel, E., Unver, B., & Karatosun, V. (2021). Hand-held dynamometry in the inpatient care setting after total knee arthroplasty: reliability of static knee strength measurements. Am J Phys Med Rehabil, 100(6), 570-575. doi:10.1097/phm.0000000000001592
  • Hunter, D. J., Sharma, L., & Skaife, T. (2009). Alignment and osteoarthritis of the knee. J Bone Joint Surg Am, 91(Supplement 1), 85-89. doi:10.2106/JBJS.H.01409
  • Kocak, F. U., Unver, B., Karatosun, V., & Bakirhan, S. (2009). Associations between radiographic changes and function, pain, range of motion, muscle strength and knee function score in patients with osteoarthritis of the knee. J Phys Ther Sci, 21(1), 93-97. doi:10.1589/jpts.21.93
  • Lee Rodgers, J., & Nicewander, W. A. (1988). Thirteen ways to look at the correlation coefficient. Am Stat, 42(1), 59-66. doi:10.1080/00031305.1988.10475524
  • Lim, B. W., Hinman, R. S., Wrigley, T. V., & Bennell, K. L. (2008). Varus malalignment and its association with impairments and functional limitations in medial knee osteoarthritis. Arthritis Rheum, 59(7), 935-942. doi:10.1002/art.23820
  • Merchant, A. C., Fraiser, R., Dragoo, J., & Fredericson, M. (2020). A reliable Q angle measurement using a standardized protocol. Knee, 27(3), 934-939. doi:10.1016/j.knee.2020.03.001
  • Örtqvist, M., Moström, E. B., Roos, E. M., Lundell, P., Janarv, P.-M., Werner, S., & Broström, E. W. (2011). Reliability and reference values of two clinical measurements of dynamic and static knee position in healthy children. Knee Surg Sports Traumatol Arthrosc, 19(12), 2060-2066. doi:10.1007/s00167-011-1542-9
  • Otsuki, S., Nakajima, M., Okamoto, Y., Oda, S., Hoshiyama, Y., Iida, G., & Neo, M. (2016). Correlation between varus knee malalignment and patellofemoral osteoarthritis. Knee Surg Sports Traumatol Arthrosc, 24(1), 176-181. doi:10.1007/s00167-014-3360-3
  • Özgül, A., Günendi, Z., Kesikburun, S., Omaç Ö, K., & Taşkaynatan, M. A. (2013). The association between patellar alignments features and tibiofemoral joint osteoarthritis. Clin Rheumatol, 32(7), 1017-1020. doi:10.1007/s10067-013-2222-6
  • Rahimi, M., Alizadeh, M., Rajabi, R., & Mehrshad, N. (2012). The Comparison of innovative image processing and goniometer methods in Q angle measurement. World Appl Sci J, 18(2), 226-232. doi:10.5829/idosi.wasj.2012.18.02.762
  • Sharma, L. (2021). Osteoarthritis of the Knee. N Engl J Med, 384(1), 51-59. doi:10.1056/NEJMcp1903768
  • Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: uses in assessing rater reliability. Psychol Bull, 86(2), 420-428. doi:10.1037//0033-2909.86.2.420
  • Shultz, S. J., Nguyen, A.-D., Windley, T. C., Kulas, A. S., Botic, T. L., & Beynnon, B. D. (2006). Intratester and intertester reliability of clinical measures of lower extremity anatomic characteristics: implications for multicenter studies. Clin J Sport Med, 16(2), 155-161. doi:10.1097/00042752-200603000-00012
  • Smith, T. O., Hunt, N. J., & Donell, S. T. (2008). The reliability and validity of the Q-angle: a systematic review. Knee Surg Sports Traumatol Arthrosc, 16(12), 1068-1079. doi:10.1007/s00167-008-0643-6
  • Springer, B. A., Arciero, R. A., Tenuta, J. J., & Taylor, D. C. (2000). A prospective study of modified Ottawa ankle rules in a military population. Interobserver agreement between physical therapists and orthopaedic surgeons. Am J Sports Med, 28(6), 864-868. doi:10.1177/03635465000280061501
  • Springer, B. A., Gill, N. W., Freedman, B. A., Ross, A. E., Javernick, M. A., & Murphy, K. P. (2009). Acetabular labral tears: diagnostic accuracy of clinical examination by a physical therapist, orthopaedic surgeon, and orthopaedic residents. N Am J Sports Phys Ther, 4(1), 38-45.
  • Vassão, P. G., Silva, B. A., de Souza, M. C., Parisi, J. R., de Camargo, M. R., & Renno, A. C. M. (2020). Level of pain, muscle strength and posture: effects of PBM on an exercise program in women with knee osteoarthritis - a randomized controlled trial. Lasers Med Sci, 35(9), 1967-1974. doi:10.1007/s10103-020-02989-1
  • Walter, S. D., Eliasziw, M., & Donner, A. (1998). Sample size and optimal designs for reliability studies. Stat Med, 17(1), 101-110. doi:10.1002/(sici)1097-0258(19980115)17:1<101::aid-sim727>3.0.co;2-e
  • Weiss, L., DeForest, B., Hammond, K., Schilling, B., & Ferreira, L. (2013). Reliability of goniometry-based Q-angle. PM&R, 5(9), 763-768. doi:10.1016/j.pmrj. 2013.03.023
  • Wilson, T., & Kitsell, F. (2002). Is the Q-angle an absolute or a variable measure?: Measurement of the Q-angle over one minute in healthy subjects. Physiother, 88(5), 296-302. doi:10.1016/S0031-9406(05)61422-8

Reliability, validity and minimal detectable change of the quadriceps angle assessment in patients with knee osteoarthritis

Yıl 2025, Cilt: 11 Sayı: 2, 61 - 68, 30.04.2025

Musa Eymir , Nihat Demirhan Demirkıran , Bayram Ünver , Mehmet Erduran

https://doi.org/10.31459/turkjkin.1626497

Öz

Knee osteoarthritis (OA) is a multifaceted degenerative disease characterized by knee alignment alterations that impact the amplitude of the quadriceps angle (Q-angle). Q-angle is a diagnostic measure of knee alignment, and an indicator of the load distribution of patellofemoral and tibiofemoral joints. However, accurate assessment of this parameter necessitates the implementation of standardized and reliable measures to ensure methodological reproducibility. Thus, this study aimed to examine the concurrent validity, reliability, and minimal detectable change (MDC) of the Q-angle in patients with knee osteoarthritis (OA). The intra-rater and inter-rater reliabilities of each goniometric measurement were determined with the use of intraclass correlations (ICCs). The correlations between goniometric (clinical) and radiography (gold standard) measurements of Q-angle were assessed for concurrent validity. The intra-rater reliabilities of goniometric assessments in the supine and standing positions of the Q-angle were 0.90 and 0.96, respectively. The standard error of measurement (SEM) and minimal detectable change (MDC95) were 1.18 and 3.27 degrees for supine assessment and 0.87 and 2.40 degrees for standing assessment, respectively. The inter-rater reliabilities of goniometric assessments of the supine and standing position of the Q-angle were 0.86 and 0.92, respectively. SEM and MDC95 values were 1.59 and 4.39 degrees for supine assessment and 1.19 and 3.28 degrees for standing assessment, respectively. The radiographic measure showed a strong correlation with supine goniometric assessment (p<0.05, r: 0.777) and a significantly excellent correlation with standing goniometric assessment (p<0.05, r: 0.878). According to the findings of the current study, the goniometric measurement for the Q-angle is a valid and reliable method in patients with knee OA. Also, our results suggest that the goniometric measurement, as an inexpensive and radiation-free alternative, can be used to assess the Q-angle as accurately as radiography, in clinical practice.

Anahtar Kelimeler

Goniometer knee osteoarthritis minimal detectable change q-angle reliability validity

Etik Beyan

Ethics approval for this study was obtained from the Ethics Committee of Dokuz Eylül University, Türkiye (approval number: 2401-GOA). Informed consent was obtained from all participants in accordance with the Declaration of Helsinki.

Destekleyen Kurum

none

Proje Numarası

none

Teşekkür

We appreciate all the people who cooperated in this research.

Kaynakça

  • Abdullah, S. S., & Rajasekaran, M. P. (2022). Do Weight-Bearing Knee Digital Radiographs Help to Track the Severity of OA? Indian J Orthop, 56(4), 664-671. doi:10.1007/s43465-021-00560-w
  • Almeida, G. P., Silva, A. P., França, F. J., Magalhães, M. O., Burke, T. N., & Marques, A. P. (2016). Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop, 51(2), 181-186. doi:10.1016/j.rboe.2016.01.010
  • Belchior, A. C. G., Arakaki, J. C., Bevilaqua-Grossi, D., Reis, F. A., & Carvalho, P. T. C. (2006). Effects in the Q angle measurement with maximal voluntary isometric contraction of the quadriceps muscle. Rev Bras Med Esporte, 12, 6-10. doi:10.1590/S1517-86922006000100002
  • Chevidikunnan, M. F., Al Saif, A., Pai, H., & Mathias, L. (2015). Comparing goniometric and radiographic measurement of Q angle of the knee. Asian Biomed, 9(5), 631-636. doi:10.5372/1905-7415.0905.433
  • de Vet, H. C., Terwee, C. B., Ostelo, R. W., Beckerman, H., Knol, D. L., & Bouter, L. M. (2006). Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change. Health Qual Life Outcomes, 4, 54. doi:10.1186/1477-7525-4-54
  • Devan, M. R., Pescatello, L. S., Faghri, P., & Anderson, J. (2004). A prospective study of overuse knee injuries among female athletes with muscle imbalances and structural abnormalities. J Athl Train, 39(3), 263-267.
  • Draper, C. E., Chew, K. T., Wang, R., Jennings, F., Gold, G. E., & Fredericson, M. (2011). Comparison of quadriceps angle measurements using short-arm and long-arm goniometers: correlation with MRI. PM&R, 3(2), 111-116. doi:10.1016/j.pmrj.2010.10.020
  • Driban, J. B., Harkey, M. S., Barbe, M. F., Ward, R. J., MacKay, J. W., Davis, J. E., Lu, B., Price, L. L., Eaton, C. B., Lo, G. H., & McAlindon, T. E. (2020). Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review. BMC Musculoskelet Disord, 21(1), 332. doi:10.1186/s12891-020-03367-2
  • Ekim, A. A., Hamarat, H., & Musmul, A. (2017). Relationship between q-angle and articular cartilage in female patients with symptomatic knee osteoarthritis: ultrasonographic and radiologic evaluation. Arch Rheumatol, 32(4), 347-352. doi:10.5606/ArchRheumatol .2017.6145
  • Eymir, M., Unver, B., & Karatosun, V. (2024). Reliability, concurrent validity, and minimal detectable change of the hand-held dynamometry for the assessment of knee muscle strength in patients with revision total knee arthroplasty. Arch Phys Med Rehabil, 105(1), 34-39. doi:10.1016/j.apmr.2023.05.002
  • Eymir, M., Yuksel, E., Unver, B., & Karatosun, V. (2021). Hand-held dynamometry in the inpatient care setting after total knee arthroplasty: reliability of static knee strength measurements. Am J Phys Med Rehabil, 100(6), 570-575. doi:10.1097/phm.0000000000001592
  • Hunter, D. J., Sharma, L., & Skaife, T. (2009). Alignment and osteoarthritis of the knee. J Bone Joint Surg Am, 91(Supplement 1), 85-89. doi:10.2106/JBJS.H.01409
  • Kocak, F. U., Unver, B., Karatosun, V., & Bakirhan, S. (2009). Associations between radiographic changes and function, pain, range of motion, muscle strength and knee function score in patients with osteoarthritis of the knee. J Phys Ther Sci, 21(1), 93-97. doi:10.1589/jpts.21.93
  • Lee Rodgers, J., & Nicewander, W. A. (1988). Thirteen ways to look at the correlation coefficient. Am Stat, 42(1), 59-66. doi:10.1080/00031305.1988.10475524
  • Lim, B. W., Hinman, R. S., Wrigley, T. V., & Bennell, K. L. (2008). Varus malalignment and its association with impairments and functional limitations in medial knee osteoarthritis. Arthritis Rheum, 59(7), 935-942. doi:10.1002/art.23820
  • Merchant, A. C., Fraiser, R., Dragoo, J., & Fredericson, M. (2020). A reliable Q angle measurement using a standardized protocol. Knee, 27(3), 934-939. doi:10.1016/j.knee.2020.03.001
  • Örtqvist, M., Moström, E. B., Roos, E. M., Lundell, P., Janarv, P.-M., Werner, S., & Broström, E. W. (2011). Reliability and reference values of two clinical measurements of dynamic and static knee position in healthy children. Knee Surg Sports Traumatol Arthrosc, 19(12), 2060-2066. doi:10.1007/s00167-011-1542-9
  • Otsuki, S., Nakajima, M., Okamoto, Y., Oda, S., Hoshiyama, Y., Iida, G., & Neo, M. (2016). Correlation between varus knee malalignment and patellofemoral osteoarthritis. Knee Surg Sports Traumatol Arthrosc, 24(1), 176-181. doi:10.1007/s00167-014-3360-3
  • Özgül, A., Günendi, Z., Kesikburun, S., Omaç Ö, K., & Taşkaynatan, M. A. (2013). The association between patellar alignments features and tibiofemoral joint osteoarthritis. Clin Rheumatol, 32(7), 1017-1020. doi:10.1007/s10067-013-2222-6
  • Rahimi, M., Alizadeh, M., Rajabi, R., & Mehrshad, N. (2012). The Comparison of innovative image processing and goniometer methods in Q angle measurement. World Appl Sci J, 18(2), 226-232. doi:10.5829/idosi.wasj.2012.18.02.762
  • Sharma, L. (2021). Osteoarthritis of the Knee. N Engl J Med, 384(1), 51-59. doi:10.1056/NEJMcp1903768
  • Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: uses in assessing rater reliability. Psychol Bull, 86(2), 420-428. doi:10.1037//0033-2909.86.2.420
  • Shultz, S. J., Nguyen, A.-D., Windley, T. C., Kulas, A. S., Botic, T. L., & Beynnon, B. D. (2006). Intratester and intertester reliability of clinical measures of lower extremity anatomic characteristics: implications for multicenter studies. Clin J Sport Med, 16(2), 155-161. doi:10.1097/00042752-200603000-00012
  • Smith, T. O., Hunt, N. J., & Donell, S. T. (2008). The reliability and validity of the Q-angle: a systematic review. Knee Surg Sports Traumatol Arthrosc, 16(12), 1068-1079. doi:10.1007/s00167-008-0643-6
  • Springer, B. A., Arciero, R. A., Tenuta, J. J., & Taylor, D. C. (2000). A prospective study of modified Ottawa ankle rules in a military population. Interobserver agreement between physical therapists and orthopaedic surgeons. Am J Sports Med, 28(6), 864-868. doi:10.1177/03635465000280061501
  • Springer, B. A., Gill, N. W., Freedman, B. A., Ross, A. E., Javernick, M. A., & Murphy, K. P. (2009). Acetabular labral tears: diagnostic accuracy of clinical examination by a physical therapist, orthopaedic surgeon, and orthopaedic residents. N Am J Sports Phys Ther, 4(1), 38-45.
  • Vassão, P. G., Silva, B. A., de Souza, M. C., Parisi, J. R., de Camargo, M. R., & Renno, A. C. M. (2020). Level of pain, muscle strength and posture: effects of PBM on an exercise program in women with knee osteoarthritis - a randomized controlled trial. Lasers Med Sci, 35(9), 1967-1974. doi:10.1007/s10103-020-02989-1
  • Walter, S. D., Eliasziw, M., & Donner, A. (1998). Sample size and optimal designs for reliability studies. Stat Med, 17(1), 101-110. doi:10.1002/(sici)1097-0258(19980115)17:1<101::aid-sim727>3.0.co;2-e
  • Weiss, L., DeForest, B., Hammond, K., Schilling, B., & Ferreira, L. (2013). Reliability of goniometry-based Q-angle. PM&R, 5(9), 763-768. doi:10.1016/j.pmrj. 2013.03.023
  • Wilson, T., & Kitsell, F. (2002). Is the Q-angle an absolute or a variable measure?: Measurement of the Q-angle over one minute in healthy subjects. Physiother, 88(5), 296-302. doi:10.1016/S0031-9406(05)61422-8
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Rehabilitasyon
Bölüm Original Research Articles
Yazarlar

Musa Eymir 0000-0002-9671-9583

Nihat Demirhan Demirkıran 0000-0002-0724-9672

Bayram Ünver 0000-0002-9829-5884

Mehmet Erduran 0000-0002-0668-7224

Proje Numarası none
Yayımlanma Tarihi 30 Nisan 2025
Gönderilme Tarihi 24 Ocak 2025
Kabul Tarihi 12 Nisan 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 11 Sayı: 2

Kaynak Göster

APA Eymir, M., Demirkıran, N. D., Ünver, B., Erduran, M. (2025). Reliability, validity and minimal detectable change of the quadriceps angle assessment in patients with knee osteoarthritis. Turkish Journal of Kinesiology, 11(2), 61-68. https://doi.org/10.31459/turkjkin.1626497
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