Livingston L A, Mandigo J L
Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.
Clin Biomech (Bristol). 1999 Jan;14(1):7-13. doi: 10.1016/s0268-0033(98)00045-x.
To determine whether quadriceps (Q) angles were bilaterally symmetric in individuals asymptomatic vs symptomatic for anterior knee pain.
Cross-sectional study.
Previous attempts to link excessive Q angles to the occurrence of knee pain have yielded equivocal results. Deriving unilateral rather than bilateral measures of the Q angle and thereafter analysing data using traditional between-group analysis-of-variance structural models may, however, play a role in obscuring the true nature of the Q angle-knee pain relationship.
Left and right Q angles were goniometrically measured in 75 subjects (37 males, 38 females) while they adopted a static, standing position with quadriceps relaxed. The majority (n = 50) were asymptomatic, while the remainder were unilaterally (n = 11) or bilaterally (n = 14) symptomatic for anterior knee pain. A questionnaire was used to determine the extent and magnitude of pain experienced in each of the symptomatic subjects.
Significant right vs left lower limb differences in Q angles were observed by group (p < 0.001) and group by gender (p < 0.05). Mean values, however, did not always reflect the true variation of data within the sample. Forty-seven percent of the subjects studied demonstrated a minimum 4 degrees bilateral Q angle difference, while in 13 of 75 subjects, this difference ranged from 8 degrees to 12 degrees. Only a weak yet significant relationship between right and left Q angles (r = 0.53, p < 0.001) was noted. While there were no correlations between Q angle measures and the magnitude of discomfort experienced in unilateral knee pain sufferers, these relationships were weak yet significant in bilateral knee pain sufferers.
Q angles are not bilaterally symmetric, with the magnitude and direction of the observed asymmetry varying according to whether an individual is asymptomatic, unilaterally symptomatic, or bilaterally symptomatic for anterior knee pain.
Future investigations of the Q angle must ensure that measures are derived bilaterally and analysed appropriately. Data from unilateral vs bilateral symptomatic subjects should be evaluated separately, and the shortcomings of standard ANOVA structural models must be recognized.
确定在无症状与有膝关节前侧疼痛症状的个体中，股四头肌（Q）角是否双侧对称。
横断面研究。
先前将过大的Q角与膝关节疼痛的发生联系起来的尝试得出了不明确的结果。然而，采用Q角的单侧而非双侧测量方法，然后使用传统的组间方差分析结构模型分析数据，可能会掩盖Q角与膝关节疼痛关系的真实本质。
对75名受试者（37名男性，38名女性）在股四头肌放松的静态站立姿势下进行双侧Q角的量角器测量。大多数（n = 50）无症状，其余受试者单侧（n = 11）或双侧（n = 14）有膝关节前侧疼痛症状。使用问卷确定每个有症状受试者所经历疼痛的程度和强度。
按组观察到右下肢与左下肢Q角存在显著差异（p < 0.001），按性别分组也存在显著差异（p < 0.05）。然而，平均值并不总是反映样本内数据的真实变化。47% 的研究对象表现出至少4度的双侧Q角差异，而在75名受试者中的13名中，这种差异在8度至12度之间。仅注意到右Q角与左Q角之间存在微弱但显著的关系（r = 0.53，p < 0.001）。虽然Q角测量值与单侧膝关节疼痛患者所经历不适的强度之间没有相关性，但这些关系在双侧膝关节疼痛患者中虽微弱但显著。
Q角并非双侧对称，观察到的不对称的程度和方向因个体是否无症状、单侧有症状或双侧有膝关节前侧疼痛症状而异。
未来对Q角的研究必须确保进行双侧测量并进行适当分析。应分别评估单侧与双侧有症状受试者的数据，并且必须认识到标准方差分析结构模型的缺点。
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