Q Angle in Static and Dynamic Postures

November 23, 2025 updated by: Gokce Leblebici, Istanbul University - Cerrahpasa

Investigation of the Changing of Quadriceps Angle in Static and Dynamic Postures in Healthy Adults and Its Relation With Physical Parameters

The Q angle, also known as the quadriceps angle, is defined as the angle formed between the quadriceps muscles and the patella tendon. It was first described by Brattstrom in 1964 (1). The Q angle is the angle between the line extending from the anterior superior of the spina iliaca to the midpoint of the patella and the line extending from the midpoint of the patella to the tuberositas tibia (2). Normally, this angle is between 8-14 degrees in men and 11-20 degrees in women. Any alignment change that increases the Q angle is thought to increase the lateral force on the patella.

The Q angle is generally evaluated in static postures in the literature. The Q angle value varies according to the patient's gender, the contractility of the quadriceps, and the patient's posture (standing or supine) (3).

Q angle was evaluated in a static posture with a standard goniometer or computerized biophotogrammetry (4) Q angle changes with the forces applied by dynamic structures. It is insufficient to evaluate only in a static posture. Therefore, the aim of this study is to examine the effect of dynamic structures on the Q angle using 2D gait analysis (video) and to detect the early signs of deviation of changes in the q angle.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The Q angle is a very important tool in evaluating the function of the knee joint and describing the biomechanical alignment and function of the lower extremity (5). Abnormal values may cause joint problems later on, and in some cases, may affect the quadriceps reflex time, causing subluxation of the patella or an increased risk of developing anterior cruciate ligament ACL injury (5). For this reason, the Q angle is routinely and regularly used as an evaluation parameter when diagnosing many knee-related problems, including anterior knee pain, osteoarthritis, and degenerative knee disorders. When evaluated correctly, it provides very useful information about the alignment of the pelvis, legs and feet (6-8).

Therefore, determining the Q angle is very important, especially for athletic and physically active patients (9). In most studies, the Q angle was measured using a goniometer or with a modified goniometer (10-12). Biedert et al. by radiography (3). Braz et al. determined the Q angle with digital photogrammetry (13). In the literature, the q angle was generally evaluated in the supine or standing position (14). Higher Q angle values have been reported when transitioning from the supine position to the standing position (15). The increased Q angle while standing has been attributed to changes in lower extremity alignment due to weight bearing. In studies in the literature, the q angle was generally evaluated in static postures. In an ideal postural alignment, there should be a dynamic balance between muscles, joints and skeletal structures (16-17). Not only static structures but also dynamic structures are responsible for problems related to the alignment of the patella. For this reason, it is important to know the changes in the q angle not only in static postures but also in dynamic postures. Evaluation in correct postures is essential for diagnosis, planning and follow-up of the development and results of physical therapy (16).

The primary aim of this study was to report the prevalence and normative reference values of the q angle in the midstance phase of gait using 2D analysis (video).

The secondary aim of this study is to examine the variation of q angles during the midstance phase gait with Q angle values in static postures.

The tertiary aim of this study is to examine the relationship of q angles with different parameters such as age, gender, BMI, lower extremity strength, and hypermobility.

Demographic information (age, weight, height, etc.) will be obtained from healthy volunteers included in the study. As primary outcome measures, q-angles will be measured in static posture (supine and standing) and dynamic posture (with video analysis). Markers will be placed on the relevant places (SIAS, Patella middle and tuberositas tibia). Afterward, the video recordings will be played in slow motion and the evaluators will pause the video during the mid-stance phases of the gait, and the q-angles will be determined with the two-dimensional video analysis software (Kinoveav.0.8.15).

As secondary outcome measures, pelvis width and thigh length with a tape measure and femoral anteversion goniometer with quadriceps muscle strength, hamstring muscle strength, Hip abduction, adduction, internal and external rotation and extension muscle strength with hand-held dynamometer, joint mobility with Beighton score, foot posture index and functionality will be evaluated by walking 8 meters.

Study Type

Observational

Enrollment (Actual)

130

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Hatay, Turkey (Türkiye)
        • Hatay Mustafa Kemal University
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye)
        • Istanbul University-Cerrahpasa

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Probability Sample

Study Population

Volunteers aged 18-25 years, healthy individuals without any spinal or neurologic injury and any injury leading to ligament, muscle or bone defect in their lower extremities.

Description

Inclusion Criteria:

  • being between the ages of 18-25
  • being volunteer
  • not have any condition that may affect cooperation

Exclusion Criteria:

  • Individuals with any injury to their lower extremities that cause ligament, muscle or bone defect and any spinal or neurological injury
  • individuals diagnosed with any knee disorder such as fracture, acute or chronic knee pain, patella dislocation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
healthy participants
Volunteers aged 18-25 years, healthy individuals without any spinal or neurologic injury and any injury leading to ligament, muscle or bone defect in their lower extremities
Other: Evaluation of q angles different positions
Q angle evaluation in two different static postures (upright and supine position) and dynamic posture during the midstance phase of the gait
Other: Physical examination

With goniometric evaluations, the femoral anteversion angle will be measured. Pelvis width and thigh length will be measured with a tape measure. Quadriceps muscle strength, hamstring muscle strength, Hip abduction, adduction, internal and external rotation and extension muscle strength will be measured with hand-held dynamometer.

Joint mobility will be assessed with the Beighton score and foot posture will be evaluated with the foot posture index-6 (FPI-6).

Other: Functional mobility assessment
10-meter walking test will be conducted to understand functional mobility.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Q angle
Time Frame: baseline
Q angle measurement in three different position; in supine, standing and midstance phase during gait. The static and dynamic positions of the participants will be recorded as a photo and frame from video recording, then the measurements will be conducted with 2-dimensions movement analysis software. The unit of measurement will be recorded in angle degree.
baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pelvic width
Time Frame: baseline
Pelvic width will be measured with a tape and the unit of measurement will be recorded in centimeters.
baseline
Thigh length
Time Frame: baseline
It will be measured with a tape and the unit of measurement will be recorded in centimeters.
baseline
Femoral anteversion angle
Time Frame: baseline
The femoral anteversion angle will be measured with goniometer. The normal angle is +10 degrees, with a range of -3 to +20 degrees. The unit of measurement will be recorded in angle degree.
baseline
Lower extremity muscle strength
Time Frame: baseline
Quadriceps muscle strength, hamstring muscle strength, Hip abduction, adduction, internal and external rotation and extension muscle strength will be measured with hand-held dynamometer. The unit of measurement will be recorded in libre.
baseline
Beighton score
Time Frame: baseline
Joint mobility will be assessed with the Beighton score. Simple actions like bending your pinky (little) finger backward to evaluate the joint angle are involved. A nine-point scoring system is used for the Beighton score. The joints are more flexible the higher your score.
baseline
Foot posture index-6
Time Frame: baseline

Foot posture will be evaluated with the foot posture index-6 (FPI-6). The FPI-6 is a rapid, accurate diagnostic tool that rates foot posture using predetermined criteria and an easy scale. It is used to determine how pronated, neutral, or supinated a foot is. Pronated postures are given a positive value, the higher the value the more pronated.

Supinated features are given a negative value, the more negative the value the more supinated.

For a neutral foot the final FPI aggregate score should lie somewhere around zero.
baseline
10-meter walking test
Time Frame: baseline
10-meter walking test will be conducted to understand functional mobility. The 10 Metre Walk Test is a performance indicator used to evaluate walking speed over a brief distance in meters per second. To assess functional mobility, gait, and vestibular function, it can be used. The cut-off values like that; Household Ambulator <0.40 m/s; Limited Community Ambulator 0.40 to <0.80 m/s; Community Ambulator ≥0.80 m/s. the unit of measurement will be recorded in second.
baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul University - Cerrahpasa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2022

Primary Completion (Actual)

June 1, 2023

Study Completion (Actual)

July 15, 2023

Study Registration Dates

First Submitted

May 31, 2023

First Submitted That Met QC Criteria

May 31, 2023

First Posted (Actual)

June 8, 2023

Study Record Updates

Last Update Posted (Actual)

November 28, 2025

Last Update Submitted That Met QC Criteria

November 23, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IstanbulUC_dynamicqangle

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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