Dynamic Q Angle and Core Endurance in Adolescent Athletes With Patellofemoral Pain Syndrome (PFPS-QCORE)
Dynamic Q Angle And Core Endurance In Adolescent Athletes With Patellofemoral Pain Syndrome: A Sex-Based Comparative Study
Study Overview
Status
Intervention / Treatment
Detailed Description
Patellofemoral pain syndrome is a common musculoskeletal condition in adolescent athletes and may be associated with altered frontal-plane knee alignment, reduced proximal trunk control, and lower-extremity flexibility impairments. Sprint athletes are exposed to repetitive high-load and high-velocity movement patterns that require coordinated control of the trunk, pelvis, and lower extremities. However, sex-related differences in the biomechanical profile of adolescent sprinters with PFPS remain insufficiently understood.
This study was designed as an observational, cross-sectional, sex-based comparative investigation involving elite adolescent sprinters aged 15 to 17 years. A total of 150 athletes were enrolled. Three participants had incomplete assessment data and were excluded from the final analysis, resulting in 147 participants with complete data. Participants were classified into four groups according to sex and PFPS status: female sprinters without pain, female sprinters with PFPS, male sprinters without pain, and male sprinters with PFPS.
PFPS status was determined through clinical assessment by a sports medicine physician. The diagnostic assessment included anterior knee pain symptoms, clinical patellofemoral tests, the Anterior Knee Pain Scale, and the Visual Analog Scale. Control participants had no current anterior knee pain or clinical findings consistent with PFPS.
Dynamic Q-angle was assessed during a standardized step-down task using a two-dimensional mobile goniometric application. Anatomical markers were placed over the anterior superior iliac spine, patellar center, and tibial tuberosity. Two repetitions were recorded, and the mean value was used for analysis.
Trunk/core endurance was assessed using the McGill trunk flexion, trunk extension, and lateral endurance tests. Lower-extremity flexibility was evaluated using the Straight Leg Raise test for hamstring flexibility, the Modified Thomas test for hip-flexor flexibility, and the Ober test for iliotibial band and tensor fascia latae tightness. Body composition and relevant demographic and training characteristics were also recorded.
The primary objective was to compare dynamic Q-angle between participants according to sex and PFPS status. Secondary objectives were to compare trunk endurance and lower-extremity flexibility outcomes and to identify independent factors associated with dynamic Q-angle. All measurements were obtained during a single assessment period, and no therapeutic, exercise, pharmacological, or experimental intervention was administered.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Adana, Turkey (Türkiye)
- Burcin Ugur Tosun
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
Female or male adolescent elite sprinters aged 15-17 years Minimum of two years of regular athletic training Participation in athletic training at least four days per week Possession of a valid track and field license Active participation in sprint events at the national or international level Ability to complete all clinical and biomechanical assessments Written informed consent from the participant and a parent or legal guardian
PFPS Group-Specific Criteria:
Diagnosis of patellofemoral pain syndrome by a sports medicine physician Anterior knee pain localized to the patellofemoral region Positive patellar compression and grind test Anterior Knee Pain Scale score below 80 Visual Analog Scale pain score of at least 3
Control Group-Specific Criteria:
No current anterior knee pain No clinical findings consistent with patellofemoral pain syndrome
Exclusion Criteria:
History of lower-extremity surgery Acute lower-extremity injury within the previous six months Notable musculoskeletal deformity Arthritis or chronic pain affecting the knee, hip, or ankle Neurological or systemic disease that could affect movement or physical performance Inability to complete the assessments because of excessive pain or insufficient cooperation Incomplete assessment data
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
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Female Sprinters Without PFPS
Elite adolescent female sprinters aged 15-17 years without current anterior knee pain or clinical findings consistent with patellofemoral pain syndrome.
Participants underwent a single standardized assessment of dynamic Q-angle, trunk/core endurance, and lower-extremity flexibility.
No therapeutic or experimental intervention was administered.
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Female Sprinters With PFPS
Elite adolescent female sprinters aged 15-17 years diagnosed with patellofemoral pain syndrome by a sports medicine physician.
Participants underwent a single standardized assessment of dynamic Q-angle, trunk/core endurance, and lower-extremity flexibility.
No therapeutic or experimental intervention was administered.
|
Participants were classified as having patellofemoral pain syndrome (PFPS) or not having PFPS based on a clinical assessment performed by a sports medicine physician.
PFPS classification was based on anterior knee pain symptoms, positive patellofemoral clinical tests, an Anterior Knee Pain Scale score below 80, and a Visual Analog Scale pain score of at least 3. Biological sex was used as an additional grouping factor.
No therapeutic, exercise, pharmacological, or experimental intervention was administered.
Other Names:
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Male Sprinters Without PFPS
Elite adolescent male sprinters aged 15-17 years without current anterior knee pain or clinical findings consistent with patellofemoral pain syndrome.
Participants underwent a single standardized assessment of dynamic Q-angle, trunk/core endurance, and lower-extremity flexibility.
No therapeutic or experimental intervention was administered.
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Male Sprinters With PFPS
Elite adolescent male sprinters aged 15-17 years diagnosed with patellofemoral pain syndrome by a sports medicine physician.
Participants underwent a single standardized assessment of dynamic Q-angle, trunk/core endurance, and lower-extremity flexibility.
No therapeutic or experimental intervention was administered.
|
Participants were classified as having patellofemoral pain syndrome (PFPS) or not having PFPS based on a clinical assessment performed by a sports medicine physician.
PFPS classification was based on anterior knee pain symptoms, positive patellofemoral clinical tests, an Anterior Knee Pain Scale score below 80, and a Visual Analog Scale pain score of at least 3. Biological sex was used as an additional grouping factor.
No therapeutic, exercise, pharmacological, or experimental intervention was administered.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Dynamic Q-Angle During the Step-Down Test (degrees)
Time Frame: Baseline (single assessment at study enrollment)
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Dynamic Q-angle was assessed during a standardized step-down task from a 16-cm platform using the DrGoniometer mobile application.
Anatomical markers were placed over the anterior superior iliac spine, center of the patella, and tibial tuberosity.
Two repetitions were recorded in the frontal plane, and the mean angle was used for analysis.
In participants with PFPS, the symptomatic extremity was assessed; in participants without PFPS, the corresponding matched extremity was used.
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Baseline (single assessment at study enrollment)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Trunk/Core Endurance Test Duration (seconds)
Time Frame: Baseline (single assessment at study enrollment)
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Trunk/core endurance was assessed using the McGill trunk flexion, trunk extension, and lateral plank endurance tests.
The duration for which each standardized test position was maintained was recorded in seconds.
Flexion, extension, and lateral endurance outcomes were analyzed separately; no composite score was calculated.
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Baseline (single assessment at study enrollment)
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Hamstring Flexibility - Straight Leg Raise Angle (degrees)
Time Frame: Baseline (single assessment at study enrollment)
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Hamstring flexibility was assessed using the Straight Leg Raise test.
The assessed lower extremity was passively raised while the knee was maintained in extension, and the maximum hip flexion angle was recorded in degrees.
Three measurements were performed, and the mean value was used for analysis.
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Baseline (single assessment at study enrollment)
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Hip Flexor Flexibility - Modified Thomas Test Angle (degrees)
Time Frame: Baseline (single assessment at study enrollment)
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Hip flexor flexibility was assessed using the Modified Thomas test.
The non-assessed lower extremity was maintained in hip flexion while the hip angle of the assessed extremity was measured in degrees.
Three measurements were performed, and the mean value was used for analysis.
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Baseline (single assessment at study enrollment)
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Iliotibial Band and Tensor Fasciae Latae Flexibility - Ober Test Angle (degrees)
Time Frame: Baseline (single assessment at study enrollment)
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Iliotibial band and tensor fasciae latae flexibility was assessed using the Ober test.
The assessed lower extremity was positioned in hip extension and abduction and then allowed to move into adduction.
The resulting thigh-drop angle was recorded in degrees.
Three measurements were performed, and the mean value was used for analysis.
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Baseline (single assessment at study enrollment)
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Collaborators and Investigators
Sponsor
Investigators
- Study Chair: burcin ugur tosun, Ministry of Youth and Sports, Olympic Preparation Center, Adana, Türkiye
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PFAS-QCORE-2025
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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