Merve YILMAZ MENEK, Miray BUDAK, Şule HANTAL

Kadınlarda Dinamik Denge Üzerinde Kuadriseps Kas Aktivasyonu ile Q Açısı Arasındaki İlişki

Giriş: Alt ekstremite biyomekaniği, Q açısı, kuadriseps kas aktivasyonu ve denge arasındaki ilişkiyi etkiler. Amaçː Kadınlarda dinamik dengede Q açısı ile kuadriseps kas aktivasyonu arasındaki ilişkiyi incelemek amaçlandı. Gereç ve Yöntemː Çalışmaya 40 kadın dahil edildi. Tek ayak üstünde dinamik denge sırasında kuadriseps kas aktivasyonu kaydedildi. Q açısı bir mezura ile; kas aktivasyonu yüzeyel Elektromiyografi ile; statik denge Flamingo Denge Testi ile; dinamik denge TechnoBody PK 200WL bilgisayarlı denge cihazıyla ve fonksiyonellik Kısa Form Kas-iskelet Değerlendirmesi ile ölçüldü. Bulgularː Ayakta ve sırtüstü pozisyonda Q açısı ve vastus medialis kas aktivasyonu arasında istatistiksel olarak anlamlı, pozitif korelasyon vardı (sırasıyla; r=0.35, p=0,02; r=0.40, p=0.01). Ayakta/sırtüstü pozisyonda Q açısı ile çevre uzunluğu arasında istatistiksel olarak anlamlı pozitif korelasyon vardı (sırasıyla; r=0.33, p=0.04; r=0.32, p=0.04). Alan boşluk yüzdesi ve ayakta Q açısı (r=0.89, p=0.02), sırtüstü pozisyon Q açısı değerleri (r=0.63, p=0.03) pozitif korelasyon gösterdi. Sonuçː Vastus medialis daha kuvvetlenirse Q açısı daha normalleşir, böylece kuadriseps kası güçlendirme egzersizleri Q açısının normalleşmesine yardımcı olur. Ayrıca Q açısı normalleştirildiğinde tek ayak üstünde durma dengesi oluşacaktır.

Anahtar Kelimeler:

Q açısı, Kuadriseps kas aktivasyonu, Elektromiyografi, Denge, Q angle, Quadriceps muscle activation, Electromyography, Balance

The Relationship Between Quadriceps Muscle Activation and Q Angle on Dynamic Balance in Women

Introduction: Lower extremity biomechanics affects the relationship between Q angle, quadriceps muscle activation and the balance. Objectiveː The aim was to examine the relationship between Q angle and quadriceps muscle activation on dynamic balance position in women. Materials and Methodsː Forty women were included in the study. The muscle activation of the quadriceps during dynamic balance in a single leg stance was recorded. A tape measure was used to measure Q angle, surface electromyography was used to assess muscle activation, the Flamingo Balance Test was used to assess static balance, the TechnoBody PK 200WL computerized balance device was used to assess dynamic balance, and the Short Form Musculoskeletal Assessment was used to assess functionality. Resultsː There was a statistically significant positive correlation between the Q angle standing and supine position and vastus medialis muscle activation respectively, (r=0.35, p=0,02; r=0.40, p=0.01). There was a statistically significant positive correlation between the perimeter length and Q angle in standing/supine position respectively, (r=0.33, p=0.04; r=0.32, p=0.04). Area gap percentage and Q angle standing (r=0.89, p=0.02), supine position Q angle values (r=0.63, p=0.03) were positively correlated. Conclusionː If vastus medialis is more strengthened, Q angle would be more normalized, so quadriceps muscle strengthening exercises are helpful for the normalization of the Q angle. Also, when the Q angle is normalized, a single leg balance would be revealed.

Keywords:

Q angle, Quadriceps muscle activation, Electromyography, Balance,

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1. Umunnah, J.O, Ogbueche, C.M, Uchenwoke, C.I, Okemuo, A.J, Association of tibiofemoral angle, quadriceps angle and body mass index in a selected adolescent population, African Health Sciences, 2020, 20(2), 891-896.
2. Austin, W.M, Women in Sports, Q Angle and ACL Injuries, Dynamic Chiropractic, 2003, 21(21).
3. Nyugen, A.D, Boling, M.C, Levine, B, Shultz, S.J, Relationships between lower extremity alignment and the quadriceps angle, Clinical Journal Sport Medicine, 2009, 19(3), 201-206.
4. Sanchez, H.M, De Morais, S.E.G, Baraúna, M.A, Canto, R.S.T, Evaluation of Q angle in differents static postures, Acta Ortopedica Brasilia, 2014, 22(6), 325-329.
5. Lathinghouse, L.H, Trimble, M.H, Effects of isometric quadriceps activation on the Q-angle in women before and after quadriceps exercise, Journal of Orthopaedic & Sports Physical Therapy, 2000, 30(4), 211-216.
6. Cote, K.P, Brunet, M.E, Gansneder, B.M, Shultz, S.J, Effects of pronated and supinated foot postures on static and dynamic postural stability, Journal of Athletic Traininig, 2005, 40(1), 41-46.
7. Thacker, S.B, Stroup, D.F, Branche, C.M, Gilchrist, J, Goodman, R.A. Prevention of knee injuries in sports. A systematic review of the literatüre, Journal of Sports Medicine Physical Fitness, 2000, 43, 165-179
8. Nyland, J, Smith, S, Beickman, K, Armsey, T, Caborn, D.N, Frontal plane knee angle affects dynamic postural control strategy during unilateral stance, Medicine Science Sports Exercice, 2002, 34(7), 1150-1157.
9. Nguyen, U.S, Felson, D.T, Niu, J, White, D.K, Segal, N.A, Lewis, C.E, The impact of knee instability with and without buckling on balance confidence, fear of falling and physical function: the Multicenter Osteoarthritis Study, Osteoarthritis Cartilage, 2014, 22(4), 527-534.
10. Siqueira, C.M, Moya, L, Bueno, G, Caffaro, R.R, Fu, C, Kohn, A.F, et al, Misalignment of the knees: Does it affect human stance stability, Journal of Bodywork and Movement Therapies, 2011, 15(2), 235-241.
11. Faul, F, Erdfelder, E, Lang, A.G, Buchner, A, G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences, Behavior Research Methods, 2007, 39(2), 175-191.
12. Greene, C.C, Edwards, T.B, Wade, M.R, Carson, E.W, Reliability of the Quadriceps angle measurement, American Journal of Knee Surgery, 2001, 14, 97–103.
13. SENIAM, Project-sensor placement, 2018, Available at http://www. seniam.org.
14. Hazar, F, Tasmektepligil, Y, The effects of balance and flexibility on agility in prepuberte period, Spormetre, Journal of Physical Education and Sports Science, 2008, 6(1), 9-12.
15. Fousekis, K, Tsepis, E, Vagenas, G, Intrınsic risk factor of noncontact ankle sprains in soccer, Ameerican Journal of Sport Medicine, 2012, 40(8), 1842-1850.
16. Swiontkowski, M.F, Engelberg, R, Martin, D.P, Agel, J, Short musculoskeletal function assessment questionnaire: validity, reliability, and responsiveness, Journal of Bone Joint Surgery American, 1999, 81, 1245–1260
17. Hryvniak, D, Magrum, E, Wilder, R, Patellofemoral Pain Syndrome: An Update, Current Physical Medicine Rehabilitation Reports, 2014, 2, 16–24.
18. Powers, C.M, The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective, Journal of Orthopedic Sports Physical Therapy, 2003, 33, 639–646.
19. Masouros, S.D, Bull, A.M.J, Amis, A.A, Biomechanics of the knee joint, Orthopedic Trauma, 2010, 24, 84–91.
20. Lotfi, H, Moghadam, A.M, Shati, M, Comparing Electromyographic Activity of Quadriceps Muscle During Straight Leg Raise in Individuals With and Without Patellofemoral Pain Syndrome, Physical Therapy Journal, 2018, 7(4), 197-204.
21. Hwangbo, P.N, The effects of squatting with visual feedback on the muscle activation of the vastus medialis oblique and the vastus lateralis in young adults with an increased quadriceps angle, Journal of Physical Therapy Science, 2018, 27, 1507-1510.
22. Sac, A, Tasmektepligil, M.Y, Correlation between the Q angle and the isokinetic knee strength and muscle activity, Turkish Journal of Physical Medicine Rehabilitation, 2018, 64(4), 308–313.
23. Pollard, C.D, Sigward, S.M, Powers, C.M, Limited hip and knee flexion during landing is associated with increased frontal plane knee motion and moments, Clinical Biomechanics, 2010, 25, 142–146.
24. Landry, S.C, McKean, K.A, Hubley-Kozey, C.L, Stanish, W.D, Deluzio, K.J, Neuromuscular and lower limb biomechanical differences exist between male and female elite adolescent soccer players during an unanticipated side-cut maneuver, American Journal of Sports Medicine, 2007, 35(11), 1888–1900.
25. Han, S.W, Yoon, J.R, Effect of rehabilitation exercise and backward walking and neuromuscular electrical stimulation on the quadriceps muscle function in patients with patellofemoral pain syndrome, Exercise Science, 2008, 7, 463-472.
26. Al Amer, H.S, Sabbahi, M.A, Alrowayeh, H.N, Bryan, W.L, Olson, S.L, Electromyographic activity of quadriceps muscle during sit-to-stand in patients with unilateral knee osteoarthritis, BMC Research Notes, 2018, 11, 356.
27. Kim, J.H, Effects of EMG-Biofeedback Using Closed Kinetic Chain Exercise on Q-angle and Quadriceps Muscle Activation in Patellofemoral Pain Syndrome, Journal of Korean Physical Therapy, 2016, 28(2), 65-70.
28. Byl, T, Cole, A, Livingston, L.A, What determines the magnitude of the Q angle? A preliminary study of select skeletal and muscular measures, Sport Rehabilitation, 2019, 9(1), 26-34.
29. Samaei, A, Bakhtiary, A.H, Elham, F, Rezasoltani, A, Effects of genu varum deformity on postural stability, International Journal of Sports Medicine, 2012, 33(6), 469-473.
30. Hassan, B, Mockett, S, Doherty, M, Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects, Annals of the Rheumatic Diseases, 2019, 60(6), 612.