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Reliability and reference values of two clinical measurements of dynamic and static knee position in healthy children

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purposes of this study were to evaluate reliability of the Single-limb mini squat test (a dynamic measure of medio-lateral knee position) and the Quadriceps-angle (Q-angle) (a static measure of medio-lateral knee position), present paediatric reference values of the Q-angle, and evaluate the association between the tests.

Methods

Two hundred and forty-six healthy children (9–16 years) were included (intra/inter-rater reliability for Q-angle (n = 37/85) and for Single-limb mini squat test (n = 33/28)). Dynamic medio-lateral knee position was assessed by the Single-limb mini squat test. Static medio-lateral knee position was evaluated by the Q-angle.

Results

The reliability of the Single-limb mini squat test was found to be moderate (kappa 0.48–0.57, 95% CI 0.16–0.85, 76–79% agreement). Fair to moderate reliability (ICC 0.35-0.42, 95% CI 0.11–0.66, SEM 1.4°–1.9°, n.s.) of the Q-angle measurements was found. Reference values for the Q-angle (mean 13.5° (1.9)–15.3° (2.8)) varies with age and gender. No associations were found between dynamic and static measures.

Conclusions

The Single-limb mini squat test showed a moderate reliability and the Q-angle showed a fair to moderate reliability. A difference found for age and gender was lower than 5° and may not be clinical significant. No association were found between the two tests, indicating dynamic and static knee position being two different concepts. In a clinical perspective, we suggest that the Single-limb mini squat test is a contribution to the available tool box for evaluation of dynamic medio-lateral knee position in children, although the Q-angle may not be used before more research has been done justifying its use.

Level of evidence

Diagnostic study, Level III.

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Acknowledgments

This study was supported by grants from Promobilia, Trygg-Hansa and Karolinska Institutet. The authors also wish to thank Elisabeth Berg for help with the statistical analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Women’s & Children’s Health, Karolinska Institutet, Stockholm, Sweden

    Maria Örtqvist, Eva B. Moström, Per-Mats Janarv & Eva W. Broström

  2. Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark

    Ewa M. Roos

  3. OS-kliniken, Sabbatsbergs närsjukhus, Stockholm, Sweden

    Pia Lundell

  4. Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Center, Karolinska Institutet, Stockholm, Sweden

    Suzanne Werner

  5. Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden

    Suzanne Werner

  6. Motoriklab Q2:07, Astrid Lindgren Children’s Hospital, 171 76, Stockholm, Sweden

    Eva W. Broström

Authors
  1. Maria Örtqvist
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  2. Eva B. Moström
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  3. Ewa M. Roos
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  4. Pia Lundell
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  5. Per-Mats Janarv
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  6. Suzanne Werner
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  7. Eva W. Broström
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Corresponding author

Correspondence to Eva W. Broström.

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Örtqvist, M., Moström, E.B., Roos, E.M. et al. Reliability and reference values of two clinical measurements of dynamic and static knee position in healthy children. Knee Surg Sports Traumatol Arthrosc 19, 2060–2066 (2011). https://doi.org/10.1007/s00167-011-1542-9

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  • DOI: https://doi.org/10.1007/s00167-011-1542-9

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