OPTOTRAK measurement of the quadriceps angle using standardized foot positions

Objective: While there is evidence to suggest that the magnitude of the quadriceps (Q) angle changes with alterations in foot position, a detailed quantitative description of this relationship has not been reported. Our purpose was to determine the effect of varying foot placement on the magnitude of the Q angle. Design and Setting: A mixed between-within, repeated-measures design was used to compare Q angles derived under static weight-bearing conditions with the feet positioned in self-selected versus standardized stance positions. Subjects: Twenty healthy young-adult men and women with no history of acute injury to or chronic dysfunction of the lower limbs. Measurements: We placed light-emitting diodes bilaterally on the left and right anterior superior iliac spines, the tibial tuberosities, and the midpoints of the patellae to bilaterally define the Q angles. An OPTOTRAK motion-measurement system was used to capture x,y coordinate data at a sampling rate of 60 Hz. These data were subsequently filtered and used to calculate the magnitude of the left and right Q angles. Results: A repeated-measures analysis of variance revealed that when measured statically, Q angles differed significantly between stance positions (P <.001) and limbs (P <.05). Depending on the stance adopted, mean Q angles varied from 7.2degrees to 12.7degrees and 11.0degrees to 16.1degrees in the left and right lower limbs, respectively. Q-angle measurements taken in conjunction with the Romberg foot position most closely resembled those gathered with the feet in a self-selected stance (Pearson r = 0.86 to 0.92). Conclusions: Q-angle magnitude varies with changes in foot position, increasing or decreasing as the foot rotates internally or externally, respectively. These data demonstrate the need for a standardized foot position for Q-angle measurements.