Klinik Araştırma
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The effects of Q angle and Hamstring Length on Balance Performance in Patients with Lumbar Disc Hernia

Yıl 2023, Cilt: 5 Sayı: 3, 518 - 22, 18.09.2023
https://doi.org/10.37990/medr.1309485

Öz

Aim: Patellafemoral angle (Q angle) and Hamstring length are important measurements to evaluate balance. This study aims to examine the effects of Q angle and Hamstring length on balance performance in patients with lumbar intervertebral disc herniation (LDH).
Material and Methods: LDH (n=32) and control group (CG)(n=30) were included in the study. Q angles and hamstring muscle lengths of the participants were measured. Balance was evaluated with Y balance test.
Results: As a result of our study, no difference was found between LDH patients and CG groups in terms of hamstring muscle length; Q angle decreased in LDH patients and there was a negative high correlation between Q angle and R -Anterior, R-Posteromedial, R-Posterolateral values on the right and between Q angle and L-Anterior, L-Posteriolmedial, L-Posterolateral values on the left.
Conclusion: It was found that Q angle measurements decreased in LDH patients, causing genu varum and leading to impairment in balance, especially in the left anterior, anteromedial and anterolateral.

Kaynakça

  • 1. Abramovitz JN, Neff SR. Lumbar disc surgery: results of the prospective lumbar discectomy study of the joint section on disorders of the spine and peripheral nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Neurosurgery. 1991;29:301-8.
  • 2. Atlas SJ, Deyo RA, Keller RB, et al. The maine lumbar spine study, part II: 1-year outcomes of surgical and nonsurgical management of sciatica. Spine (Phila Pa 1976). 1996;21:1777-86.
  • 3. Modic MT, Ross JS. Lumbar degenerative disk disease. Radiology. 2007;245:43-61.
  • 4. Waris E, Eskelin M, Hermunen H, et al. Disc degeneration in low back pain: a 17-year follow-up study using magnetic resonance imaging. Spine (Phila Pa 1976). 2007;32:681-4.
  • 5. Karvonen MJ, Viitasalo JT, Komi PV, et al. Back and leg complaints in relation to muscle strength in young men. Scand J Rehabil Med. 1980;12:53-9.
  • 6. Şenol D, Altinoğlu M, Toy Ş, et al. Investigation of the relationship of Q Angle and stork balance stand test with somatotype in healthy young individuals. Medical Records. 2019;1:60-6.
  • 7. Citaker S, Kaya D, Yuksel I, et al. Static balance in patients with patellofemoral pain syndrome. Sports Health. 2011;3:524-7.
  • 8. Lihavainen K, Sipilä S, Rantanen T, et al. Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2010;65:990-6.
  • 9. Halperin N, Copeliovitch L, Schachner E. Radiating leg pain and positive straight leg raising in spondylolysis in children. J Pediatr Orthop. 1983;3:486-90.
  • 10. Bohannon R, Gajdosik R, LeVeau BF. Contribution of pelvic and lower limb motion to increases in the angle of passive straight leg raising. Physical Therapy. 1985;65:474-6.
  • 11. Yilmaz A, Kabadayi M, Mayda M, et al. Analysis of Q angle values of female athletes from different branches. Sci Mov Heal. 2017;17:141-6.
  • 12. Baumgartner RN, Chumlea C, Roche AF. Bioelectric impedance for body composition. Exerc Sport Sci Rev. 1990;18:193-224.
  • 13. ELİÖZ M, Tülin A, Ajlan S, YAMAK B. The investigion of the relatonship between some physicial features with Q angle in athletes and sedanteries. Spor ve Performans Araştırmaları Dergisi. 2015;6:58-65.
  • 14. Akınoğlu B, Paköz B, Hasanoğlu A, Kocahan T. Investigation of the relationship between sit-and-reach flexibility and the height, the leg length and the trunk length in adolescent athletes. Balt J Health Phys Act. 2021;13:29-37.
  • 15. Hertel J, Miller SJ, Denegar CR. Intratester and intertester reliability during the star excursion balance tests. Journal of Sport Rehabilitation. 2000;9:104-16.
  • 16. Coughlan GF, Fullam K, Delahunt E, et al. A comparison between performance on selected directions of the star excursion balance test and the Y balance test. J Athl Train. 2012;47:366-71.
  • 17. Akman MN, Karataş M. Temel ve uygulanan kinezyoloji. In: Kinezyoloji. Haberal Eğitim Vakfı. 1th, Rize, 2003;123-8.
  • 18. Almeida GPL, França FJR, Magalhães MO, et al. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop. 2016;51:181-6.
  • 19. Jeon H, Lee S-U, Lim J-Y, et al. Low skeletal muscle mass and radiographic osteoarthritis in knee, hip, and lumbar spine: A cross-sectional study. Aging Clin Exp Res. 2019;31:1557-62.
  • 20. Bayraktar B, Yucesir I, Ozturk A, et al. Change of quadriceps angle values with age and activity. Saudi Med J. 2004;25:756-60.
  • 21. Schulthies SS, Francis RS, Fisher AG, Van De Graaff KM. Does the Q angle reflect the force on the patella in the frontal plane? Phys Ther. 1995;75:24-30.
  • 22. Karabulut M. Evaluation of the Relationship among radiological grading with q angle, femoral cartilage thickness and clinical parameters in patients with the knee osteoarthritis. Master thesis, Bursa Uludag University Bursa, 2018.
  • 23. Oken O, Koybasi M, Tuncbilek I, Ayhan F, Yorgancioglu RZ. The association of presacral nodules with biomechanics of the lumbar region and lumbar discopaties in patients with low back pain. Turk J Phys Med Rehab. 2010:56:18-21.
  • 24. Norris CM. Back stability: Human Kinetics Publishers. In: Scope of the Problem. 2nd edition. CRC Press, United Kingdom, 2000;317-22.
  • 25. Kroll PG, Raya MA. Hamstring muscles: an overview of anatomy, biomechanics and function, injury etiology, treatment, and prevention. Critical Reviews in Physical and Rehabilitation Medicine. 1997;9:191-203.
  • 26. Shin G, Shu Y, Li Z, Jiang Z, Mirka G. Influence of knee angle and individual flexibility on the flexion–relaxation response of the low back musculature. J Electromyogr Kinesiol. 2004;14:485-94.
  • 27. Muyor JM, López-Miñarro PA, Casimiro AJ. Effect of stretching program in an industrial workplace on hamstring flexibility and sagittal spinal posture of adult women workers: a randomized controlled trial. JJ Back Musculoskelet Rehabil. 2012;25:161-9.
  • 28. Carregaro RL, Coury HJCG. Does reduced hamstring flexibility affect trunk and pelvic movement strategies during manual handling? International Journal of Industrial Ergonomics. 2009;39:115-20.

Lomber Disk Hernili Hastalarda Q açısı ve Hamstring Uzunluğunun Denge Performansına Etkisi

Yıl 2023, Cilt: 5 Sayı: 3, 518 - 22, 18.09.2023
https://doi.org/10.37990/medr.1309485

Öz

Abstract
Amaç: Patellafemoral angle (Q açısı) ve Hamstring uzunluğu dengenin değerlendirilmesinde önemli ölçümlerdir. Çalışmada Lomber intervertebral disk herniasyonu (LDH) hastalarında Q açısı ve Hamstring uzunluğunun denge performansı üzerine etkisinin incelenmesi amaçlanmıştır.
Materyal ve Metod: Çalışmaya LDH (n=32) ve Kontrol grubu (KG)(n=30) dahil edildi. Katılımcıların Q açılarına ve hamstring kas uzunluğuna bakıldı. Denge durumu Y balans denge testi ile değerlendirildi.
Results: Çalışmamızın sonucunda LDH hastaları ve KG grupları arasında hamstring kas uzunluğu arasında fark olmadığını; LDH hastalarında Q açısının düştüğünü ve Q açısı ile sağda R-Anterior, R-Posteriomedial, R-Posteriolateral değerleriyle; solda ise, ; L-Anterior, L-Posteriolmedial, L-Posteriolateral değerleri arasında yüksek düzeyde negatif ilişki olduğunu bulduk.
Sonuç: LDH hastalarının Q açısı ölçümlerinin azaldığını, bu durumun genu varuma sebep olduğunu ve bunun sonucunda ise özellikle sol anterior, anteriomedial ve anteriolateralde dengenin bozulduğunu tespit ettik

Kaynakça

  • 1. Abramovitz JN, Neff SR. Lumbar disc surgery: results of the prospective lumbar discectomy study of the joint section on disorders of the spine and peripheral nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Neurosurgery. 1991;29:301-8.
  • 2. Atlas SJ, Deyo RA, Keller RB, et al. The maine lumbar spine study, part II: 1-year outcomes of surgical and nonsurgical management of sciatica. Spine (Phila Pa 1976). 1996;21:1777-86.
  • 3. Modic MT, Ross JS. Lumbar degenerative disk disease. Radiology. 2007;245:43-61.
  • 4. Waris E, Eskelin M, Hermunen H, et al. Disc degeneration in low back pain: a 17-year follow-up study using magnetic resonance imaging. Spine (Phila Pa 1976). 2007;32:681-4.
  • 5. Karvonen MJ, Viitasalo JT, Komi PV, et al. Back and leg complaints in relation to muscle strength in young men. Scand J Rehabil Med. 1980;12:53-9.
  • 6. Şenol D, Altinoğlu M, Toy Ş, et al. Investigation of the relationship of Q Angle and stork balance stand test with somatotype in healthy young individuals. Medical Records. 2019;1:60-6.
  • 7. Citaker S, Kaya D, Yuksel I, et al. Static balance in patients with patellofemoral pain syndrome. Sports Health. 2011;3:524-7.
  • 8. Lihavainen K, Sipilä S, Rantanen T, et al. Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2010;65:990-6.
  • 9. Halperin N, Copeliovitch L, Schachner E. Radiating leg pain and positive straight leg raising in spondylolysis in children. J Pediatr Orthop. 1983;3:486-90.
  • 10. Bohannon R, Gajdosik R, LeVeau BF. Contribution of pelvic and lower limb motion to increases in the angle of passive straight leg raising. Physical Therapy. 1985;65:474-6.
  • 11. Yilmaz A, Kabadayi M, Mayda M, et al. Analysis of Q angle values of female athletes from different branches. Sci Mov Heal. 2017;17:141-6.
  • 12. Baumgartner RN, Chumlea C, Roche AF. Bioelectric impedance for body composition. Exerc Sport Sci Rev. 1990;18:193-224.
  • 13. ELİÖZ M, Tülin A, Ajlan S, YAMAK B. The investigion of the relatonship between some physicial features with Q angle in athletes and sedanteries. Spor ve Performans Araştırmaları Dergisi. 2015;6:58-65.
  • 14. Akınoğlu B, Paköz B, Hasanoğlu A, Kocahan T. Investigation of the relationship between sit-and-reach flexibility and the height, the leg length and the trunk length in adolescent athletes. Balt J Health Phys Act. 2021;13:29-37.
  • 15. Hertel J, Miller SJ, Denegar CR. Intratester and intertester reliability during the star excursion balance tests. Journal of Sport Rehabilitation. 2000;9:104-16.
  • 16. Coughlan GF, Fullam K, Delahunt E, et al. A comparison between performance on selected directions of the star excursion balance test and the Y balance test. J Athl Train. 2012;47:366-71.
  • 17. Akman MN, Karataş M. Temel ve uygulanan kinezyoloji. In: Kinezyoloji. Haberal Eğitim Vakfı. 1th, Rize, 2003;123-8.
  • 18. Almeida GPL, França FJR, Magalhães MO, et al. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop. 2016;51:181-6.
  • 19. Jeon H, Lee S-U, Lim J-Y, et al. Low skeletal muscle mass and radiographic osteoarthritis in knee, hip, and lumbar spine: A cross-sectional study. Aging Clin Exp Res. 2019;31:1557-62.
  • 20. Bayraktar B, Yucesir I, Ozturk A, et al. Change of quadriceps angle values with age and activity. Saudi Med J. 2004;25:756-60.
  • 21. Schulthies SS, Francis RS, Fisher AG, Van De Graaff KM. Does the Q angle reflect the force on the patella in the frontal plane? Phys Ther. 1995;75:24-30.
  • 22. Karabulut M. Evaluation of the Relationship among radiological grading with q angle, femoral cartilage thickness and clinical parameters in patients with the knee osteoarthritis. Master thesis, Bursa Uludag University Bursa, 2018.
  • 23. Oken O, Koybasi M, Tuncbilek I, Ayhan F, Yorgancioglu RZ. The association of presacral nodules with biomechanics of the lumbar region and lumbar discopaties in patients with low back pain. Turk J Phys Med Rehab. 2010:56:18-21.
  • 24. Norris CM. Back stability: Human Kinetics Publishers. In: Scope of the Problem. 2nd edition. CRC Press, United Kingdom, 2000;317-22.
  • 25. Kroll PG, Raya MA. Hamstring muscles: an overview of anatomy, biomechanics and function, injury etiology, treatment, and prevention. Critical Reviews in Physical and Rehabilitation Medicine. 1997;9:191-203.
  • 26. Shin G, Shu Y, Li Z, Jiang Z, Mirka G. Influence of knee angle and individual flexibility on the flexion–relaxation response of the low back musculature. J Electromyogr Kinesiol. 2004;14:485-94.
  • 27. Muyor JM, López-Miñarro PA, Casimiro AJ. Effect of stretching program in an industrial workplace on hamstring flexibility and sagittal spinal posture of adult women workers: a randomized controlled trial. JJ Back Musculoskelet Rehabil. 2012;25:161-9.
  • 28. Carregaro RL, Coury HJCG. Does reduced hamstring flexibility affect trunk and pelvic movement strategies during manual handling? International Journal of Industrial Ergonomics. 2009;39:115-20.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Özgün Makaleler
Yazarlar

Rukiye Çiftçi 0000-0002-5894-5256

Erken Görünüm Tarihi 12 Temmuz 2023
Yayımlanma Tarihi 18 Eylül 2023
Kabul Tarihi 30 Haziran 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 5 Sayı: 3

Kaynak Göster

AMA Çiftçi R. The effects of Q angle and Hamstring Length on Balance Performance in Patients with Lumbar Disc Hernia. Med Records. Eylül 2023;5(3):518-22. doi:10.37990/medr.1309485

 Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey

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