Significance of Qangle as a prognostic outcome measure for subjects with spastic diplegia

Background: Spastic diplegia is a form of cerebral palsy that is a chronic neuromuscular condition of hypertonia and spasticity manifested as an especially high and constant tightness or stiffness in the muscles of the lower extremities of the human body, usually those of the legs, hips, and pelvis. Q angle is an angle formed by two imaginary lines, first line extending from anterior superior iliac spine to center point of patella and second line extending from tibial tuberosity to center point of patella. The abnormal twisting of patella is known as tibial torsion. Objectives: To find Q angle value in male children with spastic diplegia aged between 7 and 12 years and to compare the degree of Q angle between children with internal and external tibial torsion. Methodology and Procedure: A total of thirty male children aged between 7 and 12 years were divided into two groups based on their tibial torsion, and Q angle was assessed using standard goniometer. Results: Results were statistically analyzed. There was a significant change in Q angle of children with spastic cerebral palsy, and children with spastic diplegia with internal tibial torsion have decreased Q angle and children with external tibial torsion have a significant increase in their Q angle (P = 0.001). Conclusion: This study concludes that Q angle is a good outcome variable for assessing musculoskeletal problem related to lower limb and can be used as a major tool for prognosis during rehabilitation. This study also proves that children with spastic diplegia with internal tibial torsion have decreased Q angle and children with external tibial torsion have a significant increase in their Q angle.