Elite Athletes: Trunk Mobility, Lower Extremity Flexibility, and Functional Balance Across Sports

NCT07326046 | Completed

• 1 other identifier: TEF-BALANCE
• Study Type: observational
• Target: 75
• Locations: 1 country
• Sites: 1

Brief Summary

This cross-sectional observational study investigated the relationships among dynamic Q angle, core muscle endurance, hip flexibility, and lower extremity functional status in elite adolescent athletes with and without patellofemoral pain syndrome (PFPS). A total of 75 track-and-field athletes aged 15-18 years were included, 42 with PFPS and 33 healthy controls. Dynamic Q angle was assessed using a digital goniometric analysis of the step-down test, core endurance was measured with the McGill endurance tests, flexibility was evaluated using the Straight Leg Raise, Modified Thomas, and Ober tests, and functional status was assessed with the Lower Extremity Functional Scale (LEFS). The study found that athletes with PFPS demonstrated a higher dynamic Q angle, lower core extension and lateral endurance, reduced hip flexor and iliotibial band flexibility, and lower functional scores compared with controls. Regression analyses indicated that hip flexor tightness and functional capacity were significant predictors of the dynamic Q angle in the PFPS group. These findings suggest that PFPS in adolescent athletes is a multidimensional condition influenced by proximal endurance, flexibility, and dynamic alignment rather than isolated knee-level factors.

Conditions

Patellofemoral Pain Syndrome; Anterior Knee Pain

Keywords

Dynamic Q Angle; ore Endurance; Lower Extremity Function; Adolescent Athletes

Outcome Measures

Primary Outcomes (7)

• Dynamic Q Angle

  Dynamic Q angle measured on the index limb during the step-down test using 2-dimensional digital goniometric video analysis. Higher values indicate greater frontal-plane malalignment.

  Single assessment at baseline (cross-sectional).

• Core Muscle Endurance - Extension Test

  Duration (seconds) of trunk extensor endurance test from the McGill protocol. Longer duration reflects better endurance capacity.

  Single assessment at baseline.

• Hip Flexor Flexibility - Modified Thomas Test

  Hip flexion angle obtained during the Modified Thomas test on the index limb. Greater angles indicate muscle tightness.

  Baseline, single assessment.

• Core Muscle Endurance - Lateral Plank Test

  Duration (seconds) of lateral plank endurance on the index limb according to the McGill protocol.

  Single assessment at baseline.

• Iliotibial Band / TFL Flexibility - Ober Test

  Adduction angle recorded during the Ober test on the index limb. Lower adduction indicates greater tightness.

  Baseline, single assessment.

• Hamstring Flexibility - Straight Leg Raise Test

  Hip flexion angle at the onset of pelvic compensation during passive straight leg raise. Higher angles reflect better flexibility.

  Single assessment at baseline.

• Functional Status - Lower Extremity Functional Scale (LEFS)

  Self-reported lower-limb functional capacity scored from 0-80, with higher scores indicating better function.

  Baseline, single assessment.

Study Arms (2)

PFPS Group/ Cohort

Adolescent elite athletes diagnosed with patellofemoral pain syndrome.

Control Group

Healthy adolescent elite athletes without anterior knee pain or lower extremity complaints.

Eligibility Criteria

• Age: 15 Years - 18 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Elite adolescent track-and-field athletes training within national athletic development programs.

You may qualify if:

• Elite adolescent track-and-field athletes aged 15-18 years
• Minimum 2 years of regular training participation
• Training at least 5 days per week
• Ability to complete all assessment procedures
• PFPS group: history of anterior knee pain associated with activity, positive clinical provocation tests, and AKPS score \< 80
• Control group: no history of lower extremity pain or functional limitation

You may not qualify if:

• History of lower extremity surgery or acute injury within the past 6 months
• Neurological, rheumatological, or systemic disease
• Structural deformity of the hip, knee, or ankle
• Ongoing orthopedic rehabilitation or regular analgesic / anti-inflammatory medication use
• Any condition preventing participation in the tests or introducing measurement bias

Sponsors & Collaborators

• Eastern Mediterranean University: lead

Study Sites (1)

Burcin Ugur Tosun

Famagusta, 99010, Cyprus

Location

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator PhD Physiotherapist Burcin Ugur Tosun

Study Record Dates

• First Submitted: December 25, 2025
• First Posted: January 8, 2026
• Study Start: March 1, 2025
• Primary Completion: September 15, 2025
• Study Completion: October 16, 2025
• Last Updated: January 13, 2026

Record last verified: 2026-01

Locations

CY (1)