이중에너지 방사선 흡수법을 이용한 누운자세의 Q-angle 측정의 양호도 평가
The Reliability of Q-angle in the Supine Position Measured by DEXA
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본 연구는 이중에너지 방사선 흡수법(DEXA)으로 촬영한 X-선 이미지를 이용한 Q-angle측정법에 대한 신뢰성을평가하는데 연구의 목적이 있다. 연구의 대상자는 남여 대학생 21명(나이:18.95±0.20, 신장:170.39±2.05, 체중:67.10±3.41, BMI: 22.94±0.88)으로 하였다. 각도기(goniometer)와 DEXA를 이용한 Q-angle 값의 신뢰성을 평가하기위해 반복측정을 하였으며, X-선 촬영기법을 사용하는 DEXA의 Q-angle 값을 기준으로 각도기를 활용한 측정방법에 대한 오차발생차이를 확인하였다. 본 연구를 시행한 결과 각도기의 경우 왼쪽과 오른쪽 Q-angle 측정값 모두 신뢰성이 낮은 것으로 나타났다(왼쪽: t=-2.80,p=0.011, r=0.37, LOA, -4.93~9.41/오른쪽: t=-3.77,p=0.001, r=0.23, LOA, -5.64~13.83). 반면에 DEXA를 사용하여 Q-angle 측정한 경우 왼쪽과 오른쪽 모두 반복측정에 대한 신뢰성이goniometer로 측정하였을 때보다 높은 것으로 나타났다(왼쪽: t=0.47, p=0.643, r=0.45, LOA, -4.79~4.31/오른쪽: t=1.09,p=0.286, r=0.54, LOA, -4.38~3.42). 또한 각도기와 DEXA로 측정한 Q-angle의 차이를 확인한 결과 왼쪽과오른쪽 Q-angle 모두 재검사에서 과대추정 되는 것으로 나타났다(왼쪽: t=2.33,p=0.03, r=-0.24, LOA, -5.30~9.01/오른쪽: t=3.55,p=0.002, r=-0.46, LOA, -9.79~8.35). 이러한 결과로 미루어볼 때 각도기를 사용한 측정값은 편향(bias) 이 있는 것으로 나타나 재현성면에서 DEXA의 신뢰성이 높은 결론을 확인하였다. 따라서 누워있는 자세에서 Q-angle 측정 시 DEXA를 이용한 측정법의 활용가치가 높을 것으로 사료된다.
Abstract
The purpose of this study was to examine the reliability of Q-angle by using a goniometer and DEXA. Participants in this study was 21 athletes (age: 18.95±0.20, height: 170.39±2.05, weight: 67.10±3.41, BMI: 22.94±0.88) from Yongin university. All data was analyzed by Bland & Altman (LOA), paired t-tests (t), and Pearson's correlation coefficient. The result of this study showed that the reliability of repeated Q angle was higher in DEXA (left: t=0.47, p=0.643, r=0.45, LOA=-4.79~4.31 / right: t=1.09, p=0.286, r=0.54, LOA, -4.38~3.42) when compared to a goniometer (left: t=-2.80, p=0.011, r=0.37, LOA,-4.93~9.41 / right: t=-3.77, p=0.001, r=0.23, LOA=-5.64~13.83). The reliability of measured Q-angle in the supine position using a goniometer and DEXA showed that there was an overestimation when DEXA values were set at the standard of conformity (left: t=2.33,p=0.03, r=-0.24, LOA=-5.30~9.01 / right: t=3.55,p=0.002, r=-0.46, LOA=-9.79~8.35). In conclusion, we confirmed that DEXA would be more efficient and exact measurement method for measuring Q-angle in the supine position.
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