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Ruas CV, Pinto RS, Haff GG, Lima CD, Pinto MD, Brown LE. Alternative Methods of Determining Hamstrings-to-Quadriceps Ratios: a Comprehensive Review. SPORTS MEDICINE-OPEN 2019; 5:11. [PMID: 30911856 PMCID: PMC6434009 DOI: 10.1186/s40798-019-0185-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/12/2019] [Indexed: 11/16/2022]
Abstract
The hamstrings-to-quadriceps muscle strength ratio calculated by peak torque has been used as an important tool to detect muscle imbalance, monitor knee joint stability, describe muscle strength properties and functionality, and for lower extremity injury prevention and rehabilitation. However, this ratio does not consider other neuromuscular variables that can also influence the antagonist to agonist muscle relationship, such as torque produced at multiple angles of range of motion, explosive strength, muscle size, muscle fatigue, or muscle activation. The aim of this study was to comprehensively review alternative methods of determining the hamstrings-to-quadriceps ratio. These include ratios calculated by angle-specific torque, rate of torque development, muscle size, fatigue index, and muscle activation (measured by electromyography). Collectively, the literature demonstrates that utilizing alternative methods of determining the hamstrings-to-quadriceps ratio can be functionally relevant for a better understanding of the neuromuscular mechanisms underpinning the interaction of strength between hamstrings and quadriceps. However, there is insufficient evidence to recommend any of the alternative methods as sensitive clinical tools for predicting injury risk and monitoring knee joint integrity. Future longitudinal studies, along with injury incidence, are needed to further investigate all alternative methods of determining the hamstrings-to-quadriceps ratio. These have potential to offer insight into how athletes and the general population should be trained for performance enhancement and injury reduction, and may be used along with traditional methods for a thorough assessment of an individual’s H:Q muscle balance.
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Affiliation(s)
- Cassio V Ruas
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia.
| | - Ronei S Pinto
- Exercise Research Laboratory, School of Physical Education, Physioteraphy and Dance, Universidade Federal do Rio Grande do Sul, Rua Felizardo 750, Porto Alegre, RS, Brazil
| | - G Gregory Haff
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia
| | - Camila D Lima
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia
| | - Matheus D Pinto
- Centre for Exercise and Sports Science Research (CESSR), School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, Australia
| | - Lee E Brown
- Center for Sport Performance and Human Performance Lab, Department of Kinesiology, California State University, 800 N State College Blvd, Fullerton, CA, USA
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