Effect of Gender and Maturity on Quadriceps-to-Hamstring Strength Ratio and Anterior Cruciate Ligament Laxity

Ahmad, Christopher S.; Clark, Alexander Martin; Heilmann, Niels; Schoeb, J. Scott; Gardner, Thomas R.; Levine, William N.

doi:10.1177/0363546505280426

Cited by 138 publications

(126 citation statements)

References 59 publications

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“…Based on multiple reports of greater knee laxity values in adult females compared to males, 9,62,72 these data suggest that male values may continue to decrease with advancing age, or that female values may later rise. Our trends from early to late stages of maturation are consistent with the data from Ahmad et al, 2 who found decreased knee laxity in mature (14-18 years) compared to immature (10-13 years) boys, but no change between mature (2 years postmenarche) and immature (premenarche) girls. They attributed these differences to greater strength development in males, greater quadriceps-to-hamstring strength ratios in mature girls, and chronic exposure to estradiol postmenarche in females.…”

Section: 59supporting

confidence: 92%

Differences in Lower Extremity Anatomical and Postural Characteristics in Males and Females Between Maturation Groups

Shultz¹,

Nguyen²,

Schmitz³

2008

J Orthop Sports Phys Ther

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Descriptive, cross-sectional.We compared lower extremity anatomical characteristics in males and females between different maturation groups.Sex differences have been observed in lower extremity anatomical characteristics. While the reasons contributing to these sex differences in adults are unknown, there is evidence that anatomy and posture change considerably during growth and development.One hundred seventy-three young athletes (age range, 9-18 years) were assessed for stage of maturation and placed into 1 of 3 groups, according to Tanners stages 1 and 2 (MatGrp 1 ), 3 and 4 (MatGrp 2 ), and 5 (MatGrp 3 ). Participants were measured for pelvic angle, hip anteversion, quadriceps angle, tibiofemoral angle, femur length, tibial length, genu recurvatum, tibial torsion, navicular drop, general joint laxity, and anterior knee laxity. Data were compared by sex and maturation group.When comparing maturation groups, limb length, pelvic angle, and tibial torsion increased with maturation, and anterior knee laxity, genu recurvatum, tibiofemoral angle, and foot pronation decreased with maturation. Females had greater general joint laxity, hip anteversion, and tibiofemoral angles, and shorter femur and tibial lengths than males, regardless of maturation group. Maturational changes in knee laxity and quadriceps angles were sex dependent.We observed a general change in posture with maturation that began with greater knee valgus, knee recurvatum, and foot pronation in MatGrp1, then moved toward a relative straightening and external rotation of the knee, and supination of the foot in later maturation groups. While the majority of the measures changed similarly in males and females across maturation groups, decreases in quadriceps angles and anterior knee laxity were greater in males compared to females, and females were observed to have a more inwardly rotated hip and valgus knee posture, compared to males, particularly in later maturation groups.Diagnosis, level 4.

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Section: 59supporting

confidence: 92%

Differences in Lower Extremity Anatomical and Postural Characteristics in Males and Females Between Maturation Groups

Shultz¹,

Nguyen²,

Schmitz³

2008

J Orthop Sports Phys Ther

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“…2 The unbalanced condition of strength and the hypotrophy of the flexor and extensor muscles of the knee joint are muscle malfunctioncausing factors that alter joint stability, predisposing athletes to injury. [3][4][5] The muscular torque of the quadriceps and hamstrings, as well as their torque ratio (H/Q), is usually evaluated by the isokinetic test. 6 The H/Q ratio is used both clinically and in the laboratory as an indicator of the strength balance between the knee joint muscles.…”

Section: Introductionmentioning

confidence: 99%

Isokinetic Torque Peak and Hamstrings/Quadriceps Ratios in Endurance Athletes With Anterior Cruciate Ligament Laxity

Portes

Botelho

et al. 2007

Clinics

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VG, Pinto S de S. Isokinetic torque peak and hamstrings/quadriceps ratios in endurance athletes with anterior cruciate ligament laxity. Clinics. 2007;62(2):127-32. PURPOSE:To evaluate torque and the hamstring/quadriceps ratio of the knee of athletes with and without anterior cruciate ligament laxity. METHODS: Twenty-eight male athletes, 19 without anterior cruciate ligament laxity and 9 with anterior cruciate ligament laxity, were evaluated with an isokinetic machine model Cybex 770. The peak torque of quadriceps and hamstrings was compared, and the hamstring/quadriceps ratio on the constant angular speed of 60º per second were also compared. RESULTS: In athletes with anterior cruciate ligament laxity, the peak torque values (right and left knees) of flexors (120 ± 15 and 116 ± 15 Nm) and of extensors (218 ± 36 Nm and 207 ± 26 Nm) were not different than those of athletes without laxity (109 ± 21 Nm and 111 ± 22 Nm; 191 ± 5 Nm and 188 ± 35 Nm). The hamstring/quadriceps ratio of athletes with laxity (right: 57 ± 6% and left: 56 ± 8%) did not differ from those without anterior cruciate ligament laxity (right: 58 ± 9% and left: 58 ± 7%). CONCLUSIONS:The anterior cruciate ligament laxity of long distances running athletes did not significantly alter the peak torque of flexors and of extensors or the hamstring/quadriceps ratio. KEYWORDS: Isokinetic torque. Knee. Anterior cruciate ligament. Laxity. Athletes. INTRODUCTIONTorque is the rotational effect of force generated by a single muscle or group of muscles in relation to the considered joint.1 Because the term force is basically a linear entity, in this study when referring to muscle strength, the term torque was conventionally used. The term strength refers to the tension that a muscle or group of muscles exerts against a determined resistance.2 The unbalanced condition of strength and the hypotrophy of the flexor and extensor muscles of the knee joint are muscle malfunctioncausing factors that alter joint stability, predisposing athletes to injury. [3][4][5] The muscular torque of the quadriceps and hamstrings, as well as their torque ratio (H/Q), is usually evaluated by the isokinetic test. 6 The H/Q ratio is used both clinically and in the laboratory as an indicator of the strength balance between the knee joint muscles. 7 The H/Q ratio is conventionally calculated by dividing the maximum values of the flexion by the maximum values of the extension of the knee joint in angled speed and determined contraction modes. 8It is difficult to determine whether the hamstring weakness, the quadriceps weakness, or both are related to the knee injuries, or if muscle weakness is a consequence of the injury.9 Evidence suggests that highly developed quadriceps muscles contribute to a decrease of the co-activation of the hamstring antagonists, thus increasing the susceptibility for anterior cruciate ligament injury. The anterior cruciate ligament (ACL) is the primary ligament that limits the anterior translation of the tibia in relation to the femur. Subjects with ACL injury de...

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“…For muscular capacity, 11 studies have looked into its association with sustaining a non-contact ACL injury (Ahmad, et al, 2006;Bee-Oh, et al, 2009;Bowerman, Smith, Carlson, & King, 2006;Grygorowicz, Kubacki, Pilis, Gieremek, & Rzepka, 2010;Hiemstra, Webber, MacDonald, & Kriellaars, 2007;Holcomb, Rubley, Lee, & Guadagnoli, 2007;Hosokawa, et al, 2011;Mattacola, et al, 2002;Roberts, Ageberg, Andersson, & Fridén, 2007;Wilkerson, et al, 2004;. These studies have associated muscular capacity with risks of acquiring ACL injury, validating ACL screening tools to be used in intervention programs to prevent ACL injury.…”

Section: Reflection On Associative Studiesmentioning

confidence: 99%

“…(Hiemstra, et al, 2007;Mattacola, et al, 2002;Roberts, et al, 2007;Wilkerson, et al, 2004; Isokinetic and isometric peak torques (Ahmad, et al, 2006;Bee-Oh, et al, 2009;Bowerman, et al, 2006;Grygorowicz, et al, 2010;Holcomb, et al, 2007;Hosokawa, et al, 2011). H:Q ratio Muscular Activation (Begalle, et al, 2012;Elias, et al, 2015;Nagano, et al, 2011;R.…”

Section: Author/yearmentioning

confidence: 99%

Mapping current research trends on neuromuscular risk factors of non-contact ACL injury

Rafeeuddin

Sharir

Staes

et al. 2016

Physical Therapy in Sport

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Effect of Gender and Maturity on Quadriceps-to-Hamstring Strength Ratio and Anterior Cruciate Ligament Laxity

Cited by 138 publications

References 59 publications

Differences in Lower Extremity Anatomical and Postural Characteristics in Males and Females Between Maturation Groups

Differences in Lower Extremity Anatomical and Postural Characteristics in Males and Females Between Maturation Groups

Isokinetic Torque Peak and Hamstrings/Quadriceps Ratios in Endurance Athletes With Anterior Cruciate Ligament Laxity

Mapping current research trends on neuromuscular risk factors of non-contact ACL injury

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