• Physical Therapy Korea
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• v.13 no.3
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• pp.75-83
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• 2006

The purpose of this study was to examine the isokinetic moment of quadriceps and hamstring strength ratio among women of different ages. The study population consisted of 1,184 women referred to the Health Promotion Center at the S district. All subjects were aged 20 to 69 years old and divided into 5 groups; 20s (n=248), 30s (n=255), 40s (n=248), 50s (n=228), and 60s (n=205). The strength of the knee extensor and flexor, quadriceps, and hamstring of all the participants were assessed at 60 degrees/second with an isokinetic machine. We calculated the peak torque, peak torque %BW (%Body Weight), deficit of peak torque and hamstring/quadriceps ratio of the knee. The data were analyzed by one way ANOVA to investigate statistical differences in strength variation between different age groups and were computed by ${\Delta}%$ difference from women in their 20's. The results were obtained as follows: 1. Peak torque of the knee extensor, quadriceps, were significantly reduced in women older than 30, but peak torque of the knee flexor, hamstring, were significantly reduced in women older than 50 compared to women in their 20's. (p<.05). 2. Peak torque %BW of the knee extensor, quadriceps, were significantly reduced in women older than 20, but peak torque %BW of knee flexor, hamstring, were significantly reduced in women older than 40 compared to women in their 30's (p<.05). 3. Compared to the women in their 20's, there was no significant difference among any of the age groups in the deficit of peak torque of the knee extensor and flexor, but the deficit of peak torque of knee extensor among women between 30 and 50showed significant difference within the normal range of deficit. 4. Compared to the women in their 20's, there was no significant difference among any of the age groups in the hamstring/quadriceps ratio These results showed that peak torque, peak torque %BW, deficit of peak torque, and hamstring/quadriceps ratio of the knee were reduced in each age group, but especially among the women over 50. Further longitudinal study may be needed to see if volume of muscle mass and intervention of exercise affect knee strength in spite of aging.

• Physical Therapy Korea
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• v.27 no.4
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• pp.241-249
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• 2020

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weight-matched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

• Korean Journal of Applied Biomechanics
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• v.19 no.4
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• pp.617-625
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• 2009

The primary purpose of this study was to compare the hamstring-to-quadriceps strength(H/Q) ratios in collegiate soccer players and normal age-matched healthy students, and the secondary purpose was to investigate the changes in the H/Q ratio according to the degree of knee flexion. Twenty-five subjects volunteered to participate in this study. The study group comprised 12 healthy male collegiate soccer players, and the control group, 13 healthy age-matched male collegiate students. The modified N-K table was used for isometric strength measurement(unit: N). Mann-Whitney tests were performed to determine the differences in the H/Q ratios of soccer players and age-matched students at different knee flexion angles of the dominant leg. The strength of the hamstring muscle in the study group was significantly lower than that observed in the control group at knee flexion angles of $60^{\circ}$ (p<.001), $90^{\circ}$ (p<.01), and $120^{\circ}$ (p<05). The strength of the quadriceps muscle in the study group was significantly higher than that observed in the control group at flexion angles of $30^{\circ}$ (p<.001) and $60^{\circ}$ (p<.05). The H/Q ratios in the study and control groups differed significantly at all angles ($60^{\circ}$, p<.001, $90^{\circ}$, p<.001 and $120^{\circ}$, p<.001).

• PNF and Movement
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• v.17 no.3
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• pp.441-450
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• 2019

Purpose: This study identified the co-activation of quadriceps and hamstring muscles during hamstring strengthening exercises in healthy adults. Methods: Twenty-one participants were required for the present study design to achieve 80% power, 0.8 effect size (η2), and an alpha level of 0.05. Thus, this study recruited 21 healthy adults. All participants performed Nordic exercises, bridge exercises, and one-leg deadlifts randomly. The activity of the rectus femoris, vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (SM) were measured. In addition, the ratios of VM/VL and hamstring/quadriceps (HQ) were measured during the three hamstring strengthening exercises using electromyography. One-way ANOVA was used to compare the co-activation of quadriceps and hamstring muscles in the three exercises. Results: The activity of VM and VL during the performance of one-leg deadlifts was significantly higher than the other two exercises. The BF had significantly higher activity during the Nordic exercises compared to the other two exercises. In addition, the SM activation was significantly greater during Nordic exercises than one-leg deadlifts. Additionally, there was significant difference in HQ ratio among hamstring strengthening exercises. In specific, the one-leg deadlifts yielded a significantly lower HQ ratio. Conclusion: This study revealed that one-leg deadlifts are effective in rehabilitation for anterior cruciate ligament injury. In addition, Nordic exercises can be recommended to facilitate hamstring muscle activation.

• PNF and Movement
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• v.21 no.3
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• pp.291-298
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• 2023

Purpose: This study aimed to suggest an effective exercise for treating anterior cruciate ligament (ACL) and hamstring injuries based on the dynamic control ratio (DCR) for the hamstring and quadriceps during eccentric hamstring exercises. Methods: Twenty-four healthy participants participated in this study. The participants performed three eccentric hamstring exercises, including the Nordic exercise, the supine leg curl, and single-leg deadlifts. During the eccentric hamstring exercises, the vastus medialis oblique (VMO), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) were measured using surface electromyography. Results: The DCR was significantly lower during the supine leg curl and single-leg deadlift than during the Nordic exercise (p < 0.05). The activity of the VMO and VL was significantly greater during the supine leg curl than during the Nordic exercise and the single-leg deadlift (p < 0.05). VL activity was significantly higher during the single-leg deadlift than during the Nordic exercise (p < 0.05). ST activity was significantly higher during the supine leg curl and Nordic exercise than during the single-leg deadlift (p < 0.05). BF activity was significantly higher during the supine leg curl than during the Nordic exercise and single-leg deadlift (p < 0.05). Finally, the BF showed significantly higher activity during the Nordic exercise compared to during the single-leg deadlift (p < 0.05). Conclusion: Based on the DCR ratio and quadriceps activity, the supine leg curl should be introduced early in rehabilitation for ACL injuries.

• Physical Therapy Korea
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• v.12 no.1
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• pp.45-54
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• 2005

The quadriceps-angle (Q-angle) and the ratio of hamstring/quadriceps (H/Q) are important for the stability of the knee and for protection from excessive stress. The aim of this study was to examine the association between Q-angle and H/Q ratio with and without knee osteoarthritis. We compared knee osteoarthritis patients with symptom-free women. The mean age of the patients in the arthritis group (25 women, osteoarthritis) was 59.7 years. The non-arthritis group consisted of 25 women with a mean age of 55.2 years. Of the 25 women with osteoarthritis, 5 had the condition in their left knee, 5 had it in their right knee, and 15 had it on both sides. There was no significant difference in the knee Q-angle of the left and right knees of the arthritis group and the non-arthritis-group (p>.05). The strength of all the muscles around the involved right knee in the arthritis group was significantly weaker than that of the non-arthritis group (p<.05). However, in the left knee, only the strength of the knee extensors and internal rotators was significantly weaker than that of the non-arthritis group (p<.05). The Q-angle was not associated with the H/Q ratio and internal rotators/external rotators ratio of the involved knee in the arthritis group (p>.05). Neither was the Q-angle associated with the pain level of an involved knee in the arthritis group (p>.05). The knee pain was not associated with the H/Q ratio of the involved knee in the arthritis group (p>.05). The Q-angle was not associated with the ratio of H/Q and pain level of the involved knee in the osteoarthritis women.

• Korean Journal of Applied Biomechanics
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• v.25 no.1
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• pp.49-56
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• 2015

Objectives : The purpose of this study was to present quantitative data and basic references to decrease the accident risk of soccer instructors. Methods : To obtain data, we conducted an investigation on how H/Q ratio affects the dynamic stability of the lower extremity at the time of drop landing. The study targeted 13 soccer players from C University who have not had any injuries or wounds in the lower extremity joints and in any other parts of their bodies over the last 6 months. By using CMIS (USA), the players were divided into two groups according to H/Q ratios higher and lower than 69%, respectively. The subjects in each group were instructed to perform a drop landing. Results : The H/Q ratio did not affect the maximal flexion angle of the knee joints at the time of drop landing. In addition the dominant group with a relatively high H/Q ratio was observed to have increased time to reduce shock and to efficiently absorb the ground reaction force during drop landing. Also, the dominant group with a relatively high H/Q ratio utilized the strong performances of the antagonistic muscles around the hamstrings and the controlled rotatory powers of the thighs that were applied to the tibias supported by the ground. Finally, H/Q ratio, load factors, and mean and maximum EMG were significantly negatively related, whereas GRFx showed a positive relationship. In fact, these factors all affected the impact of the load from the H/Q ratio to the knee joints. Conclusion : From these findings it can be concluded that unbalanced H/Q ratio can be considered as a predictor of knee joint injury at the time of drop landing.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.45-51
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• 2019

Objective: The purpose of this study was to investigate the muscle activity ratio of the lower limb according to changes in straight leg raise (SLR) test angles on hamstring muscle shortening during squat exercises. Design: Randomized controlled trial. Methods: The subjects were 14 healthy adults who were informed of and agreed to the method and purpose of the study. The participants were classified into SLR groups according to two angles (over $80^{\circ}$ or under $80^{\circ}$) assessed using the SLR tests. After training and practicing the wall squat posture to be applied to the experiment, electromyography (EMG) was used to measure changes in muscle activity during the performance of a wall squat. After stretching, a sequence of pre-stretch tests were performed again, and the active and passive SLR tests were also reconducted; thereafter, a wall squat was performed again by attaching EMG electrodes. The EMG results before and after stretching were compared. Results: The muscle activity of the vastus lateralis oblique muscle increased in both groups. The muscle activity of the vastus medialis oblique muscle decreased in over both group. Rectus femorus activity increased in the under 80-degree groups but decreased in the over 80-degree group. The muscle activity of the biceps femoris muscle decreased after stretching in the over 80-degree group and increased in the under 80-degree group, and the semitendinosus muscle activity after stretching was decreased. The quadriceps-to-hamstring muscle (Q:H) ratio before and after stretching between groups showed that the hamstring muscle ratio decreased after stretching in both groups. Conclusions: The results of this study showed that the Q:H ratio before and after stretching between groups was not significantly different.

• Proceedings of the ESK Conference
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• 1997.10a
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• pp.426-432
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• 1997

본 연구에서는 EMG를 이용한 수리적 parameter를 사용하여동일한 병명(L4/L5 herniated disk)의 요통환자들의 근육활동의 정상 여부를 측정하였다. 특히 본 연구에서는 동작분석기를 사용하지 않고 근 전도의 주기를 판독하여 기존의 연구에서 사용되었던 것보다 측정이간편하고, 주관적 통증 정도가 낮 은 환자를 대상으로 실험함으로써 통증이 parameter에 미치는 심리적 영향을 최소화하였다. 또한 본 연 구에서는 동작주기마다의 근전도 신호의 변이도(variance ratio)를 새로운 parameter로 선정하여 검증하 였다. 측정된 자료를 분석한 결과 quadriceps-hamstrings의 peak time difference와 erector spinae- rectus abdominis의 coexcitation이 통계적으로 매우 유의하게 요통환자와 정상인을 구분해주는 지표임이 확인되었고, rectus abdominis와 externa/internal oblique의 근전도 변이도(variance ratio)가 진단지표 로서 의미가 있음이 밝혀졌다. 본 연구의 방법은 차후 다양한 환자군에 대한 자료와 정상인에 대한 자료를 DB화 함으로써 진단기법으로 사용할 수 있는 가능성을 보여주었다. 이 방법은 차후 요통의 조기 발견과 예 방에 기여할 것으로 기대한다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.326-333
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• 2016

This case study identified the effects of joint mobilization on knee pain, isokinetic strength, muscle tone, and muscle stiffness in an elite volleyball player with a knee injury. The subject had experienced cartilage defects of the left knee joint and underwent surgery to correct the condition. The patient complained of continuous pain in the left knee joint in daily life in addition to pain during exercise. The study was conducted from August 5 to 12, 2015 and joint mobilization was applied to the left knee joint for 15 minutes once a day for 8 days. Knee pain was measured using a visual analogue scale, and the concentric peak torque of the quadriceps and hamstring muscles was measured using an isokinetic muscular strength measurement device. The muscle tone and stiffness of the rectus femoris muscle, vastus medialis, and vastus lateralis on the injured side were measured using a myotonometer. All the measurements were conducted before and after the intervention. Joint mobilization was effective in reducing knee pain on the injured side, increasing the concentric peak torque of the quadriceps and hamstring muscles on both sides, and increasing the muscle stiffness of the quadriceps muscle on the injured side. Concentric peak torque of the quadriceps muscle on the injured side increased a great deal as the number of joint mobilizations was increased, largely diminishing the difference in concentric peak torque between the normal side and injured side. On the other hand, joint mobilization was ineffective in improving the hamstring to quadriceps strength ratio on the injured side. While this study suggests that joint mobilization can be an effective intervention to improve the knee pain, isokinetic strength, and muscle stiffness of elite volleyball players, it should be performed alongside training for an appropriate strength ratio.