The Importance of Functional Hamstring/Quadriceps Ratios in Knee Osteoarthritis

Abstract

Context: Osteoarthritis (OA) is the most common chronic joint condition. Muscle dysfunction plays a critical role in the pathogenesis of knee OA. Objective: It has been suggested that the agonist–antagonist strength relationship for the knee may be better described by a functional hamstring/quadriceps (H/Q) ratio (Hconcentric/Qeccentric: the representative of knee flexion and Qeccentric/Hconcentric: the representative of knee extension). Therefore, in this study, the authors aimed to investigate this ratio and its importance for knee OA. Design: Cross-sectional study. Setting: Research clinic. Patients or Other Participant(s): Twenty healthy women and 20 women with grade 2 or grade 3 primer knee OA between the age of 50 and 80 years were included in this study. Intervention(s): Concentric and eccentric peak torque of quadriceps and hamstring muscles were evaluated for all individuals in patient and control groups with a Cybex isokinetic device. Functional H/Q ratio is calculated manually. Main Outcome Measure(s): Functional H/Q torque ratios were analyzed between the patients with OA and healthy individuals by using the isokinetic system. Results: The values of peak torque of hamstring concentric and eccentric and quadriceps concentric for the patient group were significantly lower than the control group (P < .05). No statistically important difference was found for quadriceps eccentric peak torque between 2 groups (P > .05). H/Q ratio for extension in the patient group was significantly higher than the control group (P < .05), whereas the H/Q ratio for flexion in the patient group was significantly lower than the control group (P < .05). Conclusion: This study showed the weakness of both quadriceps and hamstring muscles in patients with knee OA. The combination of functional H/Q ratio with hamstring and quadriceps muscles concentric and eccentric strength values can help to analyze the knee functions and develop preventive-therapeutic approaches for knee OA.

Effects of Self-management Program as Adjunctive to Usual Rehabilitation Exercise on Pain and Functional Outcomes in Knee Osteoarthritis: A Randomized Controlled Trial

“… 38 Further, the prescribed strength exercise which focuses on quadriceps (vastus medialis oblique) and hamstrings could serve as a dynamic stabilizer for knee joints. 37 , 39 Although strength was not measured in this study, stronger knee muscles would allow for optimal joint stability and mechanics during gait (e.g., increase in step length and cadence). 7 , 39 Apart from exercise, improvements in TUG could also be ascribed to effective self-management of pain, which provides indirect augmentation in physical performance, allowing for a higher HBE dosage.…”

Gastrocnemius Muscle Injury Is the Condition to Induce Cartilage Degeneration of the Rabbit Tibiofemoral Joint: A New Perspective

“…Gastrocnemius injury can cause pathological changes in the femoral condyle of the tibiofemoral joint, suggesting ideas and an experimental basis for the early prevention and treatment of KOA. Attention should be paid to the effect of gastrocnemius in KOA in addition to the quadriceps and hamstring muscles [31,32]. The progression of KOA is a long-term process, and the results at different time points after modeling suggested pathological progression, which may be severe.…”

Effects of Whole-body Electromyostimulation on knee pain and physical function in adults with symptomatic knee osteoarthritis: a randomized controlled trial

“…In most of the local EMS studies, the quadriceps muscle was stimulated in isolation with adhesive electrodes. This approach appears suboptimal, considering the importance of the hamstring muscles and intermuscular and proprioceptive coordination for the stability of the knee joint [53]. Strengthening the hamstring muscles in addition to strengthening the quadriceps muscles has even been shown to be beneficial for pain symptoms, mobility and function in knee OA [54].…”