From: Alternative Methods of Determining Hamstrings-to-Quadriceps Ratios: a Comprehensive Review

Topic | Authors | Aims related to H:Q ratio | Sample | Main outcome measures | Main results |
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AST H:Q ratio | Eustace et al. 2017 [37] | To compare PT and AST H:Q ratio (FR) between limbs, angles and velocities | 26 male professional soccer players | PT H:Q ratio and AST H:Q ratio at 10° angles from 40 to 70° (0° = full knee extension) at three different isokinetic velocities (60, 180, and 270°/s) on the dominant and non-dominant legs | PT H:Q ratio was greater for the dominant than the non-dominant leg, and increased with higher velocities. AST H:Q ratio was greater for the dominant than the non-dominant leg at angles 60°, 50°, and 40° |

Eustace et al. 2018 [38] | To compare PT and AST H:Q ratio (FR) between senior professional and youth soccer players | 17 senior professional and 17 elite youth male soccer players | PT H:Q ratio and AST H:Q ratio at ten degree angles from 40 to 70° (0° = full knee extension) at three different isokinetic velocities (60, 180 and 270°/s) on the dominant and non-dominant legs | PT H:Q ratio was greater for the dominant than the non-dominant limb and increased with higher velocities similarly for both groups. AST H:Q ratio was greater at 70° and 60° on the non-dominant leg for youth compared to senior players | |

Aagaard et al. 1998 [3] | To assess PT and AST H:Q ratio (CR and FR) at different angles and velocities | 9 track and field athletes (5 males and 4 females) | PT H:Q ratio and AST H:Q ratio at 50°, 40°, and 30° of knee flexion (0° full knee extension) at two different isokinetic velocities (30 and 240°/s) | PT and AST H:Q ratio (FR) increased across movement velocities and at extended knee joint angles. AST H:Q ratio (CR) increased across extended knee joint angles. PT H:Q ratio (CR) was not affected by velocity | |

El-Ashker et al. 2017 [27] | To investigate sex differences on PT and AST H:Q ratio (FR) | 96 young adults (50 males and 46 females) | PT H:Q ratio and AST H:Q ratio at 15°, 30°, and 45° of knee extension (0° = full knee extension) at three different isokinetic velocities (60, 180 and 300°/s) | PT H:Q ratio was lower for females compared to males. PT and AST H:Q ratio decreased for both groups with increased isokinetic velocity and close to full knee extension | |

Cohen et al. 2015 [28] | To investigate the effect of simulated soccer on PT and AST H:Q ratio (FR) | 9 semi-professional male soccer players | PT H:Q ratio and AST H:Q ratio at 9 knee flexion angles (from 10 to 90°; 0° = full knee extension) at 120°/s | Simulated soccer led to reduced PT H:Q ratio. Additionally, there was an AST H:Q ratio decrease at 10° of knee flexion | |

Hiemstra et al. 2004 [36] | To compare PT and AST H:Q ratio (CR and FR) at different angles, velocities and contraction types between hamstring tendon ACL reconstruction and uninjured control participants | 16 participants (9 males and 7 females) with more than 1 year of hamstring tendon ACL reconstruction and 30 active uninjured males |
PT H:Q ratio and AST H:Q ratio measured from 5 to 95° of knee flexion (0° = full knee extension) at five angular velocities (50, 100, 150, 200, and 250°/s). Strength maps were used for comparisons between groups
| Participants with ACL reconstruction had overall lower PT H:Q ratio compared to active participants, and presented lower AST H:Q ratio near full knee flexion and higher AST H:Q ratio near full knee extension | |

Huang et al. 2017 [33] | To investigate PT and AST H:Q ratio (CR and FR) in participants with unilateral and symptomatic ACL deficiency | 46 male participants with unilateral chronic ACL-rupture | PT H:Q ratio and AST H:Q ratio at 6 knee flexion angles (from 30 to 80° of knee flexion; 0° = full knee extension) on ACL deficiency and uninvolved (healthy) limbs at 60°/s | There was no difference between groups for PT H:Q ratio. ACL deficiency limbs presented greater AST H:Q ratio compared to healthy limbs at 30° and 40° of knee flexion | |

De Ste Croix et al. 2017 [29] | To investigate sex differences on PT and AST H:Q ratio (FR) measured at different angles and velocities | 55 male and 55 female recreationally active participants | PT H:Q ratio and AST H:Q ratio at three knee flexion angles (15, 30, and 45°, 0° = full knee extension) and three angular velocities (60, 120, and 240°/s) | PT H:Q ratio was lower at 120°/s and 240°/s and AST H:Q ratio was lower at 15° and 30° of knee flexion in females compared to males | |

Ayala et al. 2012 [35] | To determine the absolute reliability of the PT and AST H:Q ratio (CR and FR) | 50 recreational athletes (26 males and 24 females) | PT H:Q, AST H:Q ratio at three different joint angles (10°, 20°, 30°), and ROM-specific torque H:Q ratios at 4 different ranges (0–10°, 11–20°, 21–30°, and 0–30°) of knee flexion measured on three different occasions | PT H:Q ratio presented moderate reliability values. AST and joint ROM-specific torque H:Q ratios demonstrated poor absolute reliability scores | |

Evangelidis et al. 2015 [5] | To compare PT, isometric, and AST H:Q ratio between soccer players and recreationally active males | 10 soccer players and 14 recreationally active males | PT H:Q ratio, isometric H:Q ratio at five angles (105°, 120°, 135°, 150°, and 165°) and AST H:Q ratio at five angles (from 100 to 160° for 60°/s; from 105 to 160° for 240°/s; and from 115 to 145° for 400°/s) | PT, isometric and AST H:Q ratios were similar between professional soccer players and recreationally active players at any velocity | |

RTD H:Q ratio | Zebis et al. 2011 [45] | To compare the RTD H:Q ratio with isometric H:Q ratio | 23 elite soccer players (11 females and 12 males) | Isometric H:Q ratio and RTD H:Q ratio at incrementing time periods of 10 ms (from 0 to 250 ms) | RTD H:Q ratio from 0 to 50 ms was lower than isometric H:Q ratio |

Greco et al. 2012 [39] | To compare PT H:Q ratio (CR) and RTD H:Q ratio in soccer players with high and low strength levels | 39 male professional soccer players | PT H:Q ratio and RTD H:Q ratio calculated at a time interval of 0–50 ms | Soccer players who had high strength levels had greater PT H:Q ratio and RTD H:Q ratio compared to counterparts with low strength levels. There was no correlation between ratios | |

Hannah et al. 2014 [41] | To compare isometric H:Q ratio and RTD H:Q ratio | 20 untrained males | Isometric H:Q ratio and RTD H:Q ratio at time intervals of 25, 50, 75, 100, and 150 ms of force onset | RTD H:Q ratio was lower than isometric H:Q ratio | |

Hannah et al. 2015 [30] | To investigate sex differences on isometric H:Q ratio and RTD H:Q ratio | 40 untrained adults (20 males and 20 female) | Isometric H:Q ratio and RTD H:Q ratio calculated at time intervals of 25, 50, 75, 100, and 150 ms of force onset | Isometric H:Q ratio was greater in males than females. RTD H:Q ratio was similar between sexes at each time point | |

Jordan et al. 2015 [42] | To investigate RTD H:Q ratio in elite ski racers | 29 elite alpine ski racers (13 males and 8 females uninjured and 3 males and 5 females with ACL reconstruction) | RTD H:Q ratio calculated at time intervals of 0–50, 0–100, 0–150, and 0–200 ms | Elite alpine ski racers with ACL reconstruction had greater RTD H:Q ratio at 0-50 ms compared to uninjured counterparts | |

Palmer et al. 2017 [43] | To examine the effects of age on isometric H:Q ratio and RTD H:Q ratio | 15 young and 15 older women | Isometric H:Q ratio and RTD H:Q ratio at time intervals of 0–30 and 0–200 ms | Older women had greater RTD H:Q ratio at 0–200 ms compared to young women | |

Greco et al. 2013 [40] | To investigate the effect of a fatiguing soccer-specific exercise on H:Q ratio (CR and FR) and RTD H:Q ratio | 22 male professional soccer players | PT H:Q ratio at 180°/s and RTD H:Q ratio at time intervals of 0–50 and 0–100 ms | The fatiguing soccer-specific exercise led to lower PT H:Q ratio, but there was no effect on RTD H:Q ratio | |

Thorlund et al. 2008 [44] | To investigate the effect of a simulated handball match on isometric H:Q ratio and RTD H:Q ratio | 10 male elite handball players | Isometric, and RTD and RTD impulse H:Q ratios at time intervals of 30, 50, 100, and 200 of force onset | The simulated handball match did not lead to changes on isometric H:Q ratio, but RTD and RTD impulse H:Q ratios increased at 0–30 ms | |

FI H:Q ratio | Pinto et al. 2018 [52] | To investigate the influence of neuromuscular fatigue on PT H:Q ratio (CR) and the association between FI H:Q ratio and PT H:Q ratio | 35 male elite professional soccer players | PT H:Q ratio and FI H:Q ratio at 300°/s | FI H:Q ratio was greater and weakly correlated to PT H:Q ratio. PT H:Q ratio only declined in the last three repetitions of the fatigue test, which was strongly correlated to hamstring torque decreases, but weakly correlated to quadriceps torque decreases |

Costa et al. 2018 [51] | To investigate the effect of hamstrings stretching and fatigue on H:Q ratio (CR) and FI H:Q ratio | 35 healthy adults (17 females and 18 males) | PT H:Q ratio and FI H:Q ratio at 180°/s | There was no effect of combined stretching and fatigue on PT and FI H:Q ratios | |

MS H:Q ratio | Denadai et al. 2016 [47] | To investigate the association between PT H:Q ratio (CR) and MS H:Q ratio | 9 male professional soccer players | PT H:Q ratio at 60°/s and MS H:Q ratio | PT H:Q ratio did not significantly correlate with MS H:Q ratio |

Evangelidis et al. 2016 [48] | To investigate the association between PT H:Q ratio (FR), isometric H:Q ratio and MS H:Q ratio | 31 recreationally active young men | PT H:Q ratio at 50 and 350°/s, isometric PT H:Q ratio, and MS H:Q ratio | MS H:Q ratio was positively correlated with isometric H:Q ratio and PT H:Q ratio at both velocities | |

Wieschhoff et al. 2017 [50] | To compare a MS VM:SM ratio between patients with ACL tears and participants with no ACL abnormalities | 100 ACL tear and 100 control participants without ACL abnormalities (54 male and 46 female in each group) | MS VM:SM ratio | MS VM:SM ratio of patients that had recent non-contact ACL injuries was greater than control participants without ACL abnormalities | |

Behan et al. 2018 [46] | To investigate sex differences on MS H:Q ratio | 66 healthy active young (32 males and 34 females) | MS H:Q ratio | MS H:Q ratio was lower in females compared to males | |

Ruas et al. 2017 [49] | To compare 3 different resistance training protocols involving concentric and eccentric muscle actions on MS H:Q ratio | Forty untrained males | MS H:Q ratio | No resistance training protocol led to any changes on MS H:Q ratio | |

MA H:Q ratio | Aagaard et al. 2000 [53] | To investigate the amount of antagonist coactivation during maximal quadriceps contraction and assess the MA H:Q ratio | 60 sedentary males | MA (EMG-moment) H:Q ratio at 30°/s | Hamstrings coactivation and MA H:Q ratio were increased towards full knee extension |

Kellis and Katis 2007^{a} [54]
| To investigate the AST H:Q ratio (FR) and the MA H:Q ratio at different velocities and movement directions | 17 pubertal males | AST and MA (EMG-moment) H:Q ratio from 0 to 90° of knee flexion at 60°/s and 180°/s | AST H:Q ratio increased as the knee extended and at an increased angular velocity. MA H:Q ratio increased near full extension |