Diagnostic value of the hamstring to quadriceps ratio in monitoring of the effectiveness of supervised 6-month physiotherapy in males after Anterior Cruciate Ligament Reconstruction (ACLR)

Abstract

The aim of the study was to assess the usefulness of isometric torque (IT) and peak torque (PT) of the hamstring to quadriceps muscles ratio (H/Q ratio) in monitoring the effectiveness of physiotherapy (PH) in males after ACLR. The H/Q ratio is a diagnostic tool for monitoring of the effectiveness of the 6- month PH after ACLR. Twenty males 6 months after ACLR (ACLR group) and 20 male controls underwent IT and PT (60°/s and 180°/s) bilateral measurements of H and Q muscles. The IT and PT were normalized to body mass, and expressed as relative IT (RIT) and relative PT (RPT). The RIT and RPT H/Q ratios, and Limb Symmetry Index (LSI) were calculated. In the ACLR group, the RIT for the H and Q, the RIT for the H/Q ratio and most of the RPT, as well as the H/Q ratio, ROM and LSI values of the operated knee, were not significantly different (NSD) than those of the non-operated side (NOS) or the control group. The between-group comparison of the H/Q ratio for RIT and RPT weren't NSD. The isokinetic test at 180 °/s showed lower RPT, H/Q ratio and LSI values for the Q muscle than those of the NOS (p = 0.042, p = 0.001). The H/Q ratio, in combination with the RIT, RPT and LSI, is a useful diagnostic tool for monitoring the effectiveness of 6-month PH after ACLR. Restoring the correct H/Q ratio can reduce the risk factor for ACL graft rupture.