2015 ISAKOS Biennial Congress ePoster #1282

Correlation Between Functional Outcomes and H/Q Ratio in ACL Reconstructed Patients

Gulcan Harput, PT,PhD, Ankara TURKEY
Gul Baltaci, PhD, Ankara TURKEY
Ahmet Atay, Prof., MD, Ankara TURKEY
Hamza Özer, MD, Prof., Ankara TURKEY
Hacettepe University, Ankara, TURKEY

FDA Status Not Applicable

Summary: Functional hamstring to quadriceps strength ratio was negatively correlated with functional outcomes in ACL reconstructed patients at sixth months after surgery

Abstract:

Background

Functional Hamstring to Quadriceps Strength (H/Q) ratio has been used as an indicator of the strength balance between quadriceps and hamstring muscles. Although functional outcomes have been shown to be correlated with knee strength in ACL reconstructed patients, there is no study in the literature that demonstrated whether there was a correlation between H/Q ratio and functional outcomes in those patients.

Methods

Thirty-eight patients (age: 28.5±8.2 years, body mass: 80.6±14.9 kg, height: 178.4±6.8 cm, BMI: 25.3±4.1 kg/m2) who underwent ACL reconstruction with hamstring tendon autograft were included in this study. The tests were performed when the patients reached their sixth months after surgery. Isokinetic dynamometer was used to measure concentric and eccentric strength of quadriceps and hamstring muscles at 90°/s angular velocity. Vertical Jump Test (VJ), One Leg Hop Test (OLHT) and Y Balance Tests (YBT) with anterior and posteromedial reach distance were used to evaluate the functional performance. Patient-reported knee performance was recorded on the International Knee Documentation Committee (IKDC). Functional hamstring to quadriceps (H/Q) ratio was calculated by dividing the maximum eccentric hamstring strength by the maximum concentric quadriceps strength. Pearson correlation coefficient was used to determine the correlation between functional outcomes and H/Q ratio and the correlation between functional outcomes and knee strength outcomes.

Results

H/Q ratio was significantly negatively correlated with YBT anterior reach (p=0.005, r=-0.48), YBT posteromedial reach (p=0.01, r =-0.42), VJ (p=0.007, r =-0.46), OLHT (p=0.02, r =-0.41) and IKDC score(p=0.02, r =-0.51). On the other hand, quadriceps concentric and eccentric strength was positively correlated with YBT anterior reach (concentric: p=0.001, r=-0.53, eccentric: p=0.002, r =-0.52), YBT posteromedial reach (concentric: p=0.01, r=0.44, eccentric: p=0.01, r =-0.43), VJ (concentric: p=0.009, r =-0.45, eccentric: p=0.003, r =0.51), OLHT (concentric: p=0.001, r =-0.53, eccentric: p<0.001, r =-0.61) and IKDC score (concentric: p=0.004, r =-0.61, eccentric: p=0.002, r =-0.65). Concentric and eccentric strength of hamstring muscle were not correlated with functional outcomes (p>0.05).

Discussion

Functional hamstring to quadriceps strength ratio was negatively correlated with functional outcomes in ACL reconstructed patients at sixth months after surgery. As only quadriceps strength was found positively correlated with the functional outcomes, restoring the strength of quadriceps muscle should be more focused on to enhance functional performance in ACL reconstructed patients.