Hamstring-to-quadriceps fatigue ratio offers new and different muscle function information than the conventional non-fatigued ratio

Document Type

Journal Article

Publication Title

Scandinavian Journal of Medicine & Science in Sports


Blackwell Munksgaard

Place of Publication



Centre for Exercise and Sport Science Research / School of Medical and Health Sciences




Pinto, M. D., Blazevich, A. J., Andersen, L. L., Mil‐Homens, P., & Pinto, R. S. (2017). Hamstring‐to‐quadriceps fatigue ratio offers new and different muscle function information than the conventional non‐fatigued ratio. Scandinavian journal of medicine & science in sports. 28(1)., 282-293. Original article Available here.


Commonly used injury risk prediction tests such as the hamstring-to-quadriceps (H:Q) strength ratio appear to be poor predictors of non-contact injury. However, these tests are typically performed in a non-fatigued state, despite accumulated fatigue being an important risk factor for both hamstring strain (HS) and anterior cruciate ligament (ACL) injuries in professional soccer players. After the effect of different H:Q calculation methods were compared and contrasted, the influence of neuromuscular fatigue on the H:Q strength ratio and the association between fatigued and non-fatigued ratio scores were examined. Thirty-five professional soccer players performed a 30-repetition isokinetic fatigue test protocol. Peak knee joint moments were computed for each repetition, and the H:Q conventional ratio (H:QCR) was calculated using several different, previously published, methods. Knee extensor and flexor moments were statistically decreased by the sixth repetition and continued to decrease until the end of the protocol. However, the H:Q ratio was statistically decreased at the end of the test due to a significant reduction in knee flexor moment (correlation between change in knee flexor moment and change in H:Q, r≈.80; P



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