Effect of Gender on the Quadriceps-to-Hamstrings Coactivation Ratio During Different Exercises

in Journal of Sport Rehabilitation
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Coactivation ratio of quadriceps to hamstring muscles (Q:H) and medial to lateral knee muscles (M:L) contributes to the dynamic stability of the knee joint during movement patterns recommended during rehabilitation and important for daily function.


To compare the quadriceps-to-hamstring and medial-to-lateral knee muscles' coactivation ratios between men and women during the following closed kinetic chain exercises performed on a balance board: forward lunge, side lunge, single-leg stance, and single-leg squat.




20 healthy subjects (10 female and 10 male).

Main Outcome Measures:

Surface electromyography was used to measure the activation level of quadriceps (vastus lateralis and medialis) and hamstrings (biceps femoris and medial hamstrings) during forward- and side-lunge, single-leg-stance, and single-leg-squat exercises. Subjects were instructed during each exercise to move into the test position and to hold that position for 15 s. EMG was recorded during the 15-s isometric period where subjects tried to maintain a “set” position while the foot was on a balance board. Analysis of variance was used for statistical analysis.


There was a significant exercise-by-gender interaction for Q:H ratio (F3,48 = 6.63, P = .001), but the exercise-by-gender interaction for M:L ratio was not significant (F3,48 = 1.67, P = .18). Women showed larger Q:H ratio in side-lunge exercises than men (P = .002). Both genders showed larger M:L and lower Q:H ratio in a single-leg-stance exercise than in the other exercises.


The results indicate that the forward- and side-lunge and single-leg-squat exercises should not be recommended as exercise where a balanced coactivation between quadriceps and hamstring muscles is warranted. Single-leg-stance exercise could be used when seeking an exercise where the ratio is balanced for both women and men.

Harput and Ergun are with the Dept of Physiotherapy and Rehabilitation, and Soylu, the Dept of Biophysics, Hacettepe University, Ankara, Turkey. Ertan is with the Faculty of Sport Sciences, Anadolu University, Anadolu University, Eskisehir, Turkey. Mattacola is with the Div of Athletic Training, University of Kentucky, Lexington, KY.