Effect of Quadriceps Muscle Strengthening Exercise on Quadriceps and Hamstring Muscle Strength Ratio in Patients with Osteoarthritis Grade 2 and 3

Thomas Sintong Pratama Purba, Marina Annette Moeliono, Sunaryo Barki Sastradimadja


Objective: To evaluate the effect of quadriceps muscle strengthening exercise on quadriceps and hamstring strength ratio in knee osteoarthritis (OA).

Methods: This was a quantitative study with quasi-experimental design. The subjects in the study were 16 female patients with knee OA grade 2 and 3. Quadriceps muscle strengthening exercise was given to the subjects 3 times a week during 8 weeks. The study was conducted at the Department of Physical Medicine and Rehabilitation of the Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital in August–September 2015.

Results: It was revealed that the quadriceps muscles improved significantly. However, the hamstring muscles did not show significant improvement based on the comparison between before and after performing the exercise. The average right quadriceps muscle strength before exercise was 12.46 and after exercise was 18. The average left quadriceps muscle strength before and after exercise were 11.59 and 17.7, respectively. The average right hamstring muscle strength before and after exercise were 7.29 and 7.94, respectively.

Conclusions: There are quadriceps muscle strength improvements after practicing quadriceps muscle strengthening exercise. However, no significant hamstring muscle strength improvement is seen after practicing quadriceps muscle strengthening exercise. An improvement in quadriceps and hamstring muscle ratio is observed.

Keywords: Osteoarthritis, quadriceps and hamstring muscle strength ratio, quadriceps muscle strengthening exercise


DOI: 10.15850/ijihs.v5n2.1041



Osteoarthritis, quadriceps and hamstring muscle strength ratio, quadriceps muscle strengthening exercise

Full Text:



Kingsbury SR, Gross HJ, Isherwood G, Conaghan PG. Osteoarthritis in Europe: impact on health status, work productivity and use of pharmacotherapies in five European countries. Rheumatology. 2014;53(5):937–47.

Hafez AR, Al-Johani AH, Zakaria AR, Al-Ahaideb A, Buragadda S, Melam GR, et al. Treatment of knee osteoarthritis in relation to hamstring and quadriceps strength. J Phys Ther Sci. 2013;25(11):1401–5.

Segal NA, Glass NA, Torner J, Yang M, Felson DT, Sharma L, et al. Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort. Osteoarthritis Cartilage. 2010;18(8):769–75.

Brandt KD, Dieppe P, Radin E. Etiopathogenesis of osteoarthritis. Med Clin North Am. 2009;93(1):1–24.

Palmieri-Smith RM, McLean SG, Ashton-Miller JA, Wojtys EM. Association of quadriceps and hamstrings cocontraction patterns with knee joint loading. J Athl Train. 2009;44(3):256–63.

Adegoke BOA, Mordi EL, Akinpenlu OA, Jaiyesimi AO. Isotonic quadriceps-hamstring strength ratios of patients with knee osteoarthritis and apparently healthy controls. Afr J Biomed Res. 2007;10(2):211–6.

Bennell KL, Hinman RS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport. 2011;14(1):4–9.

Zhang Y, Jordan J. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355–69.

Hämäläinen S, Solovieva S, Vehmas T, Luoma K, Leino-Arjas P, Hirvonen A. Genetic influences on hand osteoarthritis in Finnish women – a replication study of candidate genes. PLos One [serial on the internet]. 2014 May [cited 2016 Dec 12];9(5):[about 11p.]. Available from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0097417.

Hafez AR, Alenazi AM, Kachanathu AJ, Alroumi AM, Mohamed ES. Knee osteoarthritis: a review of literature. Phys Med Rehabil Int [serial on the internet]. 2014 May [cited 2016 Dec 12];1(5):[about 8p.]. Available from: http://austinpublishinggroup.com/physical-medicine/fulltext/pmr-v1-id1021.php#Introduction.

Blumenfeld O, Williams FMK, Hart DJ, Arden NK, Spector TD, Livshits G. Lower limbs composition and radiographic knee osteoarthritis (RKOA) in Chingford sample—A longitudinal study. Arch Gerontol Geriatr. 2012;56(1):148–54.

Henriksen M, Christensen R, Danneskiold-Samsøe B, Bliddal H. Changes in lower extremity muscle mass and muscular strength after weight loss in obese patients with knee osteoarthritis: a prospective cohort study. Arthritis Rheum. 2012;64(2):438–42.

Lohmander LS, Gerhardsson de Verdier M, Rollof J, Nilsson PM, Engström G. Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study. Ann Rheum Dis. 2009;68(4):490–6.

Mayer F, Scharhag-Rosenberger F, Carlsohn A, Cassel M, Müller S, Scharhag J. The intensity and effects of strength training in the elderly. Dtsch Arztebl Int. 2011;108(21):359–64.

Aguiar GC, Do Nascimento MR, De Miranda AS, Rocha NP, Teixeira AL, Scalzo PL. Effects of an exercise therapy protocol on inflammatory markers, perception of pain, and physical performance in individuals with knee osteoarthritis. Rheumatol Int. 2015;35(3):525–31.

Bressel E, Wing JE, Miller AI, Dolny DG. High-intensity interval training on an aquatic treadmill in adults with osteoarthritis: effect on pain, balance, function, and mobility. J Strength Cond Res. 2014;28(8):2088–96.

Kisner C, Colby LA. Therapeutic exercise: foundations and techniques. 6th ed. Philadelphia: F.A. Davis; 2012.

Kingma I, Aalbersberg S, van Dieen JH. Are hamstrings activated to counteract shear forces during isometric knee extension efforts in healthy subjects? J Electromyogr Kinesiol. 2004;14(3):307–15.

Hortobágyi T, Westerkamp L, Beam S, Moody J, Garry J, Holbert D, et al. Altered hamstring-quadriceps muscle balance in patients with knee osteoarthritis. Clin Biomech (Bristol, Avon). 2005;20(1):97–104.

Wang H, Ji Z, Jiang G, Liu W, Jiao X. Correlation among proprioception, muscular strength, and balance. J Phys Ther Sci. 2016;28(12):3468–72.

Article Metrics

Abstract view : 2611 times
PDF - 595 times


This Journal indexed by



Creative Commons License
IJIHS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

View My Stats