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2012 | 35 | 1 | 5-13

Article title

Alternating Consecutive Maximum Contraction as a Test of Muscle Function in Athletes Following ACL Reconstruction


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The novel test based on isometric alternating consecutive maximal contractions performed by two antagonisticmuscles has been recently proposed as a test of muscle function in healthy subjects. The aim of this study was toevaluate reliability and sensitivity of a novel test as a test of knee muscles function in athletes recovering from anteriorcruciate ligament reconstruction. Fifteen male athletes with recent ligament reconstruction (4.0 ± 0.1 months followingthe surgery) and 15 sport and physical education students participated in the study. Peak torques of the quadriceps andhamstring muscles assessed both through the alternating consecutive maximal contractions and standard isokinetic testperformed at 60 º/s and 180 º/s served for calculation of the hamstrings-to-quadriceps ratio and the bilateral differencein strength. When applied on individuals recovering from anterior cruciate ligament reconstruction, the novel testrevealed a high within-day reliability and sensitivity for detecting imbalances both between antagonistic and betweencontralateral muscles. The present findings suggest that alternating consecutive maximal contractions could be used asa test of muscle function that is either complementary or alternative to the isokinetic test, particularly in thelaboratories where the isokinetic devices are not available. Potential advantages of the novel test could be both a brieftesting procedure and a possibility to conduct it using relatively inexpensive devices such as custom made kitscontaining a single one-axis force transducer.










Physical description


1 - 12 - 2012
26 - 01 - 2013


  • University of Belgrade, Faculty of Sport and Physical Education, Belgrade, Serbia.
  • University of Belgrade, Institute for Medical Research, Belgrade, Serbia.
  • University of Belgrade, Faculty of Sport and Physical Education, Belgrade, Serbia.
  • Clinical Centre of Serbia, Institute for Orthopaedic Surgery and Traumatology, Belgrade, Serbia.
  • Clinical Centre of Serbia, Institute for Orthopaedic Surgery and Traumatology, Belgrade, Serbia.
  • University of Delaware, Department of Kinesiology and Applied Physiology, Newark, DE, USA.


  • Ageberg E, Thomee R, Neeter C, Silbernagel KG, Roos EM. Muscle strength and functional performance in patients with anterior cruciate ligament injury treated with training and surgical reconstruction or training only: a two to five-year followup. Arthritis Rheum, 2008; 59: 1773-1779[WoS][Crossref]
  • Anderson JL, Lamb SE, Barker KL, Davies S, Dodd CA, Beard DJ. Changes in muscle torque following anterior cruciate ligament reconstruction: a comparison between hamstrings and patella tendon graft procedures on 45 patients. Acta Orthop Scand, 2002; 73: 546-552[Crossref][PubMed]
  • Bozic P, Suzovic D, Nedeljkovic A, Jaric S. Alternating consecutive maximum contractions as a test of muscle function. J Strength Cond Res, 2011; 25: 1605-1615[WoS][Crossref][PubMed]
  • Bozic PR, Pazin N, Berjan B, Jaric S. Evaluation of alternating consecutive maximum contractions as an alternative test of neuromuscular function. Eur J Appl Physiol, 2012; 112: 1445-1456[Crossref][PubMed][WoS]
  • Coombs R, Garbutt G. Developments in the use of the Hamstring/Quadriceps ratio for hte assessment of muscle balance. J Sports Sci Med, 2002; 1: 56-62
  • Dvir Z. Isokinetics: muscle testing, interpretation, and clinical applications. Edinburgh: Churchill Livigstone, 138:154; 1995
  • Harding B, Black T, Bruulsema A, Maxwell B, Stratford PW. Reliability of a reciprocal test protocol performed on the kinetic communicator: an isokinetic test of knee extensor and flexor strength. J Orthop Sports Phys Ther, 1988; 10: 218-223[Crossref]
  • Hartigan EH, Zeni J Jr, Di Stasi S, Axe MJ, Snyder-Mackler L. Preoperative Predictors for Non-Copers to Pass Return to Sports Criteria After ACL Reconstruction. J Appl Biomech, 2012; 28: 366-373
  • Hiemstra LA, Webber S, MacDonald PB, Kriellaars DJ. Hamstring and quadriceps strength balance in normal and hamstring anterior cruciate ligament-reconstructed subjects. Clin J Sport Med, 2004; 14: 274-280[PubMed][Crossref]
  • Holcomb WR, Rubley MD, Lee HJ, Guadagnoli MA. Effect of hamstring-emphasized resistance training on hamstring:quadriceps strength ratios. J Strength Cond Res, 2007; 21: 41-47[PubMed]
  • Hopkins WG. Measures of reliability in sports medicine and science. Sports Med, 2000; 30: 1-15[PubMed][Crossref]
  • Impellizzeri FM, Bizzini M, Rampinini E, Cereda F, Maffiuletti NA. Reliability of isokinetic strength imbalance ratios measured using the Cybex NORM dynamometer. Clin Physiol Funct Imaging, 2008; 28: 113-119[PubMed][WoS][Crossref]
  • Jaric S. Muscle strength testing: use of normalization for body size. Sports Med, 2002; 32: 615-631[Crossref]
  • Jaric S, Radosavljevic-Jaric S, Johansson H. Muscle force and muscle torque in humans require different methods when adjusting for differences in body size. Eur J Appl Physiol, 2002; 87: 304-307[Crossref][PubMed]
  • Kadija M, Knezevic O, Milovanovic D, Bumbasirevic M, Mirkov D. Effect of isokinetic dynamometer velocity on muscle strength deficit in elite athletes after ACL reconstruction. Med Sport, 2010; 63: 495-507
  • Kannus P. Peak torque and total work relationship in the thigh muscles after anterior cruciate ligament injury. J Orthop Sports Phys Ther, 1988; 10: 97-101[Crossref]
  • Kannus P. Ratio of hamstring to quadriceps femoris muscles' strength in the anterior cruciate ligament insufficient knee. Relationship to long-term recovery. Phys Ther, 1988; 68: 961-965
  • Keays SL, Bullock-Saxton J, Keays AC, Newcombe P. Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendonosus and gracilis. Knee, 2001; 8: 229-234[Crossref][PubMed]
  • Kobayashi A, Higuchi H, Terauchi M, Kobayashi F, Kimura M, Takagishi K. Muscle performance after anterior cruciate ligament reconstruction. Int Orthop, 2004; 28: 48-51[PubMed][Crossref]
  • Kvist J, Karlberg C, Gerdle B, Gillquist J. Anterior tibial translation during different isokinetic quadriceps torque in anterior cruciate ligament deficient and nonimpaired individuals. J Orthop Sports Phys Ther, 2001; 31: 4-15[Crossref]
  • Latash ML. Neurophysiological basis of movement. Champaign, Illinois, Human Kinetics; 2008
  • Lautamies R, Harilainen A, Kettunen J, Sandelin J, Kujala UM. Isokinetic quadriceps and hamstring muscle strength and knee function 5 years after anterior cruciate ligament reconstruction: comparison between bone-patellar tendon-bone and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc, 2008; 16: 1009-1016[WoS][PubMed]
  • Moisala AS, Jarvela T, Kannus P, Jarvinen M. Muscle strength evaluations after ACL reconstruction. Int J Sports Med, 2007; 28: 868-872[Crossref][PubMed]
  • Montgomery LC, Douglass LW, Deuster PA. Reliability of an isokinetic test of muscle strength and endurance. J Orthop Sports Phys Ther, 1989; 10: 315-322[Crossref]
  • Myer GD, Ford KR, Barber Foss KD, Liu C, Nick TG, Hewett TE. The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes. Clin J Sport Med, 2009; 19: 3-8[WoS][Crossref][PubMed]
  • Myer GD, Paterno MV, Ford KR, Hewett TE. Neuromuscular training techniques to target deficits before return to sport after anterior cruciate ligament reconstruction. J Strength Cond Res, 2008; 22: 987-1014[PubMed][Crossref][WoS]
  • Ostenberg A, Roos E, Ekdahl C, Roos H. Isokinetic knee extensor strength and functional performance in healthy female soccer players. Scand J Med Sci Sports, 1998; 8: 257-264[Crossref][PubMed]
  • Pua YH, Bryant AL, Steele JR, Newton RU, Wrigley TV. Isokinetic dynamometry in anterior cruciate ligament injury and reconstruction. Ann Acad Med Singapore, 2008; 37: 330-340[PubMed]
  • Suzovic D, Nedeljkovic A, Pazin N, Planic N, Jaric S. Evaluation of Consecutive Maximum Contractions as a Test of Neuromuscular Function. J Hum Kinet, 2008; 20: 51-67
  • Zemach L, Almoznino Y, Barak Y, Dvir Z. Quadriceps insufficiency in patients with knee compromise: How many velocities should an iskokinetic test protocol constist of? Isokinet Exerc Sci, 2009; 17: 129-133[WoS]

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