Rectus femoris muscle thickness and cross-sectional area on ultrasonography may predict isometric and isokinetic knee extension strength: A cross-sectional study

Şekir U., Can Yalaki U., Akova B.

Spor Hekimliği Dergisi, vol.57, no.1, pp.1-57, 2022 (Peer-Reviewed Journal) identifier

  • Publication Type: Article / Article
  • Volume: 57 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.47447/tjsm.0585
  • Journal Name: Spor Hekimliği Dergisi
  • Journal Indexes: TR DİZİN (ULAKBİM)
  • Page Numbers: pp.1-57
  • Bursa Uludag University Affiliated: Yes


Objective: To examine the relationship between knee extensor strength and quadriceps muscle architecture evaluated with ultrasonography during relaxed and contracted situations. Materials and Methods: A total of 40 healthy participants (age range 18-40), doing sports at a recreational level were included. Pennation angle, muscle thickness, and cross-sectional area of the vastus medialis, vastus lateralis, and rectus femoris muscles were measured firstly during rest while participants are sitting on an isokinetic dynamometer with their knees at 0° and 60° of flexion. Thereafter, ultrasound evaluations were performed during maximal isometric contraction at 60° knee flexion and maximal isokinetic contraction at 30°/sec and 60°/sec speeds. The architectural parameters were correlated with peak isometric (measured at 60° knee flexion) and isokinetic (measured at 30°/sec and 60°/sec angular velocities) torque values. Results: Pennation angle (p<0.001), muscle thickness (p<0.001) and muscle cross-sectional area (p<0.001) of the vastus medialis muscle during rest, and isometric and isokinetic maximal contractions were higher than the vastus lateralis and rectus femoris muscles. Pennation angle, muscle thickness and muscle cross-sectional area parameters measured during rest, and isometric and isokinetic maximal contractions in the vastus medialis (r=0.39-0.64, p<0.05-0.01) and vastus lateralis (r=0.36-0.68, p<0.05-0.01) showed weak to moderate correlations with isometric and isokinetic peak torque. In rectus femoris muscle, on the other hand, except the weak correlation in pennation angle (r=0.35-0.49, p<0.05-0.01), muscle thickness (r=0.74-0.80, p<0.001) and cross-sectional area (r=0.71-0.80, p<0.001) had a moderate to strong correlation with isometric and isokinetic strength. Stepwise regression analysis indicated that rectus femoris cross-sectional area measured during knee relaxed at 60° flexion (R2=0.532-0.610) and rectus femoris muscle thickness measured during isometric and isokinetic contraction modes (R2=0.538-0.600) were decisive to predict the isometric and isokinetic strength of the quadriceps muscle. Conclusion: Contrary to pennation angle, muscle thickness and cross-sectional area of the rectus femoris measured during relaxed and contracted conditions may be determinative in predicting isometric and isokinetic strength.