Table 5

Strength as a RTS criterion

Studies reporting,
n (%)
Strength tests used as RTS criteria86 (41 of 209)
Isokinetic testing 50 (58 of 86)
LSI ≥90% 11 (22 of 50)
 Quadriceps and hamstring strength at 60°/s1 (2 of 50)
 Quadriceps and hamstring strength at 180°/s1 (2)
 Quadriceps and hamstring strength at 60°/s and 180°/s2 (4)
 Quadriceps and hamstring strength at 90°/s and 180°/s1 (2)
 Quadriceps and hamstring strength at 180°/s and 300°/s1 (2)
 Quadriceps and hamstring strength at 60°/s, 180°/s and 240°/s1 (2)
 Quadriceps and hamstring strength at 60°/s, 180°/s and 300°/s2 (4)
 Strength (parameters not stated)2 (4)
LSI ≥85% 9 (18 of 50)
 Quadriceps and hamstring strength at 60°/s1 (2 of 50)
 Quadriceps and hamstring strength at 120°/s1 (2)
 Quadriceps and hamstring strength at 60°/s and 180°/s2 (4)
 Quadriceps and hamstring strength at 90°/s and 240°/s1 (2)
 Quadriceps and hamstring strength (parameters not stated)4 (8)
LSI ≥80% 11 (22 of 50)
 Quadriceps and hamstring strength at 60°/s3 (6 of 50)
 Quadriceps and hamstring strength at 90°/s2 (4)
 Quadriceps and hamstring strength at 60°/s and 180°/s1 (2)
 Quadriceps and hamstring strength at 80°/s and 160°/s1 (2)
 Quadriceps strength at 60°/s, 180°/s and 240°/s2 (4)
 Quadriceps and hamstring strength (parameters not stated)2 (4)
LSI ≥65% 1 (2 of 50)
 Quadriceps strength1 (2 of 50)
Multiple LSI criteria 6 (12 of 50)
 Quadriceps LSI ≥85%; hamstring LSI ≥90%; H/Q ratio ≥70% at 60°/s, 180°/s and 300°/s1 (2 of 50)
 Quadriceps and hamstring LSI ≥90% at 60°/s, 180°/s and 300°/s; normalised isokinetic quadriceps strength ≥3 Nm/kg at 60°/s; H/Q ratio ≥55% for females and ≥62.5% for males at 300°/s1 (2)
 Quadriceps and hamstring LSI ≥90% at 60°/s, 180°/s and 300°/s; H/Q ratio ≥55% for females and ≥62.5% for males at 300°/s1 (2)
 Quadriceps strength of LSI≥90% and hamstring strength of LSI=100% at 60°/s and 300°/s1 (2)
 ‘Good muscular… recovery’ of quadriceps and hamstring strength; H/Q ratio between 40%–80% (parameters not stated)1 (2)
 Eccentric or concentric hamstring strength LSI ≥80% and quadriceps strength of LSI=100%1 (2)
Criteria not clearly stated 12 (24 of 50)
 Quadriceps and hamstring strength at 60°/s3 (2 of 50)
 Quadriceps and hamstring strength at 180°/s1 (2)
 Quadriceps and hamstring strength at 60°/s and 180°/s1 (2)
 Quadriceps and hamstring strength at 60°/s and 240°/s2 (4)
 Quadriceps and hamstring strength at 90°/s and 230°/s2 (4)
 Quadriceps and hamstring strength at 180°/s and 230°/s1 (2)
 Quadriceps and hamstring strength at 60°/s, 120°/s and 180°/s1 (2)
 Quadriceps and hamstring strength at 60°/s, 180°/s, 300°/s; internal rotation and external rotation strength at 60°/s, 120°/s and 180°/s1 (2)
Isometric testing 8 (9 of 86)
LSI ≥90% 5 (63 of 8)
 Quadriceps strength at 60° of knee flexion1 (13 of 8)
 Quadriceps strength at 90° of knee flexion1 (13)
 Quadriceps burst superimposition strength2 (25)
 Isometric leg press testing1 (13)
LSI ≥85% 1 (13 of 8)
 Quadriceps and hamstring strength at 30° of knee flexion1 (13 of 8)
LSI ≥80% 2 (25 of 8)
 Quadriceps strength at 90° of knee flexion1 (13 of 8)
 Hamstring strength at 70° and 90° of knee flexion in prone and supine positions1 (13)
Method of testing not clearly stated 25 (29 of 86)
 Full strength1 (1 of 86)
 Close to full strength2 (2)
 Quadriceps strength of LSI ≥90%2 (2)
 Muscle strength of LSI ≥90%2 (2)
 Quadriceps and hamstring strength of LSI ≥90%2 (2)
 Quadriceps and hamstring strength of LSI ≥85%1 (1)
 Quadriceps strength of LSI ≥85%2 (2)
 Thigh strength of LSI ≥85%1 (1)
 Quadriceps strength of LSI ≥80%1 (1)
 Quadriceps strength of LSI ≥80% and normal hamstring strength1 (1)
 Adequate quadriceps and hamstring strength1 (1)
 Good quadriceps function1 (1)
 Adequate strength2 (2)
 Functional strength1 (1)
 Proper muscular conditioning1 (1)
 Complete muscular recovery1 (1)
 Full functional stability in terms of strength1 (1)
 Regained strength1 (1)
 Leg press test demonstrating comparable strength to uninvolved lower extremity1 (1)
Predetermined benchmark 5 (6 of 86)
 Leg press for >15 reps at 100% BW of affected limb5 (6 of 86)
  • References in online appendix III.

  • BW, body weight; H/Q ratio, hamstring/quadriceps ratio; LSI, limb symmetry index ; BW, body weight; H/Q ratio, hamstring/quadriceps ratio; RTS, return to sport.