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The aim of this study was to determine the association between low back pain and the strength of knee flexor and extensor muscles in Lithuanian National Defence Volunteer Forces personnel.
This cross-sectional study investigated the association between low back pain (LBP) and the hamstring-to-quadriceps (H/Q) strength ratio in personnel of the Lithuanian National Defence Volunteer Forces. Active-duty volunteers with and without LBP underwent isokinetic testing of knee flexor and extensor muscle strength using a Biodex System 4 Pro dynamometer at angular velocities of 60°/s and 120°/s. Hamstring strength, quadriceps strength, H/Q ratios, and inter-limb asymmetries were assessed to explore potential associations with low back pain in this military population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Military personnel | Targeted population of Lithuanian National Defence Volunteer Forces personnel |
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| Measure | Description | Time Frame |
|---|---|---|
| Low back pain prevalence | Participants were asked whether they had experienced low back pain during the past 12 months (yes/no). Participants who responded "yes" were classified into the low back pain group. | Baseline |
| Low back pain intensity | LBP intensity was assessed using the Visual Analogue Scale (VAS, 0-10) , where 0 - no pain, and 10 - worst imaginable pain. | Baseline |
| Low back pain duration | Participants were asked to indicate LBP duration. LBP pain duration was classified as acute (<3 months) or chronic (≥3 months) | Baseline |
| Muscle strength peak torque | Muscle strength was assessed using the Biodex System 4 isokinetic dynamometer. Participants were instructed to avoid vigorous physical activity 24 hours before testing and refrain from eating for at least 2 hours prior to assessment. A 10-minute warm-up on a cycle ergometer (50-60 W) and light dynamic exercises were performed before testing. Participants were seated with the backrest at 85° and hip flexion at 90°. The dynamometer axis was aligned with the lateral femoral epicondyle, and the lower leg was secured 2-3 cm above the ankle. The range of motion was set from 70° knee flexion to full extension. The trunk and tested limb were stabilized using straps. Testing included 5 repetitions at 60°/s and 10 repetitions at 120°/s, with a 30-second rest interval between sets. Prior to testing, participants performed 3-5 familiarization repetitions. Peak torque normalized to body weight (Nm/kg) was recorded. | Baseline |
| Average torque | Was measured in Nm | Baseline |
| Muscle power |
| Measure | Description | Time Frame |
|---|---|---|
| Previous injuries | Participants were asked whether they had lumbar or lower limb injuries during the past 12 months that could influence the results (yes / no). | Baseline |
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Inclusion Criteria:
Exclusion Criteria:
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The study population included active-duty Lithuanian National Defence Volunteer Forces personnel recruited for participation in this cross-sectional analysis
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of health promotion and rehabilitation | Kaunas | LT | 44221 | Lithuania |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41107932 | Background | Dudoniene V, Zemaitis E. Prevalence and risk factors of low back pain among Lithuanian national defense volunteer forces. BMC Musculoskelet Disord. 2025 Oct 17;26(1):978. doi: 10.1186/s12891-025-09235-1. |
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Individual participant data (IPD) will not be publicly shared due to ethical and privacy restrictions related to participant confidentiality and informed consent agreements.Military personnel is sensitive
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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in W |
| Baseline |
| Body weight | Measured in kg | Baseline |
| Body height | Measured in meters | Baseline |
| Age | Measured in years | Baseline |
| D013568 |
| Pathological Conditions, Signs and Symptoms |