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Of these, 1666 met inclusion criteria for the current study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Not applicable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure(s)<\/jats:title><jats:p>Quadriceps strength; percentage of combined hamstring coactivation (HC), medial HC, and lateral HC. Quadriceps and hamstring strength were assessed using an isokinetic dynamometer. Surface electromyography was used to assess muscle activation patterns. General linear models, adjusted for age, BMI, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Kellgren\u2010Lawrence (KL) grade and study site, modeled the relationship between antagonist hamstring coactivation and quadriceps strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Men had significantly greater quadriceps strength (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), history of knee injury (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and surgery (<jats:italic>P<\/jats:italic>\u2009=\u2009.002), and greater presence of varus malalignment (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Women had greater pain (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and proportion of KL grade \u22652 (<jats:italic>P<\/jats:italic>\u2009=\u2009.017). Gender\u2010specific analyses revealed combined HC (<jats:italic>P<\/jats:italic>\u2009=\u2009.013) and lateral HC inversely associated with quadriceps strength in women (<jats:italic>P<\/jats:italic>\u2009=\u2009.023) but not in men (combined HC <jats:italic>P<\/jats:italic>\u2009=\u2009.320, lateral HC <jats:italic>P<\/jats:italic>\u2009=\u2009.755). A nonlinear association was detected between quadriceps strength and medial HC. Assessment of quartiles of medial HC revealed the third quartile had reduced quadriceps strength when compared to the lowest quartile of coactivation in both men and women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hamstring coactivation attenuates measured quadriceps strength in women with or at elevated risk for KOA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>II.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12253","type":"journal-article","created":{"date-parts":[[2019,10,4]],"date-time":"2019-10-04T23:09:44Z","timestamp":1570230584000},"page":"470-478","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Influence of Antagonistic Hamstring Coactivation on Measurement of Quadriceps Strength in Older Adults"],"prefix":"10.1002","volume":"12","author":[{"given":"Jason\u2010Flor","family":"Sisante","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The University of Kansas  Kansas City KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Wang","sequence":"additional","affiliation":[{"name":"Section of Rheumatology Boston University  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Felson","sequence":"additional","affiliation":[{"name":"Section of Rheumatology Boston University  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Nevitt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California San Francisco  San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Alabama at Birmingham  Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Frey\u2010Law","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science The University of Iowa  Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8294-080X","authenticated-orcid":false,"given":"Neil A.","family":"Segal","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The University of Kansas  Kansas City KS"},{"name":"Department of Epidemiology The University of Iowa  Iowa City IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Multicenter Osteoarthritis Study (MOST) 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