Strength and cross-sectional area of human skeletal muscle.

The maximum voluntary force (strength) which could be produced by the knee-extensor muscles, with the knee held at a right angle, was measured in a group of healthy young subjects comprising twenty-five males and twenty-five females. Both legs were tested: data from the stronger leg only for each subject were used in the present study. Computed tomography was used to obtain a cross-sectional image of the subjects' legs at mid-thigh level, measured as the mid-point between the greater trochanter and upper border of the patella. The cross-sectional area of the knee-extensor muscles was determined from the image obtained by computer-based planimetry. The subjects' height and weight were measured. An estimate of body fat content was obtained from measurements of skinfold thicknesses and used to calculate lean body mass. Male subjects were taller (P less than 0.001), heavier (P less than 0.001), leaner (P less than 0.001) and stronger (P less than 0.001) than the female subjects. No significant correlation was found to exist between strength of the knee-extensor muscles and body weight in the male or in the female subjects. In the male subjects, but not in the female group, there was a positive correlation (r = 0.50; P less than 0.01) between strength and lean body mass. Muscle cross-sectional area of the male subjects was greater than that of the female subjects (P less than 0.001). The ratio of strength to cross-sectional area for the male was 9.49 +/- 1.34 (mean +/- S.D.). This is greater but not significantly so, than that for females (8.92 +/- 1.11). In both male and female groups, there was a significant (P less than 0.01) positive correlation between muscle strength and cross-sectional area. A wide variation in the ratio of strength to muscle cross-sectional area was observed. This variability may be a result of anatomical differences between subjects or may result from differences in the proportions of different fibre types in the muscles. The variation between subjects is such that strength is not a useful predictive index of muscle cross-sectional area.