The Flexor Pollicis Longus Reflex – Inter- and Intra-Rater Reliability in Comparison to Established Muscle Stretch Reflexes

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Luisa Marilena Schäck ◽  
Thomas Schöttker-Königer ◽  
Christian Sturm ◽  
Christoph Gutenbrunner ◽  
Alexander Ranker
Keyword(s):  
Flexor Pollicis Longus ◽  
Muscle Stretch ◽  
Stretch Reflexes ◽  
Rater Reliability

scholarly journals Improving the Neurological Exam Skills of Medical Students

2012 ◽  
Vol 39 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Fraser G. A. Moore ◽  
Colin Chalk
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Distributed Practice ◽  
First Year ◽  
Muscle Stretch ◽  
Stretch Reflexes ◽  
Class A ◽  
Class B ◽  
Neurological Exam ◽  
Second Year

Objective:Determine if distributed practice of neurological exam (NE) skills in first year medical school produces sustained improvements in the skills of second year students.Methods:A prospective, controlled, non-blinded study conducted at McGill University (class size = 180 students). Expanded teaching of muscle stretch reflexes was provided to first year medical students. A structured examination of muscle stretch reflexes (max score = 100) was administered in second year medical school after a required two week rotation in Neurology. Results for class A (received the intervention in first year) were compared to the results for the preceding class B (had not received the intervention).Results:77 of 177 (44%) eligible students in class A and 69 of 166 (42%) eligible students in class B participated. Results were analyzed separately for each of two examiners. Mean (SD) scores were 95.2 (5.6) for class A (intervention) and 81.7 (11.1) for class B (control) for the first examiner and 90.4 (8.2) for class A and 83.8 (11.7) for class B for the second examiner. Results were statistically significant (Mann-Whitney test z = 5.27, p < 0.0001 first examiner and z = 2.67, p < 0.0038 second examiner).Conclusions:Distributed practice of muscle stretch reflexes during first year medical school results in improved performance by second year medical students after their mandatory clinical rotation in neurology, even when examined up to 14 months after the intervention. This finding has implications for the teaching of the NE.

Impairment of Muscle Stretch Reflexes in Tick Paralysis

Science ◽  
1960 ◽  
Vol 132 (3432) ◽  
pp. 958-959 ◽  
Author(s):  
D. W. Esplin ◽  
C. B. Philip ◽  
L. E. Hughes
Keyword(s):  
Muscle Stretch ◽  
Stretch Reflexes ◽  
Tick Paralysis

scholarly journals Functional assessment of stretch hyperreflexia in children with cerebral palsy using treadmill perturbations

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Eline Flux ◽  
Marjolein M. van der Krogt ◽  
Jaap Harlaar ◽  
Annemieke I. Buizer ◽  
Lizeth H. Sloot
Keyword(s):  
Cerebral Palsy ◽  
Construct Validity ◽  
Muscle Activity ◽  
Treatment Evaluation ◽  
Calf Muscle ◽  
Muscle Stretch ◽  
Stretch Reflexes ◽  
Gastrocnemius Medialis ◽  
Children With Cerebral Palsy ◽  
Spatiotemporal Parameters

Abstract Background As hyperactive muscle stretch reflexes hinder movement in patients with central nervous system disorders, they are a common target of treatment. To improve treatment evaluation, hyperactive reflexes should be assessed during activities as walking rather than passively. This study systematically explores the feasibility, reliability and validity of sudden treadmill perturbations to evoke and quantify calf muscle stretch reflexes during walking in children with neurological disorders. Methods We performed an observational cross-sectional study including 24 children with cerebral palsy (CP; 6–16 years) and 14 typically developing children (TD; 6–15 years). Short belt accelerations were applied at three different intensities while children walked at comfortable speed. Lower leg kinematics, musculo-tendon lengthening and velocity, muscle activity and spatiotemporal parameters were measured to analyze perturbation responses. Results We first demonstrated protocol feasibility: the protocol was completed by all but three children who ceased participation due to fatigue. All remaining children were able to maintain their gait pattern during perturbation trials without anticipatory adaptations in ankle kinematics, spatiotemporal parameters and muscle activity. Second, we showed the protocol’s reliability: there was no systematic change in muscle response over time (P = 0.21–0.54) and a bootstrapping procedure indicated sufficient number of perturbations, as the last perturbation repetition only reduced variability by ~ 2%. Third, we evaluated construct validity by showing that responses comply with neurophysiological criteria for stretch reflexes: perturbations superimposed calf muscle lengthening (P < 0.001 for both CP and TD) in all but one participant. This elicited increased calf muscle activity (359 ± 190% for CP and 231 ± 68% for TD, both P < 0.001) in the gastrocnemius medialis muscle, which increased with perturbation intensity (P < 0.001), according to the velocity-dependent nature of stretch reflexes. Finally, construct validity was shown from a clinical perspective: stretch reflexes were 1.7 times higher for CP than TD for the gastrocnemius medialis muscle (P = 0.017). Conclusions The feasibility and reliability of the protocol, as well as the construct validity—shown by the exaggerated velocity-dependent nature of the measured responses—strongly support the use of treadmill perturbations to quantify stretch hyperreflexia during gait. We therefore provided a framework which can be used to inform clinical decision making and treatment evaluation.

Limbs and Trunk

2016 ◽  
pp. 83-108
Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift
Keyword(s):  
Physical Examination ◽  
Position Sense ◽  
Joint Position Sense ◽  
Sensory Loss ◽  
Joint Position ◽  
Vibration Sense ◽  
Muscle Stretch ◽  
Stretch Reflexes ◽  
Patient’S History

This chapter emphasizes various clues apparent from the patient’s history and physical examination. Observation of how a patient walks, talks, and undresses is discussed as a means of discerning clues to a diagnosis. Miscellaneous aspects of the history, particularly sensory symptoms, such as tingling in the hands, feet, and face, shooting leg pains, and neuropathy are described, and clues to psychogenic disorder are elaborated. Also emphasized is the value of inspecting the limbs, skin, and joints. Shortcuts are listed for the traditional physical motor examination, which involves tone, power, coordination, muscle stretch reflexes, and Babinski response. Shortcuts are also described for the sensory examination, using joint position sense, vibration sense, and sensory loss. The chapter concludes with an outline of how to analyze coma.

Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) with chronic cough and preserved muscle stretch reflexes: evidence for selective sparing of afferent Ia fibres

2018 ◽  
Vol 265 (6) ◽  
pp. 1454-1462 ◽  
Author(s):  
Jon Infante ◽  
Antonio García ◽  
Karla M. Serrano-Cárdenas ◽  
Rocío González-Aguado ◽  
José Gazulla ◽  
...  
Keyword(s):  
Cerebellar Ataxia ◽  
Chronic Cough ◽  
Muscle Stretch ◽  
Stretch Reflexes ◽  
Ia Fibres

Notes on Variations in Muscle Stretch Reflexes in Relation to Tremor in Parkinsonism

2009 ◽  
Vol 141 (4) ◽  
pp. 301-304 ◽  
Author(s):  
K. A. EKBOM ◽  
B. JERNELIUS ◽  
E. KUGELBERG
Keyword(s):  
Muscle Stretch ◽  
Stretch Reflexes
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