scholarly journals Soleus H-Reflex Change in Poststroke Spasticity: Modulation due to Body Position

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wenting Qin ◽  
Anjing Zhang ◽  
Mingzhen Yang ◽  
Chan Chen ◽  
Lijun Zhen ◽  
...  

Purpose. This study is aimed at exploring how soleus H-reflex change in poststroke patients with spasticity influenced by body position. Materials and Methods. Twenty-four stroke patients with spastic hemiplegia and twelve age-matched healthy controls were investigated. Maximal Hoffmann-reflex (Hmax) and motor potential (Mmax) were elicited at the popliteal fossa in both prone and standing positions, respectively, and the Hmax/Mmax ratio at each body position was determined. Compare changes in reflex behavior in both spastic and contralateral muscles of stroke survivors in prone and standing positions, and match healthy subjects in the same position. Results. In healthy subjects, Hmax and Hmax/Mmax ratios were significantly decreased in the standing position compared to the prone position (Hmax: p = 0.000 , Hmax/Mmax: p = 0.016 ). However, Hmax/Mmax ratios were increased in standing position on both sides in poststroke patients with spasticity (unaffected side: p = 0.006 , affected side: p = 0.095 ). The Hmax and Hmax/Mmax ratios were significantly more increased on the affected side than unaffected side irrespective of the position. Conclusions. The motor neuron excitability of both sides was not suppressed but instead upregulated in the standing position in subjects with spasticity, which may suggest that there was abnormal regulation of the Ia pathway on both sides.

Author(s):  
Yung-Sheng Chen ◽  
Shi Zhou ◽  
Zachary J. Crowley-McHattan ◽  
Pedro Bezerra ◽  
Wei-Chin Tseng ◽  
...  

This study examined the acute effects of stretch tensions of kinesiology taping (KT) on the soleus (SOL), medial (MG), and lateral (LG) gastrocnemius Hoffmann-reflex (H-reflex) modulation in physically active healthy adults. A cross-over within-subject design was used in this study. Twelve physically active collegiate students voluntarily participated in the study (age = 21.3 ± 1.2 years; height = 175.6 ± 7.1 cm; body weight = 69.9 ± 7.1 kg). A standard Y-shape of KT technique was applied to the calf muscles. The KT was controlled in three tension intensities in a randomised order: paper-off, 50%, and 100% of maximal stretch tension of the tape. The peak-to-peak amplitude of maximal M-wave (Mmax) and H-reflex (Hmax) responses in the SOL, MG, and LG muscles were assessed before taping (pre-taping), taping, and after taping (post-taping) phases in the lying prone position. The results demonstrated significantly larger LG Hmax responses in the pre-taping condition than those in the post-taping condition during paper-off KT (p = 0.002). Moreover, the ΔHmax/Mmax of pre- and post-taping in the SOL muscle was significantly larger during 50%KT tension than that of paper-off (p = 0.046). In conclusion, the stretch tension of KT contributes minor influence on the spinal motoneuron excitability in the triceps surae during rest.


1989 ◽  
Vol 62 (1) ◽  
pp. 82-95 ◽  
Author(s):  
P. D. Gamlin ◽  
J. W. Gnadt ◽  
L. E. Mays

1. To characterize the vergence signal carried by the medial longitudinal fasciculus (MLF), it was subjected to reversible blockade by small injections of 10% lidocaine hydrochloride. The effects of these blockades on both conjugate and vergence eye movements were studied. 2. With this procedure, experimentally induced internuclear ophthalmoplegia (INO) and its effects on conjugate eye movements could be studied acutely, without possible contamination from long-term oculomotor adaptation. In the eye contralateral to the MLF blockade, saccadic and horizontal smooth-pursuit eye movements were normal. Horizontal abducting nystagmus, often seen in patients with INO, was not observed in this eye. 3. As previously reported for INO, profound oculomotor deficits were seen in the eye ipsilateral to the MLF blockade. During maximal blockade, adducting saccades and horizontal smooth-pursuit movements in this eye did not cross the midline. Adducting saccades were reduced in amplitude and peak velocity and showed significantly increased durations. Abducting saccades, which were slightly hypometric, displayed a marked postsaccadic centripetal drift. 4. The eye ipsilateral to the blockade displayed a pronounced, upward, slow drift, whereas the eye contralateral to the blockade showed virtually no drift. Furthermore, although vertical saccades to visual targets remained essentially conjugate, the size of the resetting quick phases in each eye was related to the amplitude of the slow phase movement in that eye. Thus the eye on the affected side displayed large quick phases, whereas the eye on the unaffected side showed only slight movements. On occasion, unilateral downbeating nystagmus was seen. This strongly suggests that the vertical saccade generators for the two eyes can act independently. 5. The effect of MLF blockade on the vergence gain of the eye on the affected side was investigated. As a measure of open-loop vergence gain, the relationship of accommodative convergence to accommodation (AC/A) was measured before, during, and after reversible lidocaine block of the MLF. After taking conjugate deficits into account, the net vergence signal to the eye ipsilateral to the injection was found to increase significantly during the reversible blockade. 6. The most parsimonious explanation for this increased vergence signal is suggested by the accompanying single-unit study. This study showed that abducens internuclear neurons, whose axons course in the MLF, provide medial rectus motoneurons with an appropriate horizontal conjugate eye position signal but an inappropriate vergence signal. Ordinarily, this incorrect vergence signal is overcome by another, more potent, v


2020 ◽  
Vol 100 (3) ◽  
pp. 429-437
Author(s):  
Shana E Harrington ◽  
Julie Hoffman ◽  
Dimitrios Katsavelis

Abstract Background Decreased pectoralis minor muscle length is common after primary breast cancer treatment and can result in an abnormal position of the scapula. This position can contribute to shoulder pain and pathomechanics and can lead to problems such as impingement syndrome, rotator cuff tears, and frozen shoulder. Currently, there are limited reliable methods for measuring pectoralis minor length. Objective The objective of this study was to examine the reliability and validity of measuring pectoralis minor length in women diagnosed with breast cancer. Design This was a cross-sectional reliability and validity study. Methods Bilateral pectoralis minor length (in centimeters) was assessed using a palpation meter in women (N = 29) diagnosed with breast cancer by 2 licensed physical therapists who were masked to the measures. Bilateral pectoralis minor length was also measured using a motion capture system to assess validity. Results Intratester reliability (intraclass correlation coefficient, ICC [3,k] = 0.971; 95% confidence interval [CI] = 0.939–0.986; standard error of measurement [SEM] = 0.16 cm) and intertester reliability (ICC[3,k] = 0.915; 95% CI = 0.81–0.962; SEM = 0.31 cm) were excellent for the palpation meter on the affected side and the unaffected side (intratester reliability: ICC[3,k] = 0.951; 95% CI = 0.897–0.977; SEM = 0.19 cm; intertester reliability: ICC[3,k] = 0.945; 95% CI = 0.877–0.975; SEM = 0.22 cm). Significant correlations were found between the motion capture system and the palpation meter on the affected side (r = 0.87) and the unaffected side (r = 0.81). Bland-Altman plots between the palpation meter and the motion capture system demonstrated that all the measures fell within the limits of agreement. Limitations This study encountered possible errors with the accuracy of the motion capture system tracking because of the proximity of the markers and inherent volumetric restrictions. Conclusions The palpation meter is a reliable, valid, easily administered, and cost-effective tool for assessing pectoralis minor length in women with breast cancer.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zong-chen Hou ◽  
Xin Miao ◽  
Ying-fang Ao ◽  
Yue-lin Hu ◽  
Chen Jiao ◽  
...  

Abstract Purpose Muscle strength training is a common strategy for treating chronic ankle instability (CAI), but the effectiveness decreases for mechanical ankle instability (MAI) patients with initial severe ligament injuries. The purpose of this study was to investigate the characteristics and the potential predictors of muscle strength deficit in MAI patients, with a view to proposing a more targeted muscle strength training strategy. Methods A total of 220 MAI patients with confirmed initial lateral ankle ligament rupture and a postinjury duration of more than 6 months were included. All patients underwent a Biodex isokinetic examination of the ankle joints of both the affected and unaffected sides. Then, the associations between the limb symmetry index (LSI) (mean peak torque of the injury side divided by that of the healthy side) and the patients’ sex, body mass index, postinjury duration, presence of intra-articular osteochondral lesions, presence of osteophytes and ligament injury pattern (i.e., isolated anterior talofibular ligament (ATFL) injury or combined with calcaneofibular ligament injury) were analysed. Results There was significantly weaker muscle strength on the affected side than on the unaffected side in all directions (p < 0.05). The LSI in plantar flexion was significantly lower than that in dorsiflexion at 60°/s (0.87 vs 0.98, p < 0.001). A lower LSI in eversion was significantly correlated with female sex (0.82 vs 0.94, p = 0.016) and isolated ATFL injury (0.86 vs 0.95, p = 0.012). No other factors were found to be associated with muscle strength deficits. Conclusion MAI patients showed significant muscle strength deficits on the affected side, especially in plantar flexion. There were greater strength deficits in eversion in females and individuals with an isolated ATFL injury. Thus, a muscle strength training programme for MAI patients was proposed that focused more on plantar flexion training and eversion training for females and those with an isolated ATFL injury.


2019 ◽  
Vol 122 (1) ◽  
pp. 435-446 ◽  
Author(s):  
N. Mrachacz-Kersting ◽  
U. G. Kersting ◽  
P. de Brito Silva ◽  
Y. Makihara ◽  
L. Arendt-Nielsen ◽  
...  

Changing the H reflex through operant conditioning leads to CNS multisite plasticity and can affect previously learned skills. To further understand the mechanisms of this plasticity, we operantly conditioned the initial component (M1) of the soleus stretch reflex. Unlike the H reflex, the stretch reflex is affected by fusimotor control, comprises several bursts of activity resulting from temporally dispersed afferent inputs, and may activate spinal motoneurons via several different spinal and supraspinal pathways. Neurologically normal participants completed 6 baseline sessions and 24 operant conditioning sessions in which they were encouraged to increase (M1up) or decrease (M1down) M1 size. Five of eight M1up participants significantly increased M1; the final M1 size of those five participants was 143 ± 15% (mean ± SE) of the baseline value. All eight M1down participants significantly decreased M1; their final M1 size was 62 ± 6% of baseline. Similar to the previous H-reflex conditioning studies, conditioned reflex change consisted of within-session task-dependent adaptation and across-session long-term change. Task-dependent adaptation was evident in conditioning session 1 with M1up and by session 4 with M1down. Long-term change was evident by session 10 with M1up and by session 16 with M1down. Task-dependent adaptation was greater with M1up than with the previous H-reflex upconditioning. This may reflect adaptive changes in muscle spindle sensitivity, which affects the stretch reflex but not the H reflex. Because the stretch reflex is related to motor function more directly than the H reflex, M1 conditioning may provide a valuable tool for exploring the functional impact of reflex conditioning and its potential therapeutic applications. NEW & NOTEWORTHY Since the activity of stretch reflex pathways contributes to locomotion, changing it through training may improve locomotor rehabilitation in people with CNS disorders. Here we show for the first time that people can change the size of the soleus spinal stretch reflex through operant conditioning. Conditioned stretch reflex change is the sum of task-dependent adaptation and long-term change, consistent with H-reflex conditioning yet different from it in the composition and amount of the two components.


2020 ◽  
Vol 8 (4) ◽  
pp. 48
Author(s):  
Hamad S. Al Amer ◽  
Mohamed A. Sabbahi ◽  
Sharon L. Olson

The Soleus (SOL) Hoffmann reflex (H-reflex) is commonly recorded in sitting position. However, the reliability of recording is unknown. We assessed the reliability of SOL H-reflex amplitude measurements across multiple traces and sessions during erect, slumped, and slouched sitting postures using the generalizability theory. Five traces of the SOL H-reflex maximum amplitude (Hmax) were recorded from 10 healthy participants during erect, slumped, and slouched sitting postures in two sessions. A decision study analysis was then conducted to calculate the reliability coefficients of the Hmax for five traces and two sessions and to mathematically calculate the coefficients for seven and ten traces, and one and three sessions in the three sitting postures. For five traces and two sessions, the results showed reliability coefficients between 0.970 and 0.971, 0.980 and 0.979, and equal to 0.943 for erect, slumped, and slouched sitting, respectively. Averaging five traces of the Hmax in a single recording session was sufficient to obtain acceptable reliability in the three sitting postures (reliability range, 0.892–0.988). It was concluded that the SOL Hmax can be recorded during erect, slumped, and slouched sitting postures with adequate reliability.


Author(s):  
Masako FUJITA ◽  
Kiyotaka KAMIBAYASHI ◽  
Tsuyoshi NAKAJIMA ◽  
Makoto TAKAHASHI ◽  
Shin-ichiro YAMAMOTO ◽  
...  

2014 ◽  
Vol 30 (5) ◽  
pp. 331-338 ◽  
Author(s):  
J-F Uhl ◽  
J-P Benigni ◽  
A Cornu-Thenard ◽  
J Fournier ◽  
E Blin

Background Using standing magnetic resonance imaging (MRI), we recently showed that medical compression, providing an interface pressure (IP) of 22 mmHg, significantly compressed the deep veins of the leg but not, paradoxically, superficial varicose veins. Objective To provide an explanation for this compression paradox by studying the correlation between the IP exerted by medical compression and intramuscular pressure (IMP). Material and methods In 10 legs of five healthy subjects, we studied the effects of different IPs on the IMP of the medial gastrocnemius muscle. The IP produced by a cuff manometer was verified by a Picopress® device. The IMP was measured with a 21G needle connected to a manometer. Pressure data were recorded in the prone and standing positions with cuff manometer pressures from 0 to 50 mmHg. Results In the prone position, an IP of less than 20 did not significantly change the IMP. On the contrary, a perfect linear correlation with the IMP ( r = 0.99) was observed with an IP from 20 to 50 mmHg. We found the same correlation in the standing position. Conclusion We found that an IP of 22 mmHg produced a significant IMP increase from 32 to 54 mmHg, in the standing position. At the same time, the subcutaneous pressure is only provided by the compression device, on healthy subjects. In other words, the subcutaneous pressure plus the IP is only a little higher than 22 mmHg—a pressure which is too low to reduce the caliber of the superficial veins. This is in accordance with our standing MRI 3D anatomical study which showed that, paradoxically, when applying low pressures (IP), the deep veins are compressed while the superficial veins are not.


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