T. Higashi et al., Motoneuron pool excitability of hemiplegic patients: Assessing recovery stages by using H-reflex and M response, ARCH PHYS M, 82(11), 2001, pp. 1604-1610
Objectives: To compare the excitability of the motoneuron pools of both the
spastic and the unimpaired sides of patients with hemiplegia with a new me
thod by using H-reflexes and M responses. The method determines the ratio o
f the developmental slope of the H-reflex (Hslp) to the slope of the M resp
onse (Mslp). We also examined the relation between the Brunnstrom stages an
d the Hslp/Mslp.
Design: Experiment.
Setting: Electrophysiologic experimental laboratory in a Japanese medical s
chool.
Patients: Fifteen hemiplegic patients (9 men. 6 women age range, 48-71 yr;
mean, 60yr) with spasticity caused by a stroke. Interventions: The subject
was instructed to relax while seated in a reclining chair with his foot fix
ed on an immobile pedal. After the soleus H-reflex and M responses on one s
ide were recorded. the same experimental procedures were carried out on the
other side.
Main Outcome Measures: Hslp/Mslp Brunnstrom stages.
Results: Hslp/Mslp had better predictive value than conventional indicators
of motoneuron pool excitability. Hslp/Mslp appeared to be a better match f
or the bell-shaped pattern of the Brunnstrom stages.
Conclusion: Hs1p/Mslp is the preferred index for evaluating the motoneuron
pool excitability of the spastic side of hemiplegic patients. (C) 2001 by t
he American Congress of Rehabilitation Medicine and the American Academy of
Physical Medicine and Rehabilitation.