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Motoneuron pool excitability of hemiplegic patients: Assessing recovery stages by using H-reflex and M response

Archives of Physical Medicine and Rehabilitation
DOI: 10.1053/apmr.2001.25081
  • H-Reflex
  • Motor Neurons
  • Recovery Of Function
  • Rehabilitation
  • Spasticity
  • Biology
  • Medicine


Abstract Higashi T, Funase K, Kusano K, Tabira T, Harada N, Sakakibara A, Yoshimura T. Motoneuron pool excitability of hemiplegic patients: assessing recovery stages by using H-reflex and M response. Arch Phys Med Rehabil 2001;82:1604-10. Objectives: To compare the excitability of the motoneuron pools of both the spastic and the unimpaired sides of patients with hemiplegia with a new method by using H-reflexes and M responses. The method determines the ratio of the developmental slope of the H-reflex (Hslp) to the slope of the M response (Mslp). We also examined the relation between the Brunnstrom stages and the Hslp/Mslp. Design: Experiment. Setting: Electrophysiologic experimental laboratory in a Japanese medical school. Patients: Fifteen hemiplegic patients (9 men, 6 women; age range, 48–71yr; mean, 60yr) with spasticity caused by a stroke. Interventions: The subject was instructed to relax while seated in a reclining chair with his foot fixed on an immobile pedal. After the soleus H-reflex and M responses on one side 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 for the bell-shaped pattern of the Brunnstrom stages. Conclusion: Hslp/Mslp is the preferred index for evaluating the motoneuron pool excitability of the spastic side of hemiplegic patients. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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