title: Inhibitory casting decreases a vibratory inhibition index of the H-reflex in the spastic upper limb.
abstract: OBJECTIVE
  To test the hypothesis that application of an inhibitory cast to the spastic upper limb will decrease a vibratory inhibition index (VII) of the H-reflex in the spastic upper limb.
  
  
  METHODS
  Prospective, nonrandomized, open-label trial.
  
  
  METHODS
  University tertiary care center.
  
  
  METHODS
  Eight adults with upper limb spasticity.
  
  
  METHODS
  Fiberglass cast application spanning the wrist to the upper arm.
  
  
  METHODS
  The amplitude of the H-reflex with and without continuous 60Hz vibration to the tendon of the flexor carpi radialis was measured, and the VII was calculated using the formula: [H-reflex amplitude (vibrated)/H-reflex amplitude (control)] x 100%.
  
  
  RESULTS
  Mean VII decreased from baseline (70.7) on day 1 (67.6, p = .699), day 2 (55.9, p =.066), and day 3 (43.5, p = .033) of casting, and increased on day 4 (89.9, p = .146) after removal of the cast.
  
  
  CONCLUSIONS
  Findings lend support to the idea that during application of an inhibitory cast motor neuron excitability is decreased in the spastic upper limb.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Missouri School of Medicine, Columbia 65212, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Childers
authors.forename: S S
authors.initials: SS
authors.lastname: Biswas
authors.forename: G
authors.initials: G
authors.lastname: Petroski
authors.forename: O
authors.initials: O
authors.lastname: Merveille
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D002370:Casts, Surgical; D005260:Female; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D011446:Prospective Studies; D013035:Spasm / Q000503:physiopathology* / Q000628:therapy; D014732:Vibration