title: Relationship between ankle invertor H-reflexes and acute swelling induced by inversion ankle sprain.
abstract: METHODS
  Single group, post-test design using the uninvolved lower extremity as the experimental control.
  
  
  OBJECTIVE
  To determine relationships between ankle swelling and flexor digitorum longus and peroneus longus H-reflex amplitude and latency.
  
  
  BACKGROUND
  Primary capsuloligamentous injury, neural injury, and joint effusion and swelling may contribute to H-reflex changes following inversion ankle sprain. The relationship between ankle swelling and invertor or evertor H-reflexes has not been reported.
  
  
  METHODS
  Fifteen subjects with acute grade I or II inversion ankle sprains (mean +/- SD) 6.5 +/- 3 days after onset participated in this study. Swelling was estimated using a tape measure and the figure-of-eight girth assessment method. H-reflexes were determined using standard techniques. Paired t-tests were used to compare mean differences in ankle girth (swelling) and ankle invertor or evertor H-reflex amplitude and latency between the involved and uninvolved limbs. Pearson product moment correlations were used to assess relationships between swelling and H-reflex variables.
  
  
  RESULTS
  Involved limb ankle girth was increased with respect to the uninvolved limb (1.5 +/- 0.9 cm) and the involved ankle flexor digitorum longus latency was delayed (0.72 +/- 0.7 ms). There was a moderate positive association (r = 0.73) between the latency delay in the involved ankle flexor digitorum longus and swelling. There were no significant differences in H-reflex amplitude and peroneus longus latency between ankles.
  
  
  CONCLUSIONS
  Grade I or II inversion sprains and the related swelling appear to delay involved ankle flexor digitorum longus latency to a greater extent than peroneus longus latency. Clinicians need to direct greater attention to the ankle invertors when designing and implementing ankle rehabilitation programs, particularly during the swelling management phase of treatment.
authors.affiliation: Wilford Hall Medical Center, San Antonio, Tex., USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Hall
authors.forename: J
authors.initials: J
authors.lastname: Nyland
authors.forename: A J
authors.initials: AJ
authors.lastname: Nitz
authors.forename: J
authors.initials: J
authors.lastname: Pinerola
authors.forename: D L
authors.initials: DL
authors.lastname: Johnson
mesh_terms: D000208:Acute Disease; D000328:Adult; D016512:Ankle Injuries / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D004487:Edema / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D004558:Electric Stimulation; D004576:Electromyography; D005260:Female; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities