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


METHODS
Experiment.


METHODS
Electrophysiologic experimental laboratory in a Japanese medical school.


METHODS
Fifteen hemiplegic patients (9 men, 6 women; age range, 48-71yr; mean, 60yr) with spasticity caused by a stroke.


METHODS
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.


METHODS
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.


CONCLUSIONS
Hslp/Mslp is the preferred index for evaluating the motoneuron pool excitability of the spastic side of hemiplegic patients.
Higashi
T
T
School of Allied Medical Sciences, Nagasaki University, Japan.
Funase
K
K
Kusano
K
K
Tabira
T
T
Harada
N
N
Sakakibara
A
A
Yoshimura
T
T
D000368:Aged; D005260:Female; D006181:H-Reflex / Q000502:physiology*; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology*; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology*; D018482:Muscle, Skeletal / Q000294:innervation; D009431:Neural Conduction; D020127:Recovery of Function; D011999:Recruitment, Neurophysiological / Q000502:physiology; D012815:Signal Processing, Computer-Assisted; D020521:Stroke / Q000150:complications / Q000503:physiopathology