title: Changes in motoneuron excitability in hemiplegic subjects after passive exercise when using a robotic arm.
abstract: OBJECTIVE
  To test the hypothesis that motoneuron excitability in stroke subjects is influenced by peripheral sensory input through passive exercise to the hemiplegic upper extremity.
  
  
  METHODS
  Case-control prospective study.
  
  
  METHODS
  Physical medicine and rehabilitation inpatient and outpatient clinic at a tertiary Veterans Affairs medical center.
  
  
  METHODS
  Nineteen hemiplegic adult subjects with a history of a cerebrovascular event.
  
  
  METHODS
  A standardized passive exercise program was performed on the right upper extremity by using a robotic arm. Nerve conduction study of the median nerve was obtained before and after the exercise. Maximum onset and peak amplitudes of the Hoffmann reflex (Hmax) and motor response (Mmax) wave were recorded.
  
  
  METHODS
  Hmax, Mmax, and Hmax/Mmax ratio.
  
  
  RESULTS
  Immediately after passive exercise, there was no significant alteration in the Hmax (P=.94), Mmax (P=.60), or Hmax/Mmax ratio (P=.53) as compared with pre-exercise evoked responses.
  
  
  CONCLUSIONS
  Peripheral proprioceptive input with passive exercise does not cause appreciable change in the Hmax/Mmax ratio, suggesting that motoneuron excitability of the affected upper extremity in stroke subjects is not influenced by passive robotic intervention.
authors.affiliation: Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System/University of California, Los Angeles, CA 90073, USA.
authors.forename: Sheila
authors.initials: S
authors.lastname: Patel
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Ho
authors.forename: Rajeswari
authors.initials: R
authors.lastname: Kumar
authors.forename: Khang
authors.initials: K
authors.lastname: Lai
authors.forename: Brian
authors.initials: B
authors.lastname: Ahangar
authors.forename: Charles G
authors.initials: CG
authors.lastname: Burgar
authors.forename: Antonia E
authors.initials: AE
authors.lastname: Scremin
mesh_terms: D016022:Case-Control Studies; D015444:Exercise; D005260:Female; D006181:H-Reflex / Q000502:physiology*; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008475:Median Nerve; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology*; D009431:Neural Conduction / Q000502:physiology*; D016059:Range of Motion, Articular; D012371:Robotics / Q000379:methods*