title: T-reflex studies in human upper limb muscles during voluntary contraction: normative data and diagnostic value for cervical radiculopathy.
abstract: OBJECTIVE
  To evaluate the diagnostic utility of the T reflexes elicited from the upper limb muscles during standardized volitional contraction monitored by a real-time integrating electromyographic analyzer.
  
  
  METHODS
  Prospective descriptive study.
  
  
  METHODS
  Department of orthopedic surgery at a university hospital.
  
  
  METHODS
  Healthy subjects (n=80) evenly distributed across decades of age from 21 to 79 years, and 12 consecutive patients with a single cervical root lesion based on clinical and magnetic resonance imaging studies and diagnostic block.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Using a special hammer, which externally triggers the sweep on skin contact, we evoked T reflexes in the biceps (C5), brachioradialis (C6), triceps (C7), and the first dorsal interosseous muscles (C8).
  
  
  RESULTS
  Simultaneous regression analyses yielded clinically useful upper limits of normative values for latencies, side-to-side differences, and amplitude ratios adjusted to age and arm span. Comparison of the T reflexes between the 2 sides localized the solitary root lesions with a high sensitivity (92%), specificity (81%), and accuracy (83%). T-reflex studies proved helpful to localize the lesion even in patients who solely complained of upper limb pain.
  
  
  CONCLUSIONS
  The T reflexes with a standardized facilitation of the upper limb muscles provide a clinically useful, noninvasive measure to localize the C5 to C8 radiculopathies. This study contributes in reassessing the currently underused T reflex as an electrodiagnostic technique.
authors.affiliation: Department of Orthopaedic Surgery, Kochi Medical School, Kohasu Oko-cho, Nankoku, Japan. kwdtmk1201@yahoo.co.jp
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tetsunaga
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tani
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ikeuchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishida
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Kida
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Tadokoro
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ichimiya
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakajima
authors.forename: Hideshi
authors.initials: H
authors.lastname: Tsuboya
authors.forename: Shinichirou
authors.initials: S
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D011446:Prospective Studies; D011843:Radiculopathy / Q000175:diagnosis* / Q000503:physiopathology*; D012018:Reflex / Q000502:physiology*; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D034941:Upper Extremity / Q000502:physiology*