title: Contraction induced h reflexes in the diagnosis of cervical radiculopathy.
abstract: OBJECTIVE
  To determine whether Contraction Induced H Reflexes (CIHR) can accurately detect cervical radiculopathy.
  
  
  METHODS
  Comparison of CIHR results with Needle Electromyography at academic outpatient Electromyography/Nerve Conduction laboratories. Participants were all patients over 18 with a needle electromyography diagnosis of cervical radiculopathy. Patients were tested for CIHR in at least two upper extremity muscles in electromyographically proven myotomes bilaterally. Patients were requested to perform a moderate contraction while stimulus was applied proximally (elbow or Erb's point). Outcome measures included H Reflex onset latency and side-to-side latency differences. These were compared against previously established normal values.
  
  
  RESULTS
  Overall, 10 of 15 patients who met criteria for cervical radiculopathy showed CIHR abnormalities (sensitivity = 67%; 95% confidence interval, 43-91). Counting each side and level separately, CIHR identified 16/27 radiculopathies (sensitivity = 59.2%; 95% confidence interval, 40.6-77.8). Contraction Induced H Reflexes identified 1 possible radiculopathy not seen on electromyography (specificity = 98%; 95% confidence interval, 95-100).
  
  
  CONCLUSIONS
  Contraction induced H Reflexes have a sensitivity and specificity for cervical radiculopathy similar to the resting Gastroc-Soleus H Reflex.
authors.affiliation: *Department of Physical Medicine and Rehabilitation, Cooper University Hospital, Camden, New Jersey, U.S.A.; †Cooper Medical School of Rowan University, Camden, New Jersey, U.S.A.; and ‡Department of Neurology, Cooper University Hospital, Camden, New Jersey, U.S.A.
authors.forename: Elliot B
authors.initials: EB
authors.lastname: Bodofsky
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Campellone
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Cohen
authors.forename: Holly N
authors.initials: HN
authors.lastname: Caten
authors.forename: Adam M
authors.initials: AM
authors.lastname: Schindelheim
mesh_terms: D000328:Adult; D000368:Aged; D004576:Electromyography / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction; D011843:Radiculopathy / Q000175:diagnosis* / Q000503:physiopathology; D012018:Reflex; D012680:Sensitivity and Specificity