Childers MK, Biswas SS, Petroski G, Merveille O. Inhibitory casting decreases a vibratory inhibition index of the H-reflex in the spastic upper limb.
Arch Phys Med Rehabil 1999;
80:714-6. [PMID:
10378501 DOI:
10.1016/s0003-9993(99)90178-8]
[Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE
To test the hypothesis that application of an inhibitory cast to the spastic upper limb will decrease a vibratory inhibition index (VII) of the H-reflex in the spastic upper limb.
DESIGN
Prospective, nonrandomized, open-label trial.
SETTING
University tertiary care center.
PARTICIPANTS
Eight adults with upper limb spasticity.
INTERVENTION
Fiberglass cast application spanning the wrist to the upper arm.
MAIN OUTCOME MEASURE
The amplitude of the H-reflex with and without continuous 60Hz vibration to the tendon of the flexor carpi radialis was measured, and the VII was calculated using the formula: [H-reflex amplitude (vibrated)/H-reflex amplitude (control)] x 100%.
RESULTS
Mean VII decreased from baseline (70.7) on day 1 (67.6, p = .699), day 2 (55.9, p =.066), and day 3 (43.5, p = .033) of casting, and increased on day 4 (89.9, p = .146) after removal of the cast.
CONCLUSION
Findings lend support to the idea that during application of an inhibitory cast motor neuron excitability is decreased in the spastic upper limb.
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