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JOURNAL ARTICLE

[Effect of the graded muscle contraction on the H reflex and long latency reflexes of the thenar and hypothenar muscles to a fixed threshold stimulus]

B Estañol, S Sánchez-Munguia, V Corona Marco, Y Elias, J F Téllez-Zenteno, G García-Ramos
Neurología: Publicación Oficial de la Sociedad Española de Neurología 2003, 18 (6): 303-9
12838449

INTRODUCTION: To determine the percentage of appearance of the H reflex and long latency reflexes (LLRs) in the thenar and hypothenar muscles of normal subjects to a fixed threshold mixed nerve electrical stimulus and variable degrees of muscle contraction.

METHODS: Fifteen subjects aged 21 to 32 years of age without any prior history of central or peripheral neurological diseases volunteered for the study. The stimulation was a constant currrent given at the wrist with the cathode positioned proximally; started at 1 mA and it was gradually increased mA by mA until the M response appeared with the subject relaxed. The intensity of the stimulation was thereafter kept constant. The contraction was an abducting movement of the thumb in the case of the thenar muscle and abduction of the digiti minimi in the case of the hypothenar muscle and was sustained throughout the study. The reflexes were elicited with a repetition rate of 3 Hz, the stimulus was a square pulse of 0.5 ms. We used a low frequency pass filter of 10 Hz and a high frequency pass filter of 10 kHz. The sweep speed was set a 10 ms per division. The responses were averaged 200 times and then smoothed.

RESULTS: The mean intensity of the stimulus that evoked the H response, for all subjects, was 7.5 2.8 mA. The mean latency of the H reflex elicited with stimulation of the median nerve was 26 ms 2.03 ms (std. error 0.28, maximum 28.2, minimum 22.0). The mean latency of the H reflex elicited with stimulation of the ulnar nerve was 25.1 ms 1.64 ms (std. error 0.230, maximum 28, minimum 22.3). The difference between the percentage of responses attained under a relaxed condition and with any kind of muscle contraction was highly significant statistically using the Chi square method (p < 0.001). When we compared the percentage of the H responses obtained with slight, moderate, strong contraction, and contraction against resistance, between them, we did no find a significant difference. The LLRs appeared only in the trials with strong contraction.

CONCLUSIONS: The H reflexes and the LLRs of the thenar and hypothenar muscle were not obtained with threshold stimulation when these muscles were relaxed. With any degree of muscle contraction the H reflex in these muscles could be obtained in 94 percent of the trials. Maximal contraction and contraction against resistance were the best conditions to elicit long latency responses.

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