To establish a correlation between the modified Ashworth scale (MAS) and amplitude and latency of T-reflex and to demonstrate inter-rater and intra-rater reliability of the T-reflex of the biceps muscle for assessing spasticity after stroke.
A total of 21 patients with hemiplegia and spasticity after ischemic stroke were enrolled for this study. The spasticity of biceps muscle was evaluated by an occupational therapist using the MAS. The mean value of manual muscle test of biceps muscles was 2.3±0.79. Latency and amplitude of T-reflex were recorded from biceps muscles by two physicians. The onset latency and peak to peak amplitude of the mean of 5 big T-reflex were measured. The examinations were carried out by two physicians at the same time to evaluate the inter-rater reliability. Further, one of the physicians performed the examination again after one week to evaluate the intra-rater reliability. The correlations between MAS and T-reflex, and the intra- and inter-rater reliability of biceps T-reflex were established by calculating the Spearman correlation coefficients and the intra-class correlation coefficients (ICCs).
Amplitude of the biceps T-reflex increased with increasing level of MAS (
Biceps T-reflex demonstrates a good quantitative measurement and correlation tool with MAS for spasticity, and also shows acceptable inter- and intra-rater reliability, which can be used for patients with spasticity after stroke.
Citations
Objective: To investigate the effects of Jendrassik maneuver on latency and amplitude of the T-reflex and H-reflex of the soleus muscle in normal adults.
Method: The T-reflex and H-reflex tests were performed on sixty normal adults with standardized technique using the soleus muscle. The shortest latency and the largest peak-to-peak amplitude were chosen for representative values.
Results: The results were as follows: 1) There was a significant difference in latency of the T-reflex between with and without Jendrassik maneuver. 2) The increment ratio of the amplitude with Jendrassik maneuver was 88% in the T-reflex and 18% in the H-reflex. There were a significant difference in the amplitude of both reflexes between with and without Jendrassik maneuver. 3) A high correlation was present between the latency of H- & T-reflex and the length.
Conclusion: According to these results, we suggest that Jendrassik maneuver primarily increases the sensitivity of muscle spindles and decreases the presynaptic inhibition of the Ia terminals at cortical, subcortical and spinal levels. Jendrassik maneuver can be a useful tool in cases of clinically decreased or absent deep tendon reflex.
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