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Journal of the Korean Academy of Rehabilitation Medicine 2007;31(6):683-688.
Clinical Utility of Flexor Carpi Radialis H-Reflex in the 7th Cervical Radiculopathy.
Woo, Kyoung Bong , Park, Young Sook , Ryu, Dae Gul , Lim, Gyu Nam , Kim, Woo Jin , Chung, Seung Hyun , Lee, Yong Taek
1Department of Physical Medicine and Rehabilitation, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Korea. heiwon@medigate.net
2Department of Physical Medicine and Rehabilitation, National Cancer Center, Korea.
3Department of Physical Medicine and Rehabilitation, Kangbuk Samsung Hospital, Korea.
제7 경수 신경근병변에서 요측 수근굴근 H반사의 임상적 효용성
우경봉, 박영숙, 류대걸, 임규남, 김우진, 정승현1, 이용택2
성균관대학교 의과대학 마산삼성병원 재활의학교실, 1국립암센터 재활의학과, 2강북삼성병원 재활의학과
To determine the clinical utility of flexor carpi radialis (FCR) H-reflex with and without facilitation in the diagnosis of 7th cervical radiculopathy.
Thirty-four subjects (27 men, 7 women) participated in this study showed symptoms and signs suggesitive of cervical radiculopathy and every subject had single herniated cervical disc on MRI study. All participants underwent electrophysiologic study including routine nerve conduction study (NCS), electromyography (EMG), FCR H-reflexes with and without facilitation in both arms. Abnormal parameters for FCR H-reflex were 1) side to side latency difference more than 1.0 msec, 2) absence of FCR H-reflex in one side, 3) side to side amplitude ratio below 33% for without facilitation and 22% for facilitation. If the subjects had at least one of the three abnormal parameters, we concluded as having abnormal FCR H-reflex.
In the FCR H-reflex without facilitation group, we were not able to elicit FCR H-reflex in both arms in 17 subjects. Among the 17 subjects with elicited FCR H-reflex, 7 had abnormal FCR H-reflex (C7 root; 4, other roots; 3). In the FCR H-reflex with facilitation group, FCR H-reflex was obtained in 32 subjects, 13 out of the 32 showed abnormal FCR H-reflex (C7 root; 6, other roots; 7). The sensitivity and specificity of FCR H-reflex without facilitation in the diagnosis of 7th cervical radiculopathy were 67%, 73%, with facilitation it were 50%, 65%.
Even though FCR H-reflex without facilitation is superior in its sensitivity and specificity, low elicitabiliy is the factor that limits its clinical utility. FCR H-reflex with facilitation with its good elicitability, seems to be a useful adjunctive method to routine NCS and EMG examination in the diagnosis of 7th cervical radiculopathy. (J Korean Acad Rehab Med 2007; 31: 683-688)
Key Words: H-reflex, Flexor carpi radialis, Facilitation


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