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KMID : 0361419940180020413
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Journal of Korean Academy of Rehabilitation Medicine
1994 Volume.18 No. 2 p.413 ~ p.420
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H-reflex from Tibialis anterior Muscle : Normative Data and Clinical Utility in L4, L5 Radicular Compression
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Abstract
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During a voluntary contraction, the H-reflex could be obtained at lower stimulus intensities in the tibialis anterior muscle and a more clear sparation of the H-wave from the M-wave was possible. the aim of choosing tibialis anterior is the
relative
ease in eliciting response over this muscle and the potential utility of this stest in the evaluation of L4, L5 radicular compressio, the latter being quite common in lumbar intervertebral disc prolapse.
H-reflex from tibialis anterior muscle (TAH-R) was recorded in 20 healthy subjects by averaging 100 responses fromt he maximal contracting tibialis anterior muscle after repetitive submaximal stimulation of common peroneal nerve. Subsequently,
the
test
was applied to 22 pateitns with clinical and radiologic evidence of L5 or L4, L5 radicular compression. They were studied using stimulus intensity enough to produce just visible twitch in the muscle, stimulus duration of 1.0 msec, stimulus rate
of
3Hz
and the muscle force to keep the foot in complete dorsiflexion as sufficient as possible. The take-off point was sharp and in no healthy subject was there any difficulty in measuring the latency to onset point. Abnormalities included significant
right-left latency difference within the normal range of absolute latencies, unilateral or bilateral prolongation of latency to onset point and attenuation or absence of the response. Among the patients, 21 out of 22 cases of L5 or L4, L5
radicular
compression had abnormal findings.
We concluded that the examination of the H-reflex from tibialis anterior muscle is easily performed and can be useful in the diagnosis of L4, L5 radicular compression.
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KEYWORD
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