Knee Muscle Stretch Reflex Responses After an Intrathecal Baclofen Bolus in Neurological Patients With Moderate-to-Severe Hypertonia.
Abnormal reflex
hyperreflexia
spasticity
stretch reflex threshold angle
stretch reflex threshold velocity
Journal
Neuromodulation : journal of the International Neuromodulation Society
ISSN: 1525-1403
Titre abrégé: Neuromodulation
Pays: United States
ID NLM: 9804159
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
03
09
2019
revised:
13
12
2019
accepted:
10
01
2020
pubmed:
6
2
2020
medline:
31
7
2021
entrez:
6
2
2020
Statut:
ppublish
Résumé
To examine the prevalence, onset threshold, and response magnitude of stretch reflex response (SRR) in the knee extensors and flexors before and after an intrathecal baclofen (ITB) bolus injection in patients with moderate-to-severe hypertonia. SRRs were elicited by reciprocal passive knee extension/flexion movements at preset angular velocities of 5, 60, 120, 180, 240, and 300°/s using an isokinetic dynamometer and recorded with surface electromyographic (EMG) electrodes placed over the knee extensors and flexors in 53 neurologic patients before and at 2.5 and 5 hours after an ITB injection via lumbar puncture. Outcome measures included the number of patients with presence/absence of SRRs, the number of SRRs per session, SRR onset threshold angle and velocity, and response magnitudes (peak EMG and area under the EMG curve) for each muscle. Pre-post comparisons were completed using the Fisher's exact and Wilcoxon signed rank tests. For both knee extensors and flexors, the proportion of patients with present SRRs (p < 0.0001) and the number of SRRs per session (p ≤ 0.027) decreased from pre- to post-ITB. The threshold velocity significantly increased post-injection in both muscles (p ≤ 0.001) without significant changes in the threshold angle. The response magnitudes significantly decreased in the knee extensors (p ≤ 0.016) but not the knee flexors after the injection. The prevalence and threshold velocity of SRR emerged as the most robust and practical parameters for assessing hyperreflexia during ITB bolus trial that can complement clinical assessment of muscle hypertonia.
Identifiants
pubmed: 32023360
doi: 10.1111/ner.13112
pii: S1094-7159(21)00207-5
doi:
Substances chimiques
Baclofen
H789N3FKE8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1018-1028Subventions
Organisme : Gertrude C. Ford Foundation
Organisme : H.F. McCarty, Jr. Family Foundation Fund for Stroke Research
Organisme : Wilson Research Foundation
ID : N/A
Informations de copyright
© 2020 International Neuromodulation Society.
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