Relationship between spinal reflexes and leg motor function in sub-acute and chronic stroke patients.

Abstract

OBJECTIVE:

To assess the relationship between spinal reflexes and motor function in sub-acute (SAS) and chronic stroke (CS) patients.

METHODS:

Twelve SAS and 16 CS patients underwent electrophysiological assessment of heteronymous facilitation (HF), heteronymous inhibition (HI), disynaptic reciprocal inhibition (DRI), and D1 inhibition (D1). The Fugl-Meyer Assessment Lower Extremity (FMA-LE) and modified Ashworth scale (MAS) were assessed. The relationship between spinal reflexes and motor function was examined in a cross-sectional manner. SAS patients were also longitudinally evaluated before and after intensive rehabilitation for approximately 2 months.

RESULTS:

SAS patients with triceps surae muscle spasticity (MAS ≥ 1) showed higher HF values (p = 0.03) than those without spasticity. SAS patients with quadriceps muscle spasticity showed higher HF values (p < 0.01); patients with hamstring muscle spasticity showed higher DRI value (disinhibition) (p < 0.01) than those without spasticity. CS patients showed no significant correlation between spinal reflexes and motor function. The longitudinal study revealed a significant correlation between increase in D1 inhibition and FMA-LE improvement in SAS patients (r = 0.69).

CONCLUSIONS:

The association between impaired spinal reflexes varies with the stage of stroke; HF and DRI may be spasticity indicators in SAS patients.

SIGNIFICANCE:

Spinal reflexes as potential biomarkers may facilitate tailor-made rehabilitation of stroke patients.

• Authors: Yoko Takahashi, Michiyuki Kawakami, Rena Mikami, Toshiya Nakajima, Towa Nagumo, Tomofumi Yamaguchi, Kaoru Honaga, Kunitsugu Kondo, Ryota Ishii, Toshiyuki Fujiwara, Meigen Liu
• Journal: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (Clin Neurophysiol) Vol. 138 Pg. 74-83 (06 2022) ISSN: 1872-8952 [Electronic] Netherlands
• PMID: 35366480 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Topics

• Cross-Sectional Studies
• Humans
• Leg
• Longitudinal Studies
• Lower Extremity
• Muscle Spasticity (diagnosis)
• Stroke (complications)
• Stroke Rehabilitation
• Treatment Outcome