Impaired modulation of quadriceps tendon jerk reflex during spastic gait: differences between spinal and cerebral lesions.

نویسندگان

  • M Faist
  • M Ertel
  • W Berger
  • V Dietz
چکیده

In healthy subjects, functionally appropriate modulation of short latency leg muscle reflexes occurs during gait. This modulation has been ascribed, in part, to changes in presynaptic inhibition of Ia afferents. The changes in modulation of quadriceps tendon jerk reflexes during gait of healthy subjects were compared with those of hemi- or paraparetic spastic patients. The spasticity was due to unilateral cerebral infarction or traumatic spinal cord injury, respectively. The modulation of the quadriceps femoris tendon jerk reflex at 16 phases of the step cycle was studied. The reflex responses obtained during treadmill walking were compared with control values obtained during gait-mimicking standing postures with corresponding levels of voluntary muscle contraction and knee angles. In healthy subjects the size of the reflexes was profoundly modulated and was generally depressed throughout the step cycle. In patients with spinal lesion the reflex depression during gait was almost removed and was associated with weak or no modulation during the step cycle. In patients with cerebral lesion there was less depression of the reflex size associated with a reduced reflex modulation on the affected side compared with healthy subjects. On the 'unaffected' side of these patients reflex modulation was similar to that of healthy subjects, but the reflex size during gait was not significantly different from standing control values. These observations suggest that the mechanisms responsible for the depression of reflex size and the modulation normally seen during gait in healthy subjects are impaired to different extents in spasticity of spinal or cerebral origin, possibly due to the unilateral preservation of fibre tracts in hemiparesis.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Modulation of soleus H-reflexes during gait in children with cerebral palsy.

In healthy adults, soleus H-reflexes are rhythmically modulated and generally depressed during gait compared with rest. From ages 6 to 13 yr, there is a progressive increase in the tonic inhibition of H-reflexes during walking, especially during the stance phase of the step cycle. In adults, rhythmic modulation and tonic depression are severely disturbed after bilateral spinal lesions but remai...

متن کامل

Cutaneous reflexes from the foot during gait in hereditary spastic paraparesis.

OBJECTIVE It is known that P2 cutaneous reflexes from the foot show phase-dependent modulation during gait. The role of the motor cortex and the cortico-spinal tract in these reflexes and their modulation is unknown. Patients with hereditary spastic paraparesis (HSP) have a lesion in the cortico-spinal tract and may show deficits in P2 reflexes and/or their modulation. METHODS Reflex response...

متن کامل

The Effect of Adding Homeopathic Treatment to Rehabilitation on Abnormal Reflexes of Children with Spastic Cerebral Palsy

Objectives: Cerebral palsy (CP) is a static encephalopathy with abnormal reflexes that cause motor developmental delay. In addition to conventional methods, complementary medicine like homeopathy has been used in treatment of neuro-developmental disorders. This study has been done to determine the effect of adding homeopathic treatment to rehabilitation on abnormal reflexes of children with spa...

متن کامل

Dynamic Balance During Gait in Children With Spastic Diplegic Cerebral Palsy Versus Normal Children

Purpose: Cerebral Palsy (CP) can negatively affect dynamic stability in children with spastic diplegic Cerebral Palsy during walking. This condition results in a high risk of falling. There is limited evidence regarding the dynamic stability of children with Cerebral Palsy. Thus, this study aimed to investigate the dynamic stability of children with spastic diplegic Cerebral Palsy, compared to ...

متن کامل

Comparison of voluntary and reflex activation of motor units. Functional organization of motor neurones.

The most important mechanism for gradation of muscle contraction is recruitment of new motor units with increasing effort. Whether voluntary and reflex contractions engage the different motor units in a similar order is not known. Since this question is not only of considerable physiological interest but also has clinical implications, we have compared the order in which the motor units are act...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Brain : a journal of neurology

دوره 122 ( Pt 3)  شماره 

صفحات  -

تاریخ انتشار 1999