T-reflex studies in human upper limb muscles during voluntary contraction

Normative data and diagnostic value for cervical radiculopathy

Tomoko Tetsunaga, Toshikazu Tani, Masahiko Ikeuchi, Kenji Ishida, Kazunobu Kida, Nobuaki Tadokoro, Masahiro Ichimiya, Noriaki Nakajima, Hideshi Tsuboya, Shinichirou Taniguchi

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the diagnostic utility of the T reflexes elicited from the upper limb muscles during standardized volitional contraction monitored by a real-time integrating electromyographic analyzer. Design: Prospective descriptive study. Setting: Department of orthopedic surgery at a university hospital. Participants: Healthy subjects (n=80) evenly distributed across decades of age from 21 to 79 years, and 12 consecutive patients with a single cervical root lesion based on clinical and magnetic resonance imaging studies and diagnostic block. Interventions: Not applicable. Main Outcome Measures: Using a special hammer, which externally triggers the sweep on skin contact, we evoked T reflexes in the biceps (C5), brachioradialis (C6), triceps (C7), and the first dorsal interosseous muscles (C8). Results: Simultaneous regression analyses yielded clinically useful upper limits of normative values for latencies, side-to-side differences, and amplitude ratios adjusted to age and arm span. Comparison of the T reflexes between the 2 sides localized the solitary root lesions with a high sensitivity (92%), specificity (81%), and accuracy (83%). T-reflex studies proved helpful to localize the lesion even in patients who solely complained of upper limb pain. Conclusions: The T reflexes with a standardized facilitation of the upper limb muscles provide a clinically useful, noninvasive measure to localize the C5 to C8 radiculopathies. This study contributes in reassessing the currently underused T reflex as an electrodiagnostic technique.

Original languageEnglish
Pages (from-to)467-473
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume94
Issue number3
DOIs
Publication statusPublished - Mar 2013

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Radiculopathy
Upper Extremity
Reflex
Skeletal Muscle
Muscles
Orthopedics
Healthy Volunteers
Arm
Regression Analysis
Magnetic Resonance Imaging
Outcome Assessment (Health Care)
Prospective Studies
Sensitivity and Specificity
Pain
Skin

Keywords

  • cervical
  • Radiculopathy
  • Reflex stretch
  • Rehabilitation
  • Upper extremity

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

T-reflex studies in human upper limb muscles during voluntary contraction : Normative data and diagnostic value for cervical radiculopathy. / Tetsunaga, Tomoko; Tani, Toshikazu; Ikeuchi, Masahiko; Ishida, Kenji; Kida, Kazunobu; Tadokoro, Nobuaki; Ichimiya, Masahiro; Nakajima, Noriaki; Tsuboya, Hideshi; Taniguchi, Shinichirou.

In: Archives of Physical Medicine and Rehabilitation, Vol. 94, No. 3, 03.2013, p. 467-473.

Research output: Contribution to journalArticle

Tetsunaga, Tomoko ; Tani, Toshikazu ; Ikeuchi, Masahiko ; Ishida, Kenji ; Kida, Kazunobu ; Tadokoro, Nobuaki ; Ichimiya, Masahiro ; Nakajima, Noriaki ; Tsuboya, Hideshi ; Taniguchi, Shinichirou. / T-reflex studies in human upper limb muscles during voluntary contraction : Normative data and diagnostic value for cervical radiculopathy. In: Archives of Physical Medicine and Rehabilitation. 2013 ; Vol. 94, No. 3. pp. 467-473.
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