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 journalArticlepeer-review


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
Issue number3
Publication statusPublished - Mar 2013


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

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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