Wednesday, February 20, 2019

Patellar Tendon Reflex and Vastus Medialis Hoffmann Reflex Are Down Regulated and Correlated in Women With Patellofemoral Pain

Publication date: March 2019

Source: Archives of Physical Medicine and Rehabilitation, Volume 100, Issue 3

Author(s): Marcella Ferraz Pazzinatto, Danilo de Oliveira Silva, Amanda Schenatto Ferreira, Marina Cabral Waiteman, Evangelos Pappas, Fernando Henrique Magalhães, Fábio Mícolis de Azevedo

Abstract
Objectives

The aims of this study were threefold: (1) to compare the amplitude of patellar tendon reflex (T-reflex) between women with patellofemoral pain (PFP) and pain-free controls; (2) to compare the amplitude of vastus medialis Hoffmann reflex (VM H-reflex) between women with PFP and pain-free controls; (3) to investigate the association between the amplitude of patellar T-reflex and VM H-reflex in women with PFP and pain-free controls.

Design

Cross-sectional observational study.

Setting

Laboratory of biomechanics and motor control.

Participants

Thirty women with PFP and 30 pain-free women aged 18 to 35 years (N=60).

Main Outcome Measures

Peak-to-peak amplitudes of maximal VM H-reflex (elicited via electrical stimulation on the femoral nerve) and patellar T-reflex (elicited via mechanical percussion on the patellar tendon) were estimated.

Results

Women with PFP had significant lower amplitude of patellar T-reflex (mean difference=0.086; 95% confidence interval=0.020 to 0.151; P=.010; moderate effect) and VM H-reflex (mean difference=0.150; 95% confidence interval =0.073 to 0.227; P<.001; large effect) compared to pain-free controls. The VM H-reflex was strongly correlated with patellar T-reflex in both PFP group (r=0.66; P<.001) and control group (r=0.72; P<.001).

Conclusions

As the T-reflex is easier to perform than H-reflex assessments in a clinical setting, it represents a feasible option to assess the impaired excitability of the stretch reflex pathway associated with PFP.



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