<原著>H-反射と緊張性振動反射(TVR)を用いた筋緊張異常および相反性機能失調の検討

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概要

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• The reciprocal reflex activity in various muscle tone abnormalities was analyzed using the H-reflex together with tonic vibration reflex (TVR). The H-reflex was elicited by short interval (5-8 ms) double volleys while vibratory stimulation (TVR) of 100 Hz was applied to the synergist (gastrocnemius) or antagonist (peroneus) muscles. On the other hand, the frequency depression (FD) curve of the H-reflex was plotted at a higher frequency (1-50 Hz) stimulation. The patients analyzed in this study totaled 48,consisting of 8 normal subjects, 1 with peroneal damage, 22 with spasticity, 5 with rigidity, 9 with cerebellar-brainstem lesion and 3 with cervical cord lesion. In the normal subjects, two successive H-reflexes (H_1 and H_2) were elicited by short interval double volleys, and attenuated by TVR applied to the gastrocnemitus as well as TVR applied to the peroneus muscle. The attenuation rates were 68% in gastrocnemius TVR and 80% in peroneus TVR. The FD-curve showed a medium level in lower frequencies and then rose gentlly higher frequencies. In the peroneal nerve damage patient, although the H-reflexes of H_1 and H_2 were attenuated by gastrocnemius TVR they were not attenuated by peroneus TVR because of a loss of the reciprocal innervation. The FD-curve showed a normal characteristic configuration because there were no lesions in the upper center. In spasticity, the H-reflex was not attenuated by gastrocnemius nor by peroneus TVR's at a sufficient rate. The rates were 38% in the former and 46% in the latter. The FD-curve showed a higher level at a lower frequency then showed a steep sloping configuration from medium to higher frequencies. In rigidity, the rates was 26% in gastrocnemius TVR and 51% in peroneus TVR. The FD-curve showed a higher level at a lower frequency, then showed a slighter sloping configuration of higher level from medium to higher frequencies. In cerebellar-brainstem lesion, the rates were 25% in gastrocnemius TVR and 49% in peroneus TVR. The FD-curve showed a higher level in all frequencies then showed a gentle sloping configuration at a higher level from medium to higher frequencies. These findings could be considered as a result of the disturbance of the reflex modulation from the upper center. The combined examination of the H-reflex and TVR seems to be a useful diagnostic method and may also help in the determination of a therapeutic approach that is most appropriate.

• 近畿大学の論文
• 1992-03-25

著者

• 柳原 章

  近畿大学医学部脳神経外科学教室

• 柳原 章

  近畿大学医学部付属病院救命救急センター

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• H-反射と緊張性振動反射(TVR)を用いた筋緊張異常および相反性機能失調の検討

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