神経筋促通法のH波による検討 : とくに振動刺激について
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概要
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The method of neuromuscular facilitation in attempt to increase the muscular strength in patients with nervous diseases is applied in the field of rehabilitation. However, the term is not quite suitable since the physiological meaning is obscure. The author used the H-reflex especially that evoked by vibratory stimulation, to study the mechanism of the neuromuscular facilitation. 1) Painr touch and vibration are used as stimuli. These stimuli, when applied on the posterior surface of the thigh or on the foot sole, increased the amplitude of the H-reflex in some instances depending upon the intensity of the stimuli, but they uniformly decreased its amplitude when applied on the other parts of the lower extremity. This phenomenon may well relate to the withdrawal reflex mechanism. 2) Vibratory stimulation upon Achilles tendon caused the diminution of the Hreflex, which is assumed to be depended upon the hyperpolarization of alpha motoneurons as well as the inhibition by way of group II, Ib, and other fibers. 3) After ceasing the vibratory stimulation, the suppressed H-reflex gradually recovered its amplitude to surpass its original amplitude, and then, through the period of variable length, returned to the stable status quo ante. The duration of the post vibratory effect was proportional to the frequency and duration of vibration. 4) The reciprocal inhibition was observed in the antagonist. The vibration applied to the muscles of the upper extremity, either brachial biceps or triceps, gave facilitatory effect on the H-reflex of the soleus. This effect was most marked when the stimulation was applied to the ipsilateral brachial biceps. 5) In case of spastic paresis, the motor disturbance due to spasticity can be improved by reciprocal inhibition of the spastic muscle induced by vibratory stimulation of its antagonists. However, such stimulation increased the motor disturbances in cases of extrapyramidal and cerebellar diseases. Therefore, the vibratory stimulation can be utilized for both diagnosis and treatment of motor disturbances.
- 千葉大学の論文
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関連論文
- H波と臨床神経診断(脳と神経の研究V)
- H波の変動をめぐって(脳と神経の研究III)
- 緊張性振動反射のH波による検討(神経内科学的研究,脳と神経の研究VIII-脳と神経の障害と修復-)
- 神経筋促通法のH波による検討 : とくに振動刺激について