Revista Ciencias de la Salud (Aug 2011)
Efecto de la movilización articular sobre la amplitud del Reflejo H en personas con espasticidad
Abstract
Objective: To determine the effect of ankle joint mobilization on the H reflex amplitude of the soleus muscle in people with spasticity. Materials and methods: A quasi-experimental study with crossover design and simple masking was conducted in 24 randomized subjects to initiate the control or experimental group. Traction and rhythmic oscillation were applied for five minutes to the ankle joint. H wave amplitude changes of Hoffmann reflex (electrical equivalent of the monosynaptic spinal reflex) was assessed, stimulating the tibial nerve at the level of the popliteal fossa and recording in the soleusmuscle. In each subject 12 measurements were taken: basalrate, during and after mobilization. Changes in H reflex amplitudewere calculated in relation to basal measurement. For each measurement a hypothesis test was performed (Student t test). Results: In groups of patients with brain injury and incomplete spinal cord injury, a significant difference was found between measurements of both studies, concerning variation in H reflex amplitude during the application of joint mobilization techniques, with a decrease in the experimental group and an increase in the control group. In contrast, no significant differences were found after mobilization therapy. Patients with complete spinal cord injuryshowed no significant differences in any measurements. Conclusion: Wedemonstrate the effectiveness of joint mobilization in the decreaseof H reflex amplitude in patients with brain injury or incompletespinal cord injury during the mobilization maneuver, but no residualeffect after completion of the trial. This research showed noevidence regarding excitability reduction in complete spinal cordinjury. We suggest that therapeutic interventions to decrease muscletone based on the joint mobilization should be reconsidered.
