Author/Editor		Voerman, GE; Gregorič, M; Hermens, HJ
Title		Neurophysiological methods for the assessment of spasticity: the Hoffmann reflex, the tendon reflex, and the stretch reflex
Type		članek
Source		Disabil Rehabil
Vol. and No.		Letnik 27, št. 1-2
Publication year		2005
Volume		str. 33-68
Language		eng
Abstract		Purpose: To review the literature concerning neurophysiological methods to assess spasticity with respect to mechanisms and methodology, and to describe the three most commonly used methods: the Hoffmann reflex (H-reflex), the Tendon reflex (T-reflex), and the Stretch Reflex (SR). Method: A systematic internet database search was performed to identify neurophysiological measurement methods of spasticity. A systematic exclusion procedure resulted in 185 included references, completed by additional informal search. For this paper, information about the H-, T- and stretch reflexes was extracted from these references. Results: Although the reflexes are basically monosynaptic, there are many supraspinal pathways which modulate the responses in terms of their amplitude and latency. As a consequence the methods are sensitive to a considerable number of experimental conditions and are characterized by a moderate reliability and sensitivity. Correlations with other (i.e. biomechanical, neurophysiological or clinical) spasticity assessment parameters are moderate to poor. Standardised and broadly accepted protocols are still largely lacking preventing an effective exchange of knowledge. Conclusion: The clinical and experiemntal use of the three methods is restricted due to moderate reliability and sensitivity. It is recommended to perform combined neurophysiological-biomechanical assessment of spasticity during active, functional movement.
Descriptors		MUSCLE SPASTICITY MUSCLE, SKELETAL NEUROPHYSIOLOGY REFLEX, STRETCH REFLEX, ABNORMAL ELECTROMYOGRAPHY MOTOR NEURONS MUSCLE CONTRACTION POSTURE RANGE OF MOTION, ARTICULAR