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Relationship between spinal reflexes and leg motor function in sub-acute and chronic stroke patientsTakahashi, Yoko; Kawakami, Michiyuki; Mikami, Rena; Nakajima, Toshiya; Nagumo, Towa; Yamaguchi, Tomofumi; Honaga, Kaoru; Kondo, Kunitsugu; Ishii, Ryota; Fujiwara, Toshiyuki; Liu, Meigen
Clinical neurophysiology, 06/2022, Volume: 138Journal Article
•The relation of spinal reflexes with leg motor function was tested in sub-acute and chronic stroke.•Severe spasticity is linked to heteronymous facilitation and disynaptic reciprocal inhibition in sub-acute stroke patients.•Spinal reflexes are potential biomarkers for spasticity and motor function. To assess the relationship between spinal reflexes and motor function in sub-acute (SAS) and chronic stroke (CS) patients. Twelve SAS and 16 CS patients underwent electrophysiological assessment of heteronymous facilitation (HF), heteronymous inhibition (HI), disynaptic reciprocal inhibition (DRI), and D1 inhibition (D1). The Fugl-Meyer Assessment Lower Extremity (FMA-LE) and modified Ashworth scale (MAS) were assessed. The relationship between spinal reflexes and motor function was examined in a cross-sectional manner. SAS patients were also longitudinally evaluated before and after intensive rehabilitation for approximately 2 months. SAS patients with triceps surae muscle spasticity (MAS ≥ 1) showed higher HF values (p = 0.03) than those without spasticity. SAS patients with quadriceps muscle spasticity showed higher HF values (p < 0.01); patients with hamstring muscle spasticity showed higher DRI value (disinhibition) (p < 0.01) than those without spasticity. CS patients showed no significant correlation between spinal reflexes and motor function. The longitudinal study revealed a significant correlation between increase in D1 inhibition and FMA-LE improvement in SAS patients (r = 0.69). The association between impaired spinal reflexes varies with the stage of stroke; HF and DRI may be spasticity indicators in SAS patients. Spinal reflexes as potential biomarkers may facilitate tailor-made rehabilitation of stroke patients.
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