Highlights
- •Women with patellofemoral pain presented reduced vastus medialis Hoffman reflex (H-reflex) excitability.
- •Vastus medialis H-reflex presented large and balanced discriminatory capability values.
- •H-reflex modulation may be a factor to be considered in patellofemoral pain investigations.
Abstract
Objectives
To investigate whether vastus medialis (VM) Hoffmann reflexes (H-reflexes) differ
on the basis of the presence or absence of patellofemoral pain (PFP) and to assess
the capability of VM H-reflex measurements in accurately discriminating between women
with and without PFP.
Design
Cross-sectional study.
Setting
Laboratory of biomechanics and motor control.
Participants
Women (N=30) aged 18 to 35 years were recruited, consisting of 2 groups: women with
PFP (n=15) and asymptomatic controls (n=15).
Interventions
Not applicable.
Main Outcome Measures
Maximum evoked responses were obtained by electrical stimulation applied to the femoral
nerve, and peak-to-peak amplitudes of maximal Hoffmann reflex (Hmax) and maximal motor
wave (Mmax) ratios were calculated. Independent samples t tests were performed to identify differences between groups, and a receiver operating
characteristic curve was constructed to assess the discriminatory capability of VM
H-reflex measurements.
Results
VM Hmax/Mmax ratios were significantly lower in participants with PFP than in pain-free
participants (P=.007). In addition, the VM Hmax/Mmax ratios presented large and balanced discriminatory
capability values (sensitivity, 73%; specificity, 67%).
Conclusions
This study is the first to show that VM H-reflexes are lower in women with PFP than
in asymptomatic controls. Therefore, increasing the excitation of the spinal cord
in PFP participants may be essential to maintaining the gains acquired during the
rehabilitation programs.
Keywords
List of abbreviations:
Hmax (maximal Hoffmann reflex), H-reflex (Hoffmann reflex), ICC (intraclass correlation coefficient), Mmax (maximal motor wave), PFP (patellofemoral pain), ROC (receiver operating characteristic), VM (vastus medialis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 04, 2016
Footnotes
Supported by the São Paulo Research Foundation (grant no. 2014/24939-7; scholarship no. 2013/10755-9).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
