Vastus Medialis Hoffmann Reflex Excitability Is Associated With Pain Level, Self-Reported Function, and Chronicity in Women With Patellofemoral Pain



      To determine the association between the amplitude of vastus medialis (VM) Hoffmann reflex (H-reflex) and pain level, self-reported physical function, and chronicity of pain in women with patellofemoral pain (PFP).


      Cross-sectional study.


      Laboratory of biomechanics and motor control.


      Women diagnosed with PFP (N=15) aged 18 to 35 years.


      Not applicable.

      Main Outcome Measures

      Data on worst pain level during the previous month, self-reported physical function, and symptom duration (chronicity) were collected from the participants. Maximum evoked responses were obtained by electrical stimulation applied to the femoral nerve and peak-to-peak amplitudes of normalized maximal H-reflexes (maximal Hoffmann reflex/maximal motor wave ratios) of the VM were calculated. A Pearson product-moment correlation matrix (r) was used to explore the relations between the amplitude of VM H-reflex and worst pain during the previous month, self-reported function, and chronicity of pain.


      Strong negative correlations were found between the amplitude of VM H-reflex and worst pain in the previous month (r=−.71; P=.003) and chronicity (r=−.74; P=.001). A strong positive correlation was found between the amplitude of VM H-reflex and self-reported physical function (r=.62; P=.012).


      The strong and significant relations reported in this study suggest that women with PFP showing greater VM H-reflex excitability tend to have lower pain, better physical function, and more recent symptoms. Therefore, rehabilitation strategies designed to increase the excitability of the monosynaptic stretch reflex should be considered in the treatment of women with PFP if their effectiveness is demonstrated in future studies.


      List of abbreviations:

      AKPS (Anterior Knee Pain Scale), Hmax (maximal Hoffmann reflex), H-reflex (Hoffmann reflex), ICC (intraclass correlation coefficient), Mmax (maximal motor wave), PFP (patellofemoral pain), VM (vastus medialis)
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