Abstract
IntroductionPeripheral neuropathy (PN) affects up to 20% of the population over the age of 60. Hoffmann reflex (H-reflex) may assess PN adaptation by measuring the function of the peripheral neural system and central nervous system (CNS) modulation. This project aimed to find a reliable muscle among triceps surae muscles during standing and walking among the PN population.Materials and MethodsSixteen older adults (> 65 years of age) diagnosed with PN were recruited in this study. The H-reflex test was conducted on the muscle belly of the soleus (SOL), the medial (MG), and lateral gastrocnemius (LG) during standing and walking (heel contact, midstance, and toe-off phases). All measurements were collected on two occasions, separated by at least 7 days. Intraclass correlation coefficients (ICCs) and their confidence intervals (CIs) were used to examine the consistency of the H-reflex outcome variables in the repeated tests for all three tested muscles.ResultsThe ICCs of H-index during standing and the three walking phases were poor to moderate in SOL (0.486∼0.737) and MG (0.221∼0.768), and moderate to high in LG (0.713∼0.871). The ICCs of H/M ratio were poor to moderate in SOL (0.263∼0.702) and MG (0.220∼0.733), and high in LG (0.856∼0.958).ConclusionThe H-reflex of LG was more reliable than SOL and MG during standing and walking among older adults with peripheral neuropathy. It is crucial for future studies in this population to study H-reflex of LG, not SOL and MG, for more reliable results.
Highlights
Peripheral neuropathy (PN) affects up to 20% of the population over the age of 60
Individuals were excluded with one or more of the following: (1) Self-reported history or evidence of central nervous system dysfunction; (2) self-reported trauma or disease that may significantly affect gait or postural control; (3) evidence of foot sole ulcer(s); (4) with a cardiac pacemaker; (5) global cognitive impairment defined by a Mini-Mental State Exam (MMSE) score < 24; and (6) contraindications to physical activity determined by the Physical Activity Readiness Questionnaire Plus (PAR-Q+), i.e., (a) heart condition; (b) high blood pressure; (c) spinal cord disease; (d) lose balance because of dizziness or lost consciousness within the past 12 months; (e) bone, joint, or soft tissue problem that could be made worse by becoming more physically active; (f) only do medically supervised physical activity
Skin temperature at the test site was consistent within participants, between the two testing visits, during the tests of both standing and walking
Summary
Hoffmann reflex (H-reflex) may assess PN adaptation by measuring the function of the peripheral neural system and central nervous system (CNS) modulation. This project aimed to find a reliable muscle among triceps surae muscles during standing and walking among the PN population. Patients often exhibit neural impairments and associated abnormal sensations, including tingling, pricking, burning, and numbness in the lower extremities (Richardson, 2002). Together, these impairments and symptoms decrease postural control (Dixit, 2015), increase the likelihood of falls in older adults (Richardson et al, 1992), along with increased mortality (Kan et al, 2009). The CNS alters the latency and amplitude of the monosynaptic stretch reflex by modifying the sensitivity and threshold of excitability of the spinal interneurons (Li et al, 2019)
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