Quantifying the deep tendon reflex using varying tendon indentation depths: applications to spasticity.
Quantifying the deep tendon reflex using varying tendon indentation depths: applications to spasticity.
复制标题
使用不同的肌腱压痕深度量化深部腱反射：在痉挛中的应用。
DOI：
10.1109/tnsre.2014.2299753
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Suresh,NinaL
中科院分区：
文献类型：
--
作者：
Chardon,MatthieuK;Rymer,WZev;Suresh,NinaL
深腱反射（DTR）经常被用来表征个体的神经肌肉健康，因为它便宜，快速实施，并需要有限的设备。然而，DTR评估是不可靠的，评估员依赖性提高DTR评估的可靠性，我们设计了一种新的标准化程序。我们的方法是基于这样的假设，即肌肉的神经肌肉状态的变化系统相对于其肌腱的压痕深度。我们通过逐步将9名偏瘫中风幸存者两侧的肱二头肌肌腱缩进不同深度来测试这一假设，然后在每个缩进深度叠加一系列简短的受控轻拍以引起反射反应。我们的研究结果表明，存在一个独特的压痕深度，反射反应一致记录（称为反射阈值），随着幅度沿着增加压痕深度。我们进一步表明，反射阈值深度是系统性的中风幸存者的患侧较小，它与改良Ashworth评分（VAF 70%）呈负相关。我们的程序还可以测量被动力学性能的压痕位置。总之，我们的研究表明，控制肌腱的压痕深度可以预测地改变其反射反应。我们的新设备和方法可用于估计肌肉中的神经肌肉变化（例如，痉挛状态）。虽然需要一些改进，但这种方法为更可靠地量化DTR打开了大门。
The deep tendon reflex (DTR) is often utilized to characterize the neuromuscular health of individuals because it is cheap, quick to implement, and requires limited equipment. However, DTR assessment is unreliable and assessor-dependent improve the reliability of the DTR assessment, we devised a novel standardization procedure. Our approach is based on the hypothesis that the neuromuscular state of a muscle changes systematically with respect to the indentation depth of its tendon. We tested the hypothesis by progressively indenting the biceps tendons on each side of nine hemiplegic stroke survivors to different depths, and then superimposing a series of brief controlled taps at each indentation depth to elicit a reflex response. Our results show that there exists a unique indentation depth at which reflex responses are consistently recorded (termed the Reflex Threshold) with increasing amplitude along increasing indentation depth. We further show that the reflex threshold depth is systematically smaller on the affected side of stroke survivors and that it is negatively correlated with the Modified Ashworth Score (VAF 70%). Our procedure also enables measurement of passive mechanical properties at the indentation location. In conclusion, our study shows that controlling for the indentation depth of the tendon of a muscle alters its reflex response predictably. Our novel device and method could be used to estimate neuromuscular changes in muscle (e.g., spasticity). Although some refinement is needed, this method opens the door to more reliable quantification of the DTR.