Patellar Tendon Reflex and Vastus Medialis Hoffmann Reflex Are Down Regulated and Correlated in Women With Patellofemoral Pain

Author(s)

Pazzinatto, Marcella Ferraz ^{[1, 2]} ; Silva, Danilo de Oliveira ^{[1, 2]} ; Ferreira, Amanda Schenatto ^[2] ; Waiteman, Marina Cabral ^[2] ; Pappas, Evangelos ^[3] ; Magalhaes, Fernando Henrique ^[4] ; de Azevedo, Fabio Micolis ^[2]

Affiliation

^[1] La Trobe Univ, Sch Allied Hlth, La Trobe Sports & Exercise Med Res Ctr LASEM, Bundoora, Vic - Australia

^[2] Univ Sao Paulo State UNESP, Sch Sci & Technol, Phys Therapy Dept, Presidente Prudente - Brazil

^[3] Univ Sydney, Fac Hlth Sci, Discipline Physiotherapy, Sydney, NSW - Australia

^[4] Univ Sao Paulo, Sch Arts Sci & Humanities, Sao Paulo - Brazil

• Document type: Journal article
• Source: ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION; v. 100, n. 3, p. 514-519, MAR 2019.
• Web of Science Citations: 0

Abstract

Objectives: The aims of this study were threefold: (1) to compare the amplitude of patellar tendon reflex (T-reflex) between women with patellofemoral pain (PFP) and pain-free controls; (2) to compare the amplitude of vastus medialis Hoffmann reflex (VM H-reflex) between women with PFP and pain-free controls; (3) to investigate the association between the amplitude of patellar T-reflex and VM H-reflex in women with PFP and pain-free controls. Design: Cross-sectional observational study. Setting: Laboratory of biomechanics and motor control. Participants: Thirty women with PFP and 30 pain-free women aged 18 to 35 years (N=60). Main Outcome Measures: Peak-to-peak amplitudes of maximal VM H-reflex (elicited via electrical stimulation on the femoral nerve) and patellar T-reflex (elicited via mechanical percussion on the patellar tendon) were estimated. Results: Women with PFP had significant lower amplitude of patellar T-reflex (mean difference=0.086; 95% confidence interval=0.020 to 0.151; P=.010; moderate effect) and VM H-reflex (mean difference = 0.150; 95% confidence interval = 0.073 to 0.227; P<.001; large effect) compared to pain-free controls. The VM H-reflex was strongly correlated with patellar T-reflex in both PFP group (r=0.66; P<.001) and control group (r=0.72; P<.001). Conclusions: As the T-reflex is easier to perform than H-reflex assessments in a clinical setting, it represents a feasible option to assess the impaired excitability of the stretch reflex pathway associated with PFP. (C) 2018 by the American Congress of Rehabilitation Medicine (AU)

• FAPESP's process: 14/10839-0 - Influence of pain on electromyographic parameters in subjects with patellofemoral pain syndrome during stair climbing: frequency and time domain
• Grantee: Marcella Ferraz Pazzinatto
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 16/19784-0 - Does altered modulation of the H-reflex is a risk factor for patellofemoral pain?
• Grantee: Marcella Ferraz Pazzinatto
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 16/50320-0 - International partnership to improve clinical and biomechanical studies related to knee disability
• Grantee: Fábio Mícolis de Azevedo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/10631-3 - Does it matter that my knee clicks? a longitudinal study of functional decline based on the presence of CREPITUS: data from the osteoarthritis initiative
• Grantee: Marcella Ferraz Pazzinatto
• Support Opportunities: Scholarships abroad - Research Internship - Master's degree