Vastus medialis H-reflex excitability is associated with pain level, self-reported function and chronicity in women with patellofemoral pain

Publication date: Available online 13 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Danilo de Oliveira Silva, Fernando Henrique Magalhães, Nathálie Clara Faria, Deisi Ferrari, Marcella Ferraz Pazzinatto, Evangelos Pappas, Fábio Mícolis de Azevedo
Objective(s): 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).DesignCross-sectional study.SettingLaboratory of biomechanics and motor control.ParticipantsWomen diagnosed with PFP (N = 15) aged 18 to 35 years were recruited.Main Outcome Measure(s)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 (Hmax/Mmax ratios) of the VM were calculated. A Pearson product–moment correlation matrix (r) was used to explore the relationships among VM H-reflex and the worst pain during the previous month, self-reported function and chronicity of pain.ResultsStrong negative correlations were found among VM H-reflex and worst pain in the previous month (r = -0.71; p = 0.003) and chronicity (r = -0.74; p = 0.001). A strong positive correlation was found between VM H-reflex and self-reported physical function (r = 0.62; p = 0.012).Conclusion(s): The strong and significant relationships reported in this study suggest that women with PFP showing larger 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.



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