Patellar Tendon Reflex And Vastus Medialis Hoffmann Reflex Are Down Regulated And Correlated In Women With Patellofemoral Pain

Publication date: Available online 27 July 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Marcella Ferraz Pazzinatto, Danilo de Oliveira Silva, Amanda Schenatto Ferreira, Marina Cabral Waiteman, Evangelos Pappas, Fernando Henrique Magalhães, Fábio Mícolis de Azevedo

ABSTRACT

Objective

(s): The aim of this study was threefold: (i) To compare the amplitude of patellar tendon reflex (T-reflex) between women with patellofemoral pain (PFP) and pain-free controls; (ii) To compare the amplitude of vastus medialis Hoffmann reflex (VM H-reflex) between women with PFP and pain-free controls; (iii) 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 thirty pain-free women aged 18 to 35 years.

Main Outcome Measure(s)

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% CI = 0.020 to 0.151; p = 0.010; moderate effect) and VM H-reflex (mean difference = 0.150; 95% CI = 0.073 to 0.227; p < 0.001; 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 < 0.001) and control group (r = 0.72; p < 0.001).

Conclusion

(s): 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.

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