Hiraoka Koichi, Matsuo Yoshimi, Abe Kazuo
Department of Physical Therapy, Osaka Prefectural University, Osaka, Japan.
Mov Disord. 2005 Jul;20(7):858-64. doi: 10.1002/mds.20448.
The soleus H-reflex excitability during gait initiation was investigated in Parkinson's disease. Eleven patients participated in this study. Patients stepped forward as soon as the start signal flashed. Soleus H-reflex was evoked from the trailing leg 100, 300, or 600 msec after the start signal. The electromyographic activity in the soleus muscle immediately before evoking the H-reflex and the ankle joint motion were recorded. The soleus H-reflex was inhibited 300 msec after the start signal. The amount of the soleus H-reflex inhibition was inversely correlated with the Hoehn and Yahr stage; Items 14, 29, and 31 of the Unified Parkinson's Disease Rating Scale; and the delay of the onset of the ankle dorsiflexion from the start signal. In contrast, the amount of electromyographic activity immediately before evoking the H-reflex was not significantly correlated with those measures but was significantly correlated with Item 22 of the Unified Parkinson's Disease Rating Scale. Those findings indicate that the amount of soleus H-reflex inhibition during gait initiation depends on the severity of the disease. Abnormality of descending command may be related to the severity-dependent H-reflex inhibition.
在帕金森病患者中研究了步态起始过程中比目鱼肌H反射的兴奋性。11名患者参与了本研究。一旦开始信号闪烁，患者即向前迈步。在开始信号发出后100、300或600毫秒，从 trailing leg 诱发比目鱼肌H反射。记录诱发H反射前比目鱼肌的肌电图活动和踝关节运动。开始信号发出后300毫秒，比目鱼肌H反射受到抑制。比目鱼肌H反射抑制量与Hoehn和Yahr分期、统一帕金森病评定量表的第14、29和31项以及从开始信号到踝关节背屈起始的延迟呈负相关。相比之下，诱发H反射前的肌电图活动量与这些指标无显著相关性，但与统一帕金森病评定量表的第22项显著相关。这些发现表明，步态起始过程中比目鱼肌H反射抑制量取决于疾病的严重程度。下行指令异常可能与严重程度依赖的H反射抑制有关。
