Bodofsky Elliot B, Campellone Joseph V, Cohen Stephen J, Caten Holly N, Schindelheim Adam M
*Department of Physical Medicine and Rehabilitation, Cooper University Hospital, Camden, New Jersey, U.S.A.; †Cooper Medical School of Rowan University, Camden, New Jersey, U.S.A.; and ‡Department of Neurology, Cooper University Hospital, Camden, New Jersey, U.S.A.
J Clin Neurophysiol. 2015 Jun;32(3):244-6. doi: 10.1097/WNP.0000000000000152.
To determine whether Contraction Induced H Reflexes (CIHR) can accurately detect cervical radiculopathy.
Comparison of CIHR results with Needle Electromyography at academic outpatient Electromyography/Nerve Conduction laboratories. Participants were all patients over 18 with a needle electromyography diagnosis of cervical radiculopathy. Patients were tested for CIHR in at least two upper extremity muscles in electromyographically proven myotomes bilaterally. Patients were requested to perform a moderate contraction while stimulus was applied proximally (elbow or Erb's point). Outcome measures included H Reflex onset latency and side-to-side latency differences. These were compared against previously established normal values.
Overall, 10 of 15 patients who met criteria for cervical radiculopathy showed CIHR abnormalities (sensitivity = 67%; 95% confidence interval, 43-91). Counting each side and level separately, CIHR identified 16/27 radiculopathies (sensitivity = 59.2%; 95% confidence interval, 40.6-77.8). Contraction Induced H Reflexes identified 1 possible radiculopathy not seen on electromyography (specificity = 98%; 95% confidence interval, 95-100).
Contraction induced H Reflexes have a sensitivity and specificity for cervical radiculopathy similar to the resting Gastroc-Soleus H Reflex.
