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H-反射と緊張性振動反射（TVR）を用いた筋緊張異常および相反性機能失調の検討 Reciprocal reflex activity of muscle tone abnormality, studied by electromyography together with tonic vibration reflex (TVR) 柳原, 章 Yanagihara, Akira 近畿大学 Kinki University reciprocal reflex activity muscle tone abnormality H-reflex tonic vibration reflex (TVR) frequency depression curve The reciprocal reflex activity in various muscle tone abnormalities was analyzed using the H-reflex together with tonic vibration reflex (TVR). The H-reflex was elicited by short interval (5-8 ms) double volleys while vibratory stimulation (TVR) of 100 Hz was applied to the synergist (gastrocnemius) or antagonist (peroneus) muscles. On the other hand, the frequency depression (FD) curve of the H-reflex was plotted at a higher frequency (1-50 Hz) stimulation. The patients analyzed in this study totaled 48, consisting of 8 normal subjects, 1 with peroneal damage, 22 with spasticity, 5 with rigidity, 9 with cerebellar-brainstem lesion and 3 with cervical cord lesion. In the normal subjects, two successive H-reflexes (H_1 and H_2) were elicited by short interval double volleys, and attenuated by TVR applied to the gastrocnemius as well as TVR applied to the peroneus muscle. The attenuation rates were 68% in gastrocnemius TVR and 80% in peroneus TVR. The FD-curve showed a medium level in lower frequencies and then rose gentlly higher frequencies. In the peroneal nerve damage patient, although the H-reflexes of H_1 and H_2 were attenuated by gastrocnemius TVR they were not attenuated by peroneus TVR because of a loss of the reciprocal innervation. The FD-curve showed a normal characteristic configuration because there were no lesions in the upper center. In spasticity, the H-reflex was not attenuated by gastrocnemius nor by peroneus TVR's at a sufficient rate. The rates were 38% in the former and 46% in the latter. The FD-curve showed a higher level at a lower frequency then showed a steep sloping configuration from medium to higher frequencies. In rigidity, the rates was 26% in gastrocnemius TVR and 51% in peroneus TVR. The FD-curve showed a higher level at a lower frequency, then showed a slighter sloping configuration of higher level from medium to higher frequencies. In cerebellar-brainstem lesion, the rates were 25% in gastrocnemius TVR and 49% in peroneus TVR. The FD-curve showed a higher level in all frequencies then showed a gentle sloping configuration at a higher level from medium to higher frequencies. These findings could be considered as a result of the disturbance of the reflex modulation from the upper center. The combined examination of the H-reflex and TVR seems to be a useful diagnostic method and may also help in the determination of a therapeutic approach that is most appropriate. 本文データはCiNiiから複製したものである。 近畿大学医学会 1992-03-25 jpn departmental bulletin paper AM https://kindai.repo.nii.ac.jp/records/2002453 03858367 近畿大学医学雑誌 Medical Journal of Kinki University 17 1 23 35 https://kindai.repo.nii.ac.jp/record/2002453/files/AN00063584-19920325-0023.pdf application/pdf 945.9 KB