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Effect of Joint Mobilization on Alpha Motoneuron Reflex Excitability (JM-HRreflex)

This study has been completed.
Sponsor:
Information provided by:
Universidad Autónoma de Manizales, Colombia
ClinicalTrials.gov Identifier:
NCT01153022
First received: May 12, 2010
Last updated: June 28, 2010
Last verified: June 2010
History of Changes
  Purpose

Objective: To determine the effect of ankle joint mobilization on the alpha motoneuron reflex excitability of the soleus muscle in people with spasticity.

Subjects and Methods: A controlled clinical trial with crossover design and simple masking was conducted in 24 randomized subjects to initiate the control or experimental group. Traction and rhythmic oscillation were applied for five minutes to the ankle joint. Alpha motoneuron reflex excitability was assessed by measuring H wave amplitude (Hoffmann reflex - H reflex), stimulating the tibial nerve at the level of the popliteal fossa and recording in the soleus muscle. In each subject 12 measurements were taken: basal rate, during and after mobilization. Changes in alpha motoneuron reflex excitability were calculated in relation to basal measurement. For each measurement a hypothesis test was performed (Student t test).

Results: In groups of patients with brain injury (BI) and incomplete spinal cord injury (ISCI), a significant difference was found between measurements of both studies, concerning variation in alpha motoneuron reflex excitability during the application of joint mobilization techniques, with a decrease in the experimental group and an increase in the control group. In contrast, no significant differences were found after mobilization therapy. Patients with complete spinal cord injury (CSCI) showed no significant differences in any measurements.

Conclusion: We demonstrate the effectiveness of passive movement in the decrease of muscle tone during the mobilization maneuver in patients with BI or ISCI, but no residual effect after completion of the trial. This research project showed no evidence regarding spasticity reduction in complete spinal cord injuries. This suggests that therapeutic interventions to decrease muscle tone, based on the passive exercise and stimulation of proprioceptors should be reconsidered.


Condition Intervention
Muscle Spasticity
Spinal Cord Injury
Stroke
Craniocerebral Trauma
 Other: joint mobilization techniques

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Effect of Joint Mobilization on Alpha Motoneuron Reflex Excitability in People With Spasticity: Controlled Clinical Trial

Resource links provided by NLM:

U.S. FDA Resources

Further study details as provided by Universidad Autónoma de Manizales, Colombia:

Primary Outcome Measures:
  • H reflex [ Time Frame: Twelve measurements were performed for each patient: basal rate (0), during joint mobilization (1, 3 and 5 minutes) and after the completion of joint mobilization (1, 3, 5, 10, 15, 20, 25 and 30 minutes) ] [ Designated as safety issue: No ]
    The Hoffmann reflex is an electrically induced reflex, analogous to the myotatic reflex that is mechanically triggered by stretching the neuromuscular spindle. In contrast, the H reflex stimulates the Ia fiber at the peripheral nerve level.


Enrollment: 24
Study Start Date: February 2008
Study Completion Date: March 2009
Primary Completion Date: March 2009 (Final data collection date for primary outcome measure)
Intervention Details:
    Other: joint mobilization techniques
    In the experimental group, ankle joint mobilization was applied for five minutes, using grade II joint traction rhythmic oscillation (Mailland Scale) with the knee in 15° of flexion, subtalar in neutral and ankle in resting position (10º plantarflexion). During the control study, participants were placed under the same conditions as those of the experimental group but only the hands of the evaluator were placed in the foot, in the position of joint traction simulation.
  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  • people over 18 years old
  • spasticity acquired after five years of age
  • any etiology
  • any location of the injury

Patients were instructed not to consume coffee, cigarettes or energy drinks 24 hours prior to the study nor participate in excessive physical exercise during the day.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01153022

Locations
Colombia
UAM
Manizales, Caldas, Colombia
Sponsors and Collaborators
Universidad Autónoma de Manizales, Colombia
Investigators
Principal Investigator: Julio E Pérez, Master Universidad Autónoma de Manizales
  More Information

No publications provided

Responsible Party: María del Carmen Vergara Quintero, Universidad Autónoma de Manizales
ClinicalTrials.gov Identifier: NCT01153022     History of Changes
Other Study ID Numbers: CT01UAM-H reflex
Study First Received: May 12, 2010
Last Updated: June 28, 2010
Health Authority: Colombia: National Institutes of Health

Keywords provided by Universidad Autónoma de Manizales, Colombia:
Musculoskeletal manipulations
Muscle spasticity

Additional relevant MeSH terms:
Craniocerebral Trauma
Muscle Spasticity
Spinal Cord Injuries
Stroke
Trauma, Nervous System
Nervous System Diseases
Wounds and Injuries
Muscular Diseases
Musculoskeletal Diseases
Muscle Hypertonia
 Neuromuscular Manifestations
Neurologic Manifestations
Signs and Symptoms
Spinal Cord Diseases
Central Nervous System Diseases
Cerebrovascular Disorders
Brain Diseases
Vascular Diseases
Cardiovascular Diseases

ClinicalTrials.gov processed this record on June 13, 2013