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

Primary Purpose

Muscle Spasticity, Spinal Cord Injury, Stroke

Status
Completed
Phase
Not Applicable
Locations
Colombia
Study Type
Interventional
Intervention
joint mobilization techniques
Sponsored by
Universidad Autónoma de Manizales, Colombia
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Muscle Spasticity focused on measuring Musculoskeletal manipulations, Muscle spasticity

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

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.

Sites / Locations

  • UAM

Outcomes

Primary Outcome Measures

H reflex
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.

Secondary Outcome Measures

Full Information

First Posted
May 12, 2010
Last Updated
June 28, 2010
Sponsor
Universidad Autónoma de Manizales, Colombia
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1. Study Identification

Unique Protocol Identification Number
NCT01153022
Brief Title
Effect of Joint Mobilization on Alpha Motoneuron Reflex Excitability
Acronym
JM-HRreflex
Official Title
Effect of Joint Mobilization on Alpha Motoneuron Reflex Excitability in People With Spasticity: Controlled Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
June 2010
Overall Recruitment Status
Completed
Study Start Date
February 2008 (undefined)
Primary Completion Date
March 2009 (Actual)
Study Completion Date
March 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Universidad Autónoma de Manizales, Colombia

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Muscle Spasticity, Spinal Cord Injury, Stroke, Craniocerebral Trauma
Keywords
Musculoskeletal manipulations, Muscle spasticity

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Other
Intervention Name(s)
joint mobilization techniques
Intervention Description
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.
Primary Outcome Measure Information:
Title
H reflex
Description
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.
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)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility 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.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Julio E Pérez, Master
Organizational Affiliation
Universidad Autónoma de Manizales
Official's Role
Principal Investigator
Facility Information:
Facility Name
UAM
City
Manizales
State/Province
Caldas
Country
Colombia

12. IPD Sharing Statement

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Effect of Joint Mobilization on Alpha Motoneuron Reflex Excitability

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