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Patellar tapping

Diego Z Carvalho, Christopher J Boes
As opposed to finger flexion response upon tapping the styloid process with absent brachioradialis reflex (inverted brachioradialis reflex), toe flexion response upon patellar percussion with absent quadriceps reflex is a quite underrecognized neurological sign, and has been reported only once in the literature. Similar to the inverted brachioradialis reflex, this sign can also be useful for neurological localization. We hereby report a patient presenting with signs and symptoms of lumbar radiculopathy in the setting of an anterior epidural mass compressing the cauda equina at L2-L4, without evidence of myelopathy...
October 2016: Clinical Neurology and Neurosurgery
Nasimah Maricar, Michael J Callaghan, Matthew J Parkes, David T Felson, Terence W O'Neill
OBJECTIVE: The aim of this systematic review was to determine the validity and inter- and intra-observer reliability of the assessment of knee joint effusion in osteoarthritis (OA) of the knee. METHODS: MEDLINE, Web of Knowledge, CINAHL, EMBASE, and AMED were searched from their inception to February 2015. Articles were included according to a priori defined criteria: samples containing participants with knee OA; prospective evaluation of clinical tests and assessments of knee effusion that included reliability, sensitivity, and specificity of these tests...
April 2016: Seminars in Arthritis and Rheumatism
Zachary K Pope, Jason M DeFreitas
PURPOSE: Localized mechanical vibration, applied directly to a muscle, is known to have powerful, duration-dependent effects on the muscle spindle's reflex arc. Here, the conditioning of the function of the spindle reflex arc via vibration was examined with considerations for use as a non-invasive, sensorimotor research tool. METHODS: Muscle spindle function was examined with patellar tendon taps prior to and following exposure to muscle vibration applied to the quadriceps femoris for acute (<5 s) and prolonged (20 min) durations...
2015: Somatosensory & Motor Research
Faustyna Manikowska, Brian Po-Jung Chen, Marek Jóźwiak, Maria K Lebiedowska
The aim of this pilot study was to determine if exaggerated patellar tendon jerk affects knee joint position sense (JPS) in cerebral palsy (CP) patients, by comparing JPS of the knee between participants with normal and exaggerated reflexes. The thresholds for reflex classification were based upon the data from able-bodied volunteers. JPS was measured as the ability of a subject (with eyes closed) to replicate a knee joint position demonstrated by an examiner. Tendon jerk was measured as the moment of force in response to patellar tendon taps...
October 2015: Research in Developmental Disabilities
Tanya Onushko, Brian D Schmit, Allison Hyngstrom
The purpose of this study was to understand how stretch-related sensory feedback from an antagonist muscle affects agonist muscle output at different contraction levels in healthy adults. Ten young (25.3 ± 2.4 years), healthy subjects performed constant isometric knee flexion contractions (agonist) at 6 torque levels: 5%, 10%, 15%, 20%, 30%, and 40% of their maximal voluntary contraction. For half of the trials, subjects received patellar tendon taps (antagonist sensory feedback) during the contraction. We compared error in targeted knee flexion torque and hamstring muscle activity, with and without patellar tendon tapping, across the 6 torque levels...
2015: PloS One
Zachary K Pope, Jason M DeFreitas
Our purpose was to examine the effects of body position and a low-intensity voluntary contraction on patellar tendon tap reflex properties.Surface electromyography, torque, and accelerometry signals were obtained from 30 subjects (25.0   ±   4.6 years) during patellar tendon taps. These signals were used to quantify reflex magnitude and the subcomponents of reflex latency for each subject in the upright position (i.e. control), supine position, and during α-γ coactivation (i.e. a low-intensity contraction)...
July 2015: Physiological Measurement
Dali Xu, Xin Guo, Chung-Yong Yang, Li-Qun Zhang
Hyperactive reflexes are commonly observed in patients with spinal cord injury (SCI) but there is a lack of convenient and quantitative characterizations. Patellar tendon reflexes were examined in nine SCI patients and ten healthy control subjects by tapping the tendon using a hand-held instrumented hammer at various knee flexion angles, and the tapping force, quadriceps EMG, and knee extension torque were measured to characterize patellar tendon reflexes quantitatively in terms of the tendon reflex gain (G tr), contraction rate (R c ), and reflex loop time delay (t d )...
2015: BioMed Research International
Yoshitsugu Tanino, Toshiaki Suzuki
[Purpose] The gross morphology of the vastus medialis (VM) muscle has been thoroughly described. However, there is insufficient evidence of physiological differentiation between the VM obliquus (VMO) and VM longus (VML). To elucidate spinal reflex arc excitability in two divisions of the VM, we compared H-reflexes and T-waves in VMO and VML. [Subjects] Twenty-three healthy male volunteers participated in this study. [Methods] The H-reflex was evoked from the VMO and VML by electrical stimulation of the femoral nerve during knee extension at 10% maximal voluntary isometric contraction...
January 2014: Journal of Physical Therapy Science
Lucie Brosseau, Prinon Rahman, Karine Toupin-April, Stéphane Poitras, Judy King, Gino De Angelis, Laurianne Loew, Lynn Casimiro, Gail Paterson, Jessica McEwan
Clinical practice CPGs (CPGs) have been developed to summarize evidence related to the management of osteoarthritis (OA). CPGs facilitate uptake of evidence-based knowledge by consumers, health professionals, health administrators and policy makers. The objectives of the present review were: 1) to assess the quality of the CPGs on non-pharmacological management of OA; using a standardized and validated instrument--the Appraisal of Guidelines Research and Evaluation (AGREE II) tool--by three pairs of trained appraisers; and 2) to summarize the recommendations based on only high-quality existing CPGs...
2014: PloS One
Annapoorna Chandrasekhar, Noor Azuan Abu Osman, Lai Kuan Tham, Kheng Seang Lim, Wan Abu Bakar Wan Abas
BACKGROUND: A clinical parameter commonly used to assess the neurological status of an individual is the tendon reflex response. However, the clinical method of evaluation often leads to subjective conclusions that may differ between examiners. Moreover, attempts to quantify the reflex response, especially in older age groups, have produced inconsistent results. This study aims to examine the influence of age on the magnitude of the patellar tendon reflex response. METHODOLOGY/PRINCIPAL FINDINGS: This study was conducted using the motion analysis technique with the reflex responses measured in terms of knee angles...
2013: PloS One
Arko Ghosh, Patrick Haggard
Both voluntary and involuntary movements activate sensors in the muscles, skin, tendon and joints. As limb movement can result from a mixture of spinal reflexes and voluntary motor commands, the cortical centres underlying conscious proprioception might either aggregate or separate the sensory inputs generated by voluntary movements from those generated by involuntary movements such as spinal reflexes. We addressed whether healthy volunteers could perceive the contribution of a spinal reflex during movements that combined both reflexive and voluntary contributions...
January 1, 2014: Journal of Physiology
Lai Kuan Tham, Noor Azuan Abu Osman, Wan Abu Bakar Wan Abas, Kheng Seang Lim
BACKGROUND: The deep tendon reflex assessments that are essential to the accurate diagnosis of neurological or neuromuscular disorders are conducted subjectively in clinical neurology. Our aim was to assess deep tendon reflexes objectively with a new reflex quantification method. METHODOLOGY/PRINCIPAL FINDINGS: The present study used a motion analysis technique to collect quantitative measurements for both the input and output of normal patellar tendon reflex. Reflex responses were measured as knee angles...
2013: PloS One
Chung-Yong Yang, Xin Guo, Yupeng Ren, Sang Hoon Kang, Li-Qun Zhang
OBJECTIVES: To quantify tendon tap response (TTR) properties and their position dependence using multiple neuromechanical parameters, and to analyze correlations among neuromechanical and clinical measures. DESIGN: Hyperexcitable dynamics of TTR were investigated in a case-control manner. An instrumented hammer was used to induce the patellar deep tendon reflex (DTR), with reflex-mediated electromyography and torque responses measured across a range of knee flexion...
February 2013: Archives of Physical Medicine and Rehabilitation
Maria K Lebiedowska, Siddhartha Sikdar, Avinash Eranki, Lindsay Garmirian
Tendon jerk (TJ) is one of the most commonly used clinical tests in differential diagnosis of human motor disorders. There remains some ambiguity in the physiological interpretation of the test, especially with respect to its association to the functional status of patients. The TJ test inputs a non-physiological stimuli, but it is unclear to what degree the kinematics generated during the TJ test exceed the ranges that muscles encounter in activities of daily living (ADLs). The aim of our pilot study was to determine the range of angular knee kinematics (angular velocities and accelerations) corresponding to the muscle stretch elicited by TJ...
June 15, 2011: Journal of Neuroscience Methods
Jan M Kuemmerle, Anton E Fürst
OBJECTIVE: To report open reduction and joint stabilization using a prosthetic capsule technique for treatment of a craniodorsal coxofemoral luxation in a lightweight pony. STUDY DESIGN: Clinical report. ANIMALS: Pony stallion (8 years old, 113 kg). METHODS: A craniodorsal approach to the coxofemoral joint was performed under general anesthesia. After open reduction, a prosthetic capsule technique was used. Four 3.5 mm self-tapping cortical anchor screws were implanted: 2 screws were inserted above the cranial aspect of the dorsal acetabular rim, and 2 screws were inserted into the femoral neck...
July 2011: Veterinary Surgery: VS
L K Tham, N A Abu Osman, K S Lim, B Pingguan-Murphy, W A B Wan Abas, N Mohd Zain
The investigation of patellar tendon reflex involves development of a reflex hammer holder, kinematic data collection and analysis of patellar reflex responses using motion analysis techniques. The main aim of this research is to explore alternative means of assessing reflexes as a part of routine clinical diagnosis. The motion analysis system was applied to provide quantitative data which is a more objective measure of the patellar tendon reflex. Kinematic data was collected from 28 males and 22 females whilst subjected to a knee jerk test...
May 2011: Medical Engineering & Physics
Michael D Lewek, Rachel Breslin, Lesley Hlad, Alex Lanton, Jamie St John
OBJECTIVE: Inappropriate muscle activity is common following stroke. Paretic muscle activation may be influenced by non-paretic volitional activation. We examined the influence of non-paretic quadriceps activation on paretic quadriceps excitability. METHODS: Individuals with chronic stroke performed bilateral and unilateral (paretic and non-paretic) maximum voluntary isometric contractions. Peak torque and muscle activity were compared between conditions. An instrumented tendon tapper elicited a patellar tendon reflex of the relaxed paretic leg while the non-paretic leg was relaxed and pre-activated...
November 2010: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Kathryn Hemsley, Michael Sitler, Ray Moyer, Carol Oatis
To identify distinguishing characteristics for knee surgery patients who experience a protracted recovery process, we sought to determine if there is an association between the neuromuscular stretch reflex and psychological factors of pain perception and anxiety on the range of motion (ROM) recovery rate of post-operative anterior cruciate ligament reconstruction (ACLR) rehabilitation patients. The ACLR participants were categorized into a slow recovery group (SRG: >6 weeks to recover 0-125 degrees knee flexion [n=10]) and a normal recovery group (NRG: <6 weeks to recovery 0-125 degrees knee flexion [n=12])...
August 2010: Journal of Electromyography and Kinesiology
Siddhartha Sikdar, Maria Lebiedowska, Avinash Eranki, Lindsay Garmirian, Diane Damiano
We have developed a vector tissue Doppler imaging (TDI) system based on a clinical scanner that can be used to measure muscle velocities independent of the direction of motion. This method overcomes the limitations of conventional Doppler ultrasound, which can only measure velocity components along the ultrasound beam. In this study, we utilized this method to investigate the rectus femoris muscle velocities during a patellar tendon jerk test. Our goal was to investigate whether the muscle elongation velocities during a brisk tendon tap fall within the normal range of velocities that are expected due to rapid stretch of limb segments...
2009: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Darryl J Cochrane, Stephen R Stannard, Elwyn C Firth, Jörn Rittweger
Whole-body vibration (WBV) leads to a rapid increase in intra-muscular temperature and enhances muscle power. The power-enhancing effects by WBV can, at least in part, be explained by intra-muscular temperature. However, this does not exclude possible neural effects of WBV occurring at the spinal level. The aim of this study was to examine if muscle twitch and patellar reflex properties were simultaneously potentiated from an acute bout of WBV in a static squat position. Six male and six female athletes performed three interventions for 5 min, static squat with WBV (WBV+, 26 Hz), static squat without WBV (WBV-) and stationary cycling (CYCL, 70 W)...
January 2010: European Journal of Applied Physiology
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