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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 2007 Marzo;43(1):37-47
Frequency rhythmic electrical modulation system (frems) on H-reflex amplitudes in healthy subjects
Barrella M., Toscano R., Goldoni M., Bevilacqua M.
Endocrine and Diabetes Unit, Ospedale L. Sacco University of Milan, Milan, Italy
Aim. Changes in the amplitude of Hoffmann reflex (H-reflex) may reflect variations in the characteristics of the largely monosynaptic circuitry that is explored and are a possible target for diagnostic and physical therapeutic intervention. However, previous attempts to induce predictable changes in the H-reflex amplitude by transcutaneous electrical nervous stimulation (TENS) have generally failed. Previous workers applied fixed frequency in the low- (2-5 Hz) or in the high- (100 Hz) field, but they did not attempt to vary frequency and/or impulse duration in time.
Methods. We evaluated the effect of a new type of painless electric stimulation, i.e. frequency rhythmic electrical modulation system (FREMS). FREMS is characterized by the use of transcutaneous electric pulses with sequentially modulated frequency (f: 1-39 Hz) and width (w: 10-40 µs) at constant, perceptive threshold voltage (~150 V). FREMS was applied at the abductor hallucis muscle (AHM), as conditioning stimulus of the H-reflex which was recorded ipsilaterally at the soleus muscle, according to the classic method, in 10 normal volunteers (age range 21-40 years).
Results. H-reflex amplitude was substantially decreased (-50%) during FREMS and H-reflex amplitude variations were influenced by w/f variation in time during FREMS subphase C in a predictable way (r2=0.43; P<0.001). Our results suggest an effective ability of FREMS to modulate H reflex amplitude.
Conclusion. The ability to achieve large and predictable changes of the H-reflex amplitude simply by modulating both frequency and duration of a conditioning painless electrical stimulation offers new possibilities for the treatment of diseases characterized by motoneuron excitability abnormalities.