Physiological effects of selective tibial neurotomy on lower limb spasticity.
J Neurol Neurosurg Psychiatry
; 63(5): 575-8, 1997 Nov.
Article
em En
| MEDLINE
| ID: mdl-9408095
ABSTRACT
OBJECTIVES:
To assess by electrophysiology the effect of tibial selective neurotomy on muscle imbalance of the spastic ankle.METHOD:
The amplitudes of the H reflexes, M responses (muscle contractions recorded after stimulation of the tibial nerve), and HmaxMmax ratio were recorded in 12 patients with chronic lower limb spasticity, before and one month after tibial selective neurotomy. Recordings were done on medial and lateral gastrocnemius and soleus muscles. Clinical evaluation was done with both global (Held's score) and analytical tests (step measurements, gait velocity, and ankle angulation during active and passive movements).RESULTS:
After neurotomy, gait improved in all patients. Held's score of spasticity was better in all patients. Active dorsiflexion of the ankle was unchanged in three patients, but the others improved by 5 degrees to 12 degrees. Hmax, Mmax, and HmaxMmax ratios were lower. The Hmax on the gastrocnemius muscle, clinical strength, Mmax of all the muscles, and HmaxMmax ratio for the soleus and lateral gastrocnemius muscle were significantly lower after surgery.CONCLUSION:
There was an improvement of clinical and electrophysiological spastic indices after selective tibial neurotomy. Neurotomy acted not only on motor neurons by decreasing strength, but also the reflex enlargement by decreasing sensory afferents.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nervo Tibial
/
Tornozelo
/
Espasticidade Muscular
Limite:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Neurol Neurosurg Psychiatry
Ano de publicação:
1997
Tipo de documento:
Article
País de afiliação:
França