Soleus H-Reflex Change in Poststroke Spasticity: Modulation due to Body Position

This study is aimed at exploring how soleus H-reflex change in poststroke patients with spasticity influenced by body position.

Twenty-four stroke patients with spastic hemiplegia and twelve age-matched healthy controls were investigated. Maximal Hoffmann-reflex (Hmax) and motor potential (Mmax) were elicited at the popliteal fossa in both prone and standing positions, respectively, and the Hmax/Mmax ratio at each body position was determined. Compare changes in reflex behavior in both spastic and contralateral muscles of stroke survivors in prone and standing positions, and match healthy subjects in the same position.

In healthy subjects, Hmax and Hmax/Mmax ratios were significantly decreased in the standing position compared to the prone position (Hmax: p = 0.000, Hmax/Mmax: p = 0.016). However, Hmax/Mmax ratios were increased in standing position on both sides in poststroke patients with spasticity (unaffected side: p = 0.006, affected side: p = 0.095). The Hmax and Hmax/Mmax ratios were significantly more increased on the affected side than unaffected side irrespective of the position.

The motor neuron excitability of both sides was not suppressed but instead upregulated in the standing position in subjects with spasticity, which may suggest that there was abnormal regulation of the Ia pathway on both sides.