ISSN : 2663-2187

Comparison of H reflex in abductor digiti minimi between dominant and non- dominant hand of healthy adult male volunteers in Puducherry-Observational Study

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Dr.Sathiyamoorthy P, Dr.Jalli Shanti Sudha, Dr.Subhasis Das, Mr.Mohan
» doi: 10.33472/AFJBS.6.13.2024.2247-2255

Abstract

A nerve conduction study is a commonly used medical diagnostic test to evaluate the function of the motor and sensory nerves in the human body and to diagnose some of the common disorders like Peripheral neuropathy, ulnar neuropathy, Guillain Barrie syndrome 1.They can be used to localize the site or level of lesion and it can also determine if the pathology involves the neuromuscular junction, nerve root, anterior horn cells or the peripheral nerves2, 3. Nerve conduction studies are motor nerve conduction tests, sensory nerve conduction tests, F response and H reflex tests. H reflex is the electrical analogue of the routinely used stretch reflex. The H reflex is a non invasive technique used to study the reflex pathways and associated activities in the spinal circuitry4. H reflex is used as an effective tool in research and clinical neurophysiology because of its monosynaptic nature5. The H reflex is used to assess the nerve conduction in the proximal segment of the nerves. It is used to detect lesion in more proximal nerve lesions which might be missed in peripheral conduction studies6. H reflex is found to be useful in detecting conditions like radiculopathies, Parkinson’s disease, neuropathies and clinically proven C6, C7 or C8 radiculopathies and plexopathies. H reflex is found to be an attractive tool in diagnosing diabetic peripheral neuropathy7. The present study was undertaken to determine latency and amplitude of H reflex of abductor digiti minimi of the dominant and non dominant hand, and to find if there is any side-side difference, as very few Indian studies are available on H reflex. Methodology :Fifty healthy male subjects in the age group of 25-35 years were studied by stimulating ulnar nerve while the subject is maintaining 10-20% of maximum voluntary contraction of the abductor digiti minimi. The stimulus intensity was 5-10mA (submaximal) of 1 ms duration, delivered from a constant current stimulator through bipolar stimulating electrodes. The latency of the first deflection from the baseline and the peak to peak amplitude of the evoked H reflex responses were measured digitally using a digitalized nerve conduction / EMG / EP machine (Aleron, Recorders Medicare systems, Chandigarh, India) . Statistical analysis showed that the H reflex latency of ADM of dominant hand(27.42±2.0ms, Mean± SD) was equal to the corresponding value of non dominant hand(27.37±1.7ms). H reflex amplitude of ADM of dominant hand(0.62±0.3µV,Mean± SD) was also equal to the corresponding value of non dominant hand(0.59±0.2 µV). Wilcoxon signed rank test was used to compare the corresponding values of latency and amplitude of the H reflex of dominant and non dominant hands as the data was not normally distributed. RESULTS AND CONCLUSION The study was conducted with the objective to compare the H reflex latency and amplitute of upper limb muscle, abductor digiti minimi (ADM) in the dominant and non dominant hands in healthy adult male volunteers. We observed that the differences in the side- side mean latencies and the mean amplitude were not statistically significant. There was no difference between dominant and non-dominant hand in the mean amplitude and latency of H reflex (abductor digiti minimi muscle-Ulnar nerve) in healthy young adult males.

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