Abstract Details

Title A Retrospective Analysis of the Association between Ankle Jerk and Tibial H-Reflex

Topic Clinical Neurophysiology

Presentation(s) P02 - (-)

Poster/Presentation
Number 228

Objective

Background BACKGROUND: H-reflex has been considered an electrophysiological equivalent of the ankle jerk. Few studies have assessed the association between ankle jerk and H-reflex amplitude and its latency. Prone position is considered the gold standard for measuring the H-reflex though many patients have difficulty lying prone.

Design/Methods DESIGN/METHODS: 110 consecutive adult patients referred to the lab between 2006 and 2009 for lower limbs EDX were included. H-reflex was measured bilaterally in supine and prone positions. An ankle jerk which elicited a grading of 2+ and above on the Medical Research Council (MRC) grading scale was considered positive ankle jerk. The association between H-reflex amplitude (HRA) and latency in both position and a positive ankle jerk was assessed. The sensitivity of the supine and prone H-reflex measurements in predicting a positive ankle jerk was calculated as well.

Results RESULTS: 110 patients (men: 51women: 59 average age: 50.5) with 109 supine studies and 100 prone studies bilaterally were included. Right supine and prone normal H-reflex latencies had the strongest correlation with positive ankle jerk (r=0.45, 0.50 respectively). Similarly left supine and prone normal H-reflex latencies showed the strongest correlation (r=0.60, 0.54 respectively). There was a significant association between supine and prone HRA and positive ankle jerk (x2=36.4, x2=35.4; p<0.05). The sensitivity of supine HRA was 94% and specificity 57%, where as the sensitivity of prone HRA was 88% and specificity 64%. There was no statistical difference between supine and prone studies and positive ankle jerk.

Conclusions CONCLUSIONS: There is no significant difference between supine and prone H-reflex amplitude and positive ankle jerk. H-reflex amplitude had the strongest association with positive ankle jerk.

Authors/Disclosures
Raghav Govindarajan, MD, FAAN (HSHS St. Elizabeth Medical Group) PRESENTER	Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MT pharma. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Catalyst. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sarepta. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amicus. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Govindarajan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MT pharma . Dr. Govindarajan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Catalyst. Dr. Govindarajan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Argenx. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biohaven. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Takeda. Dr. Govindarajan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Govindarajan has received research support from Band of Hope . The institution of Dr. Govindarajan has received research support from Alexion. Dr. Govindarajan has received publishing royalties from a publication relating to health care.
Disha U. Shah, MD (University of Louisville)	No disclosure on file
Efrain D. Salgado, MD (Cleveland Clinic Florida)	Dr. Salgado has nothing to disclose.
Martin Bernhard Merschhemke	Martin Bernhard Merschhemke has received personal compensation for serving as an employee of Novartis Pharma AG. Martin Bernhard Merschhemke has received stock or an ownership interest from Novartis Pharma AG.

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