Soleus Muscle H-reflex: Reference Data of Adult Population From a Tertiary Care Center in India

Binay K Pandey; Ashok Kumar; Abhay Ranjan; Josni Pandey

doi:10.7759/cureus.59083

Soleus Muscle H-reflex: Reference Data of Adult Population From a Tertiary Care Center in India

Cureus. 2024 Apr 26;16(4):e59083. doi: 10.7759/cureus.59083. eCollection 2024 Apr.

Authors

Binay K Pandey¹, Ashok Kumar¹, Abhay Ranjan¹, Josni Pandey²

Affiliations

¹ Neurology, Indira Gandhi Institute of Medical Sciences (IGIMS) Patna, Patna, IND.
² Physiotherapy, Indian Institute of Health Education and Research, Patna, IND.

Abstract

Introduction The Hoffmann reflex (H reflex) is one of the most studied reflexes in human neurophysiological literature. Detection of the H reflex is useful in the diagnosis of early polyneuropathy, S1 radiculopathy, early GBS, tibial neuropathy and sciatica, and sacral plexopathy. The H reflex is also used as a tool to measure the excitability of the nervous components of the arc, regardless of the sensitivity of the sensory organs. The monosynaptic nature of reflex circuits makes H-reflex an attractive tool for clinical neurophysiology and research. Objective The objective is to create reference data of soleus H-reflex latency in an adult population from a tertiary care center in India. Materials and methods Seven hundred eighty-four healthy volunteers underwent a physical examination and brief electrophysiological examination before elicitation of the soleus H reflex of both lower extremities using standard techniques. Reference values are expressed as mean ± standard deviation as well as the third and 97th percentiles for latency as the dependent variable. Results The study population included 346 (44.1%) women and 438 (55.9%) men. The men were aged 40.46 ± 14.76 years, and the women were aged 41.63 ± 13.49 years. The average weight of the men was 73.32 ± 10.28 kilograms, and the women were 62.91 ± 7.46 kilograms. The average height of the men was 172.06 ± 4.22 cm, and the women were 159.12 ± 2.42 cm. The third and 97th percentiles for H-reflex latency on the right side were 22.86 ms to 34.22 ms and on the left side were 22.86 ms to 35.39 ms. The average right tibial H latency and left tibial H latency were 28.18 ± 2.59 ms and 28.14 ± 2.70 ms, respectively. Conclusion A sizable subject population was used to provide reference data for this study. Because of the huge sample size and nearly appropriate coverage of different age groups, reference ranges have been established for various age, height, and BMI groups.

Keywords: h-reflex; hoffmann reflex; nerve conduction studies; reference values; soleus h-reflex.