NDLI: Neuromechanical assessment of lidocaine test block in spastic lower limbs.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Buffenoir, Kévin Decq, Philippe Lambertz, Daniel Perot, Chantal
Description	Country affiliation: France Author Affiliation: Buffenoir K ( a Université de Technologie de Compiègne, UMR CNRS 7338 Biomécanique et Bioingénierie, France.)
Abstract	The objective of this study was to quantify in spastic lower limbs the changes in reflex EMGs and in ankle stiffness after a lidocaine block of the soleus nerve to better understand physiological effects of lidocaine. Twenty patients were prospectively included and assessed before and after lidocaine block of the soleus nerve. We studied clinical and neuromechanical parameters of the triceps surae, including quantification of the maximum Hoffmann's reflex (Hmax) and tendinous reflex (T) normalized to the maximum direct motor response (Mmax), and passive ankle stiffness assessed by sinusoidal length perturbations. All patients whatever the aetiology of spasticity were improved in clinical parameters of spasticity after the block (62% reduction of the Ashworth score, 85% reduction of stretch reflex scores, increased score on the Physicians' Rating Scale). All patients presented a reduction of the Hmax-Mmax ratio (mean reduction of 67%) and the T-Mmax ratio (82%). Ankle stiffness was decreased by an average of 23%. Measured stiffness was correlated with the Ashworth score and the T-Mmax ratio. Relatively greater change in the T reflex than in the H reflex suggests that lidocaine block reduces hyperreflexia not only by interfering with generation of afferent volleys in the injected nerve, but also probably by altering generation of the volleys at the level of muscle spindles in the affected spastic muscles, presumably by blocking the transmission along gamma-efferent fibers.
File Format	HTM / HTML
ISSN	17155312
Issue Number	11
Volume Number	38
e-ISSN	17155320
Journal	Applied Physiology, Nutrition, and Metabolism
Language	English
Publisher	Canadian Science Publishing
Publisher Date	2013-11-01
Publisher Place	Canada
Access Restriction	Subscribed
Subject Keyword	Discipline Physiology Discipline Metabolism Discipline Nutritional Sciences Discipline Sports Medicine Lidocaine Muscle Spasticity H-reflex Humans Lower Extremity Muscle, Skeletal Reflex, Stretch Journal Article
Content Type	Text
Resource Type	Article
Subject	Nutrition and Dietetics Physiology Endocrinology, Diabetes and Metabolism Physiology (medical) Sports Science

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