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1.  Similarities and Differences of the Soleus and Gastrocnemius H-reflexes during Varied Body Postures, Foot Positions, and Muscle Function: Multifactor Designs for Repeated Measures 
BMC Neurology  2011;11:65.
Although the soleus (Sol), medial gastrocnemius (MG), and lateral gastrocnemius (LG) muscles differ in function, composition, and innervations, it is a common practice is to investigate them as single H-reflex recording. The purpose of this study was to compare H-reflex recordings between these three sections of the triceps surae muscle group of healthy participants while lying and standing during three different ankle positions.
The Sol, MG and LG muscles' H-reflexes were recorded from ten participants during prone lying and standing with the ankle in neutral, maximum dorsiflexion, and maximum plantarflexion positions. Four traces were averaged for each combination of conditions. Three-way ANOVAs (posture X ankle position X muscle) with planned comparisons were used for statistical comparisons.
Although the H-reflex in the three muscle sections differed in latency and amplitude, its dependency on posture and ankle position was similar. The H-reflex amplitudes and maximum H-reflex to M-response (H/M) ratios were significantly 1) lower during standing compared to lying with the ankle in neutral, 2) greater during standing with the ankle in plantarflexion compared to neutral, and 3) less with the ankle in dorsiflexion compared to neutral during lying and standing for all muscles (p ≤ .05).
Varying demands are required for muscles activated during distinctly different postures and ankle movement tasks.
PMCID: PMC3146399  PMID: 21635748
2.  H-reflex amplitude asymmetry is an earlier sign of nerve root involvement than latency in patients with S1 radiculopathy 
BMC Research Notes  2011;4:102.
Based on our clinical experience, the H-reflex amplitude asymmetry might be an earlier sign of nerve root involvement than latency in patients with S1 radiculopathy. However, no data to support this assumption are available. The purpose of this study was to review and report the electrophysiological changes in H-reflex amplitude and latency in patients with radiculopathy in order to determine if there is any evidence to support the assumption that H-reflex amplitude is an earlier sign of nerve root involvement than latency.
Patients with radiculopathy showed significant amplitude asymmetry when compared with healthy controls. However, latency was not always significantly different between patients and healthy controls. These findings suggest nerve root axonal compromise that reduced reflex amplitude earlier than the latency parameter (demyelination) during the pathologic processes.
Contrary to current clinical thought, H-reflex amplitude asymmetry is an earlier sign/parameter of nerve root involvement in patients with radiculopathy compared with latency.
PMCID: PMC3078869  PMID: 21466665
3.  Prevalence, characteristics, and impacts of work-related musculoskeletal disorders: a survey among physical therapists in the State of Kuwait 
Physical therapists working in the State of Kuwait are at risk of work-related musculoskeletal disorders (WMSDs). However, prevalence rates and risk factors are not well documented. The objective of this study was to determine the prevalence, characteristics, and impacts of WMSDs among physical therapists in the State of Kuwait.
A self-administered questionnaire was distributed to 350 physical therapists. The questionnaire gathered demographic data as well as information on occurrence of musculoskeletal complaints in the previous 12 months. Descriptive statistics, frequency, and Chi-square analyses were used.
The response rate to the questionnaire was 63% (222/350). Of the 212 responders included in the study, the one-year prevalence of WMSDs was 47.6%, with lower back complaints as the most common (32%). This was followed by neck (21%), upper back (19%), shoulder (13%), hand/wrist (11%), knee (11%), ankle/foot (6%), elbow (4%), and hip/thigh (3%) complaints. The frequency of WMSDs was not gender related (except lower back, neck, and shoulder complaints) nor was it related to age (except lower back complaints), working venues (except hand/wrist), working hours, area of specialty, or exercise. WMSDs' impact on work was minor.
WMSDs among physical therapists in Kuwait were common, with lower back and neck affected most. Lower back and neck WMSDs were related to the participant's demographics. Hand/wrist WMSDs were related to work settings. Further research is needed to investigate the effect of risk factors as physical load, psychosocial load, and general health status on prevalence musculoskeletal disorders.
PMCID: PMC2905326  PMID: 20540724

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