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Investigation to predict patellar tendon reflex using motion analysis technique

Tham LK, Osman NA, Lim KS, Pingguan-Murphy B, Abas WA, Zain NM

Med Eng Phys, 2011 May;33(4):407-10.
PMID: 21146440 DOI: 10.1016/j.medengphy.2010.11.002

The investigation of patellar tendon reflex involves development of a reflex hammer holder, kinematic data collection and analysis of patellar reflex responses using motion analysis techniques. The main aim of this research is to explore alternative means of assessing reflexes as a part of routine clinical diagnosis. The motion analysis system was applied to provide quantitative data which is a more objective measure of the patellar tendon reflex. Kinematic data was collected from 28 males and 22 females whilst subjected to a knee jerk test. Further analysis of kinematic data was performed to predict relationships which might affect the patellar tendon reflex. All subjects were seated on a high stool with their legs hanging freely within the capture volume of the motion analysis system. Knee jerk tests were applied to all subjects, on both sides of the leg, by eliciting hypo, hyper, and normal reflexes. An additional reinforcement technique called the Jendrassik manoeuvre was also performed under the same conditions to elicit a normal patellar tendon reflex. The comparison of reflex response between genders showed that female subjects generally had a greater response compared to males. However, the difference in reflex response between the left leg and the right leg was not significant. Tapping strength to elicit a hyper-reflex produced greater knee-jerk compared to the normal clinical tapping strength. All results were in agreement with clinical findings and results found by some early researchers.

Matched MeSH terms: Reflex/physiology*
The nasocardiac reflex during nasoendoscopy: A commonly overlooked risk

Wong A, Abu Bakar MZ

Am J Otolaryngol, 2021 01 04;42(2):102869.
PMID: 33429183 DOI: 10.1016/j.amjoto.2020.102869

PURPOSE: The nasocardiac reflex is known but not well researched. We aimed to ascertain the electrocardiographic features of the reflex and to chronologically map the heart rhythm dynamics during nasoendoscopy. We also intended to identify variables that could potentially affect the occurrence of this reflex.
MATERIAL AND METHODS: A prospective, quasi-experimental physiological study. Selected healthy subjects were observed electrocardiographically for 60 s continuously in three equal phases of 20 s each - baseline phase, nasoendoscopic phase, and recovery phase (post-nasoendoscopy). Heart rate fluctuations were charted, followed by identification of a positive nasocardiac reflex group of subjects and a negative group. Analyses against multiple variables were done.
RESULTS: A total of 53 subjects were analysed. Heart rate during the baseline phase was 81.0 ± 9.9, nasoendoscopic phase was 72.7 ± 10.1, and recovery phase was 75.2 ± 9.6. Sixteen subjects (30.2%) had a positive nasocardiac reflex, and they remained in sinus rhythm with no occurrences of skipped beats, atrioventricular blocks or asystoles. One subject (1.9%) developed temporary ectopic premature ventricular contractions after nasoendoscopy. No variables were found affecting the incidence of a nasocardiac reflex in our study.
CONCLUSIONS: The pattern of heart rate dynamics was consistent as heart rates drop rapidly upon endoscope insertion and recover in some measure after its withdrawal. Although all our subjects remained asymptomatic, clinicians should not overlook the risks of a severe nasocardiac reflex when performing nasoendoscopy. We recommend that electrical cardiac monitoring be part of the management of vasovagal responses during in-office endonasal procedures.

Matched MeSH terms: Reflex/physiology*
Bulbar signs in normal population

Lim KS, Hew YC, Lau HK, Lim TS, Tan CT

Can J Neurol Sci, 2009 Jan;36(1):60-4.
PMID: 19294890

BACKGROUND AND OBJECTIVES: There is lack of published data on bulbar signs among the healthy population. This study aims to determine the range of normality of bulbar signs particularly among the elderly.
METHODS: Systemic examination of bulbar signs was carried out according to a predetermined protocol on a cohort of young and elderly healthy subjects.
RESULTS: A total of 206 subjects were recruited in the study, 104 young adults with mean age of 20 years, and 102 elderly with mean age of 73 years. Uvula deviation was seen in 28 (26.9%) young subjects and 22 (21.6%) elderly. Irregular tongue border was seen in 17 subjects, unilateral in 4 subjects. Fourteen (6.8%) subjects had deviation on tongue protrusion. Occasional tremor of tongue on protrusion is common in both young and old. Persistent (severe) tongue tremor on protrusion was seen in 18.6% of the elderly, and 4.8% of the young. None of the subjects had tremor of tongue at rest. In gag reflex, absence of gagging response was common in elderly, seen in two thirds of the subjects on stimulation of the posterior pharyngeal wall. However, all the subjects had uvular movement. Habituation or suppression of gagging response was seen in close to 90% of young males.
CONCLUSION: There is wide range of normality in bulbar signs in normal population, particularly among the elderly.

Matched MeSH terms: Reflex/physiology
Fulltext Recent developments in breastfeeding

Jelliffe DB

Med J Malaysia, 1986 Mar;41(1):59-63.
PMID: 3796352

Recent developments in breastfeeding are reviewed in relation to species-specific adaptive suckling and the level of maturity of the newborn. Scientific advantages and advances are noted concerning biochemistry, protective substances, emotional differences, child spacing and economics. The significance of unimpaired maternal reflexes and the need for information is stressed with regard to successful lactation and as common causes of inadequacy. The components needed in varying degrees, in breastfeeding programmes are mentioned briefly.

Matched MeSH terms: Reflex/physiology
Recovery of H-Reflex with Transforaminal Epidural Steroid Injection in S1 Radiculopathy

Gunduz OH, Sencan S, Ercalik T, Suhaimi A

Pain Med, 2017 08 01;18(8):1594-1597.
PMID: 28087843 DOI: 10.1093/pm/pnw303
Matched MeSH terms: H-Reflex/physiology*