A pilot study to measure upper extremity H-reflexes following neuromuscular electrical stimulation therapy after stroke

A. M. Stowe, L. Hughes-Zahner, V. K. Barnes, L. L. Herbelin, S. M. Schindler-Ivens, B. M. Quaney

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Upper extremity (UE) hemiparesis persists after stroke, limiting hand function. Neuromuscular electrical stimulation (NMES) is an effective intervention to improve UE recovery, although the underlying mechanisms are not fully understood. Our objective was to establish a reliable protocol to measure UE agonist-antagonist forearm monosynaptic reflexes in a pilot study to determine if NMES improves wrist function after stroke. We established the between-day reliability of the H-reflex in the extensor carpi radialis longus (ECRL) and flexor carpi radialis (FCR) musculature for individuals with prior stroke (n= 18). The same-day generation of ECRL/FCR H-reflex recruitment curves was well tolerated, regardless of age or UE spasticity. The between-day reliability of the ECRL H-reflex was enhanced above FCR, similar to healthy subjects [20], with the Hmax the most reliable parameter quantified in both muscles. H-reflex and functional measures following NMES show the potential for NMES-induced increases in ECRL Hmax, but confirmation requires a larger clinical study. Our initial results support the safe, easy, and efficacious use of in-home NMES, and establish a potential method to measure UE monosynaptic reflexes after stroke.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalNeuroscience Letters
Issue number1
StatePublished - Feb 22 2013

Bibliographical note

Funding Information:
The authors would like to thank Danielle Keenan and Abby Leising for their invaluable help. Funding was provided by the Foundation for Physical Therapy, Inc., Magistro Award 2006 and by the Clinical and Translational Science Award program, National Center for Research Resources, NIH .


  • ECRL
  • FCR
  • H-reflex
  • Neuromuscular electrical stimulation
  • Stroke
  • Upper extremity spasticity

ASJC Scopus subject areas

  • General Neuroscience


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