Stimulus Point Distribution in Deep or Superficial Peroneal Nerve for Treatment of Ankle Spasticity |
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Authors: | Shinji Kubota RPT Shigeo Tanabe RPT PhD Kenichi Sugawara RPT PhD Yoshihiro Muraoka PhD Norihide Itoh RPT PhD Yoshikiyo Kanada RPT PhD |
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Affiliation: | 1. Department of Rehabilitation, Nanakuri Sanatorium, Fujita Health University, Tsu, Mie, Japan;2. Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aich, Japan;3. School of Rehabilitation, Faculty of Health and Social Work, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan;4. Faculty of Human Sciences, Waseda University, Tokorozawa, Saitama, Japan;5. and;6. Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aich, Japan |
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Abstract: | Objectives: To develop effective electrical stimulation treatment to reduce spasticity, we examined the optimal stimulus point of the common peroneal nerve. Materials and Methods: The locations of selective stimulus points for the deep peroneal nerve or superficial peroneal nerve fiber were examined in 25 healthy subjects in both legs (50 legs) using the ratio of the tibialis anterior (TA) to the peroneus longus (PL) M‐wave amplitude (TA/PL ratio). In addition, we measured reciprocal Ia inhibition in ten healthy subjects. The amount of inhibition was determined from short‐latency suppression of the soleus (Sol) H‐reflex by conditioning stimuli to the deep or superficial peroneal nerve. The paired t‐test was used for statistical analysis. Results: The mean TA/PL ratio during deep peroneal nerve stimulation was significantly different from superficial peroneal nerve stimulation (p < 0.001). The mean stimulus point for the deep peroneal nerve was located 7 ± 5 mm distal and 3 ± 6 mm anterior from the distal edges of the head of fibula and was markedly different from the stimulus point for the superficial peroneal nerve (20 ± 7 mm distal and 12 ± 8 mm posterior). During deep peroneal nerve stimulation, the mean conditioned H‐reflex was depressed to 83.8 ± 10.7% of the unconditioned value of the H‐reflex. In contrast, during superficial peroneal nerve stimulation, the mean conditioned H‐reflex increased to 105.3 ± 5.2%. These values were significantly different (p < 0.001). Conclusions: In the present study, we revealed a stimulus area of the deep peroneal nerve. Also, we observed the inhibitory effects of stimulation upon the deep peroneal nerve at individual stimulus point. Our results appear to indicate that localized stimulation of the deep peroneal nerve is more useful for the reduction of ankle spasticity. |
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Keywords: | Deep peroneal nerve peripheral nerve stimulation reciprocal Ia inhibition spasticity superficial peroneal nerve |
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