1. Fikriye O. Bittar, Mohamed A. Sabbahi, Selda Uzun, Ambia Abdilahi;.
Effects of Body Posture on Multisegmental Motor responses in the upper and lower limbs of Healthy subjects.
Fikriye O. Bittar, Mohamed A. Sabbahi, Selda Uzun, Ambia Abdilahi;.
Texas Woman’s University, School of Physical Therapy, Houston, and Texas Electrophysiology Services, Houston, Texas.
INTRODUCTION
RESULTS 1
RESULTS 4: Comparison C7-T11 Upper Extremity MMR
Multi segmental motor responses for cervical (CMMR) and thoracolumbar (TMMR) have been recorded in the upper and lower limbs of healthy subjects. However, the effects of different body postures have not been studied.
Signal amplitude was larger in the distal more than proximal limb muscles in the upper limbs; in the antigravity muscle > pogravity muscles in the lower limb and. No significant change in signal latencies was recorded with body postures.
C7 &T11 R-UE AMP ,mv
SITTING
LYING C7
T11
C7/T11 %
T11/C7
APB
13.5±6.2
15.3±6.8
74.5
134.2
8.6±3.7
11.3±5.2
76.1
131.4
FCR
5.8±3
6±3 95
105
4.9±4
4.8±3.5
102 98 BI
7.7±5.1
6±4.3
126.7 79
6.9±3.8
5.5±3.4
125.4
79.7
TRI
6±3.6
7±4.6
82.8
120.7
4.5±3.5
3.7±2.7
121.6
82.2
RESULTS 2: C7-T11-12 Stimulation &UE Recording
PURPOSE OF STUDY
Signals showed robust signal amplitude in the upper limbs with C7 and T11 stimulation. Signal amplitude was higher (by 133 %) during sitting than lying positions for C7 and T11 upper limb MMR (by 135.4%).
There were no significant differences of amplitude values between two different positions (sitting & lying) stimulation recording from upper extremity muscles (p>0.05).
The Purpose of this study was to evaluate the changes in CMMR & TMMR in different body postures.
HYPOTHESIS
It is hypothesized that testing MMR in different body postures will show the optimal testing method for neurological disorders.
RESULTS-5: Comparison C7-T11 Lower Extremity MMR
There were no significant differences of amplitude values between two different positions (sitting & lying) stimulation recording from upper extremity muscles (p>0.05).
C7&T11 LE MMR Amp
Sitting
Lying
Standing C7
T11
C7/T11 %
T11/C7 %
VMO
0.5±0.3
1.8±1.6
27.8
360
0.5±0.2
3.4±2.4
14.7
680
0.8±0.5
3.6±3.2
22.2
400
M.H
0.1±0.07
1.6±2.2
6.25
160
0.3±0.2
3.3±2.4 9
1100
0.4±0.4
4±3.5 10
1000
SOL
0.2±0.15
2.2±3.1
0.2±0.2
5.4±3.4 37
2700
0.7±1
6.1±3.8
11.5
871.4
T.A
0.2±0.3 40
250
0.1±0.06
12.5
800
0.2±0.1
0.6±0.3
33.3
300
T11 UE MMR AMP Mv
Sitting
Lying
P Value
Sit/Ly %
Ly/Sit
APB
15.3±6.8
11.3±5.2
p>0.05
135.4
73.9
FCR
6±3
4.8±3.5
125 80 BI
6±4.3
5.5±3.4
109
91.7
TRI
7±4.6
3.7±2.7
189.2
52.9
C7 UE MMR
Amp, mv
Sitting
Lying
P Value
Sit/Ly
Ly/Sit
APB
13.5±6.2
8.6±3.7
p>0.05
132.56
75.4
FCR
5.8±3
4.9±4
116.3
85.9 BI
7.7±5.1
6.9±3.8
110.14
90.7
TRI
6±3.6
4.5±3.5
128.9
77.6
METHODS
Participants:
8 healthy females (3) and males (5)
with age range (42.5±13.6).
STIMULATION & RECORDING
CERVICAL:
Stimulation: C7 vertebral site (1 msec., response max.)- surface electrodes
Recording: Sitting and lying positions.
APB, FCR, Biceps, Triceps(R UE) (surface electrodes). Ground: Acromion.
Recording: Sitting, Standing and Lying positions: (R LE) for VMO, TA, Soleus, MH Ref: ASIS Ground : Head Of Tibia
THORACOLUMBAR:
Stimulation: T11-12 vertebral site (same stim. Parameters) Recording (R UE) same as cervical MMR.
Recording : Sitting , Standing and Lying positions (R LE) for VMO, TA, Soleus, MH Ref : ASIS Ground : Head Of Tibia
Fig. (1)
DISCUSSIONS
The MMR facilitation of lower limb signal during standing and upper limb signal during sitting are probably due to loading effect that engage the central nervous system in function especially in the extensor > flexor muscles.
RESULTS-3: C7 or T11-12 Stimulation & LE Recording
Robust lower limb signal amplitude with T11 stimulation, but small lower limb signal with C7 stimulation .
CONCLUSION
Optimal testing of patients with neurological disorders should be carried out during loading (standing) > unloading. A comparison of testing results during loading and unloading could be clinically useful for evaluating spinal cord circuitries.
No significant differences between three postures (sitting, standing and lying) with C7 stimulation for recording lower extremity muscles. (p>0.05) .
T11 Lower limb MMR showed statistically significant increase in the amplitude of Soleus muscle during standing versus lying & sitting (p=0.048). No significant differences were recorded in the other leg muscles (VMO, MH, and TA) (p>0.05).
EXPERIMENTAL PROCEDURES
1.Sign informed consent form (TWU approved)
2.Testing cervical MMR for Right UE and LE .
3.Testing Thoracolumbar MMR for UE and LE.
4.Subjects were tested for UE while sitting and lying positions and for LE sitting, standing and lying positions.
C7 LE MMR Amp
Sitting
Lying
Standing
P Value
Si/Ly %
Sit/Stan
Ly/Stan
VMO
0.5±0.3
0.5±0.2
0.8±0.5
P>0.05
100
62.5
M.H
0.1±0.07
0.3±0.2
0.4±0.4
33.3 25 75
SOL
0.2±0.15
0.2±0.2
0.7±1
28.5
T.A
0.2±0.3
0.1±0.06
0.2±0.1
200 50
T11 LE MMR
Amp
Sitting
Lying
Standing
P Value
Sit/Ly %
Sit/Stan %
Ly/Stan
VMO
1.8±1.6
3.4±2.4
3.6±3.2
p>0.05 53 50
94.4
M.H
1.6±2.2
3.3±2.4
4±3.5
48.5 40
82.5
SOL
2.2±3.1
5.4±3.4
6.1±3.8
P<0.05
40.7 36
88.5
T.A
0.5±0.3
0.8±0.5
0.6±0.3
62.5
83.3
133.3
REFERENCES
Sabbahi M, Sengul Y. Cervical Multisegmental Motor Responses In Healthy Subjects. Spinal Cord (Spinal Cord,50(6);432-9,Jan 2012).
Sabbahi M, Sengul Salik Y. Thoracolumbar Multisegmental Motor Responses In The Upper And Lower Limbs In Healthy Subjects. Spinal Cord 49, , 2011
Similarities And Differences Of The Soleus And Gastrocnemius H-reflexes During Varied Body Postures, Foot Positions, And Muscle Function: Multifactor Designs For Repeated Measures. Alrowayeh HN,Sabbahi M.A,Etnyre B. BMC Neurology.2011 Jun2;11:65
DATA AND STATISTICAL ANALYSIS
Averaged 5 traces
Dependent Parameters:
Peak-to peak amplitude
Deflection latency
Statistics: Descriptive analysis.