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David Marinus Laman - One of the best experts on this subject based on the ideXlab platform.

  • Normative values of semitendinosus tendon Reflex latencies
    Clinical neurophysiology practice, 2016
    Co-Authors: Juerd Wijntjes, Antonius Hilgevoord, David Marinus Laman
    Abstract:

    Abstract Objectives The semitendinosus tendon Reflex (STR), also known as the medial hamstring Reflex, is rarely described in literature and is believed to provide information mainly concerning the fifth lumbar spinal nerve (L5). Latencies can be obtained with clinical neurophysiological tests. Normative data for STR latencies are not available. The aim of this study was to provide normative values of STR latencies. Also we will describe the technique used for performing the tendon Reflex measurements in a clinical neurophysiological setting. Methods To determine STR latencies, we measured the stimulus (tap with Reflex Hammer) – response (EMG activity associated with muscle contraction) relation. The stimulus was administered with a manually operated Reflex Hammer, tipped with electrically conductive rubber, triggering the EMG recording sweep on impact. The EMG response was recorded with surface electrodes placed on the skin overlying the semitendinosus muscle. Results Forty healthy subjects participated in the study. The group consisted of 18 women and 22men with a median age of 30years. The mean subject body height was 181cm (SD 8.1). Latencies showed a significant correlation with body height (r=0.70, R 2 =0.48, P Conclusion We present, as far as we know, the first report on normative values of STR latencies. The STR could be elicited in 100% of our population. The left–right difference seems to be the most promising clinical parameter for diagnostic purposes. Significance We think our results can be of practical use for all clinical neurophysiologists/neurologists and may provide the basis for further research on test characteristics of STR latencies in patients with L5 radiculopathy.

  • Normal values of patellar and ankle tendon Reflex latencies
    1997
    Co-Authors: Frijns Cjm, David Marinus Laman, Vanduijn Maj, Vanduijn H
    Abstract:

    The clinical value of latency measurement of tendon Reflexes in neurological patients has been reported by several authors. However, normal values are not readily comparable. In the present study, latencies and amplitudes of patellar (PTR) and ankle tendon Reflexes (ATR) were measured at rest and after facilitation in 102 normal controls. A manually operated Reflex Hammer, tipped with electrically conductive rubber, ensured an immediate start of the sweep of the oscilloscope. Latencies showed a significant correlation with height (r = 0.70 for PTR and r = 0.72 for ATR, P

  • Normal values of patellar and ankle tendon Reflex latencies
    Clinical neurology and neurosurgery, 1997
    Co-Authors: C.j.m. Frijns, David Marinus Laman, M. A. J. Van Duijn, H. Van Duijn
    Abstract:

    The clinical value of latency measurement of tendon Reflexes in neurological patients has been reported by several authors. However, normal values are not readily comparable. In the present study, latencies and amplitudes of patellar (PTR) and ankle tendon Reflexes (ATR) were measured at rest and after facilitation in 102 normal controls. A manually operated Reflex Hammer, tipped with electrically conductive rubber, ensured an immediate start of the sweep of the oscilloscope. Latencies showed a significant correlation with height (r = 0.70 for PTR and r = 0.72 for ATR, P < 0.0001) and to a lesser degree with age (r = 0.16 and r = 0.30, P < 0.0001). While amplitudes were highly variable, rendering them less useful for diagnostic purposes, latencies showed minimal intra-individual variability (CV 1.5 and 0.8%, respectively). Correlation of ATR-latency with the H-Reflex latency of the soleus muscle was very high (r = 0.97, P < 0.0001). Comparison with three other Hammer types yielded corresponding results with a Hammer supplied with a piezo-electric element; however, significantly shorter latencies were found with a Hammer with a microswitch, and with another Hammer with a spring-contact, due to a delay from the tap on the tendon until the start of the sweep of the monitor.

  • Normative values of semitendinosus tendon Reflex latencies
    Elsevier, 1
    Co-Authors: Juerd Wijntjes, Antonius Hilgevoord, David Marinus Laman
    Abstract:

    Objectives: The semitendinosus tendon Reflex (STR), also known as the medial hamstring Reflex, is rarely described in literature and is believed to provide information mainly concerning the fifth lumbar spinal nerve (L5). Latencies can be obtained with clinical neurophysiological tests. Normative data for STR latencies are not available. The aim of this study was to provide normative values of STR latencies. Also we will describe the technique used for performing the tendon Reflex measurements in a clinical neurophysiological setting. Methods: To determine STR latencies, we measured the stimulus (tap with Reflex Hammer) – response (EMG activity associated with muscle contraction) relation. The stimulus was administered with a manually operated Reflex Hammer, tipped with electrically conductive rubber, triggering the EMG recording sweep on impact. The EMG response was recorded with surface electrodes placed on the skin overlying the semitendinosus muscle. Results: Forty healthy subjects participated in the study. The group consisted of 18 women and 22 men with a median age of 30 years. The mean subject body height was 181 cm (SD 8.1). Latencies showed a significant correlation with body height (r = 0.70, R2 = 0.48, P 

Timothy Mastroianni - One of the best experts on this subject based on the ideXlab platform.

  • Wireless Health - Smartphone wireless gyroscope platform for machine learning classification of hemiplegic patellar tendon Reflex pair disparity through a multilayer perceptron neural network
    2016 IEEE Wireless Health (WH), 2016
    Co-Authors: Robert Lemoyne, Timothy Mastroianni
    Abstract:

    The patellar tendon enables fundamental insight regarding neurological health status. Clinically observed dysfunction may warrant escalation to more advanced and expensive medical diagnostics. Conventionally clinicians apply an ordinal scale to quantify Reflex response characteristics. However the reliability of ordinal scales is a subject of debate, and even highly skilled clinicians have disputed the observation of an asymmetric Reflex pair. An alternative is the use of the wireless quantified Reflex system, which features an impact pendulum attached to a Reflex Hammer for providing precisely targeted levels of potential energy with a smartphone (iPhone) equipped with software to function as a wireless gyroscope platform that can email a trial sample as an email attachment by wireless connectivity to the Internet. With notable attributes of the gyroscope signal recordings of the Reflex response of a hemiplegic patellar tendon Reflex pair observed a feature set is developed for machine learning classification. Using the multilayer perceptron neural network considerable classification accuracy is attained. The research implications reveal the potential of integrating machine learning with a wireless Reflex quantification system that applies a smartphone (iPhone) as a wireless gyroscope platform.

  • EMBC - Implementation of a smartphone as a wireless gyroscope application for the quantification of Reflex response.
    Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Inte, 2014
    Co-Authors: Robert Lemoyne, Timothy Mastroianni
    Abstract:

    The patellar tendon Reflex constitutes a fundamental aspect of the conventional neurological evaluation. Dysfunctional characteristics of the Reflex response can augment the diagnostic acuity of a clinician for subsequent referral to more advanced medical resources. The capacity to quantify the Reflex response while alleviating the growing strain on specialized medical resources is a topic of interest. The quantification of the tendon Reflex response has been successfully demonstrated with considerable accuracy and consistency through using a potential energy impact pendulum attached to a Reflex Hammer for evoking the tendon Reflex with a smartphone, such as an iPhone, application representing a wireless accelerometer platform to quantify Reflex response. Another sensor integrated into the smartphone, such as an iPhone, is the gyroscope, which measures rate of angular rotation. A smartphone application enables wireless transmission through Internet connectivity of the gyroscope signal recording of the Reflex response as an email attachment. The smartphone wireless gyroscope application demonstrates considerable accuracy and consistency for the quantification of the tendon Reflex response.

  • EMBC - Implementation of an iPhone wireless accelerometer application for the quantification of Reflex response
    Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Inte, 2013
    Co-Authors: Robert Lemoyne, Timothy Mastroianni, Warren S. Grundfest, Kiisa C. Nishikawa
    Abstract:

    The patellar tendon Reflex represents an inherent aspect of the standard neurological evaluation. The features of the Reflex response provide initial perspective regarding the status of the nervous system. An iPhone wireless accelerometer application integrated with a potential energy impact pendulum attached to a Reflex Hammer has been successfully developed, tested, and evaluated for quantifying the patellar tendon Reflex. The iPhone functions as a wireless accelerometer platform. The wide coverage range of the iPhone enables the quantification of Reflex response samples in rural and remote settings. The iPhone has the capacity to transmit the Reflex response acceleration waveform by wireless transmission through email. Automated post-processing of the acceleration waveform provides feature extraction of the maximum acceleration of the Reflex response ascertained after evoking the patellar tendon Reflex. The iPhone wireless accelerometer application demonstrated the utility of the smartphone as a biomedical device, while providing accurate and consistent quantification of the Reflex response.

  • Wireless accelerometer Reflex quantification system characterizing response and latency
    2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2009
    Co-Authors: Robert Lemoyne, Cristian Coroian, Timothy Mastroianni
    Abstract:

    The evaluation of the deep tendon Reflex is a standard aspect of a neurological evaluation, which is frequently evoked through the patellar tendon Reflex. Important features of the Reflex are response and latency, providing insight to status for peripheral neuropathy and upper motor neuron syndrome. A wireless accelerometer Reflex quantification system has been developed, tested, and evaluated. The Reflex input is derived from a potential energy setting. Wireless accelerometers characterize the Reflex Hammer strike and Reflex response acceleration waveforms, enabling the quantification of Reflex response and latency. Spectral analysis of the Reflex response acceleration waveform elucidates the frequency domain, opening the potential for new Reflex classification metrics. The wireless accelerometer Reflex quantification system yields accurate and consistent quantification of Reflex response and latency.

  • QUANTIFIED DEEP TENDON Reflex DEVICE FOR RESPONSE AND LATENCY, THIRD GENERATION
    Journal of Mechanics in Medicine and Biology, 2008
    Co-Authors: Robert Lemoyne, Cristian Coroian, Timothy Mastroianni, Warren S. Grundfest
    Abstract:

    Deep tendon Reflex is fundamental for a neurological examination. A hyperactive Reflex response is correlated with spasticity, which can also be associated with the degree of damage to the supraspinal input, essentially assessing the severity of traumatic brain injury. Clinical evaluation of the myotatic stretch Reflex is provided by the National Institute of Neurological Disorders and Stroke (NINDS) Myotatic Reflex Scale (0 to 4); however, the results of the NINDS Myotatic Reflex Scale vary in terms of interpretation and lack temporal data. Deep tendon Reflex can assess the severity and degree of peripheral neuropathy. Subsequent to the neurological examination, suspect patients are often referred to a specialist for definitive electrodiagnostic testing. A study by Cocito found that 28% of the prescriptions for testing were considered to be inappropriate. Therefore, the solution is a fully quantified tendon Reflex evaluation system. The input force of the Reflex Hammer is derived from a predetermined potential energy setting. Tandem wireless three-dimensional (3D) microelectromechanical systems (MEMS) accelerometers quantify the output and latency time of the Reflex. The wireless 3D MEMS accelerometers are positioned to a standard anchor point near the ankle and Reflex Hammer swing arm. Reflex response is quantified by the maximum and minimum components of the acceleration profile. The temporal disparity between Hammer strike and response defines the latency of the Reflex loop. The quantified data collected from wireless 3D MEMS accelerometers are conveyed to a portable computer. Enclosed are the initial test and evaluation and the description of such a device, which quantitatively evaluates the Reflex response and latency using wireless 3D MEMS accelerometers, while demonstrating precision for reproducibility.

Juerd Wijntjes - One of the best experts on this subject based on the ideXlab platform.

  • Normative values of semitendinosus tendon Reflex latencies
    Clinical neurophysiology practice, 2016
    Co-Authors: Juerd Wijntjes, Antonius Hilgevoord, David Marinus Laman
    Abstract:

    Abstract Objectives The semitendinosus tendon Reflex (STR), also known as the medial hamstring Reflex, is rarely described in literature and is believed to provide information mainly concerning the fifth lumbar spinal nerve (L5). Latencies can be obtained with clinical neurophysiological tests. Normative data for STR latencies are not available. The aim of this study was to provide normative values of STR latencies. Also we will describe the technique used for performing the tendon Reflex measurements in a clinical neurophysiological setting. Methods To determine STR latencies, we measured the stimulus (tap with Reflex Hammer) – response (EMG activity associated with muscle contraction) relation. The stimulus was administered with a manually operated Reflex Hammer, tipped with electrically conductive rubber, triggering the EMG recording sweep on impact. The EMG response was recorded with surface electrodes placed on the skin overlying the semitendinosus muscle. Results Forty healthy subjects participated in the study. The group consisted of 18 women and 22men with a median age of 30years. The mean subject body height was 181cm (SD 8.1). Latencies showed a significant correlation with body height (r=0.70, R 2 =0.48, P Conclusion We present, as far as we know, the first report on normative values of STR latencies. The STR could be elicited in 100% of our population. The left–right difference seems to be the most promising clinical parameter for diagnostic purposes. Significance We think our results can be of practical use for all clinical neurophysiologists/neurologists and may provide the basis for further research on test characteristics of STR latencies in patients with L5 radiculopathy.

  • Normative values of semitendinosus tendon Reflex latencies
    Elsevier, 1
    Co-Authors: Juerd Wijntjes, Antonius Hilgevoord, David Marinus Laman
    Abstract:

    Objectives: The semitendinosus tendon Reflex (STR), also known as the medial hamstring Reflex, is rarely described in literature and is believed to provide information mainly concerning the fifth lumbar spinal nerve (L5). Latencies can be obtained with clinical neurophysiological tests. Normative data for STR latencies are not available. The aim of this study was to provide normative values of STR latencies. Also we will describe the technique used for performing the tendon Reflex measurements in a clinical neurophysiological setting. Methods: To determine STR latencies, we measured the stimulus (tap with Reflex Hammer) – response (EMG activity associated with muscle contraction) relation. The stimulus was administered with a manually operated Reflex Hammer, tipped with electrically conductive rubber, triggering the EMG recording sweep on impact. The EMG response was recorded with surface electrodes placed on the skin overlying the semitendinosus muscle. Results: Forty healthy subjects participated in the study. The group consisted of 18 women and 22 men with a median age of 30 years. The mean subject body height was 181 cm (SD 8.1). Latencies showed a significant correlation with body height (r = 0.70, R2 = 0.48, P 

Robert Lemoyne - One of the best experts on this subject based on the ideXlab platform.

  • Wireless Health - Smartphone wireless gyroscope platform for machine learning classification of hemiplegic patellar tendon Reflex pair disparity through a multilayer perceptron neural network
    2016 IEEE Wireless Health (WH), 2016
    Co-Authors: Robert Lemoyne, Timothy Mastroianni
    Abstract:

    The patellar tendon enables fundamental insight regarding neurological health status. Clinically observed dysfunction may warrant escalation to more advanced and expensive medical diagnostics. Conventionally clinicians apply an ordinal scale to quantify Reflex response characteristics. However the reliability of ordinal scales is a subject of debate, and even highly skilled clinicians have disputed the observation of an asymmetric Reflex pair. An alternative is the use of the wireless quantified Reflex system, which features an impact pendulum attached to a Reflex Hammer for providing precisely targeted levels of potential energy with a smartphone (iPhone) equipped with software to function as a wireless gyroscope platform that can email a trial sample as an email attachment by wireless connectivity to the Internet. With notable attributes of the gyroscope signal recordings of the Reflex response of a hemiplegic patellar tendon Reflex pair observed a feature set is developed for machine learning classification. Using the multilayer perceptron neural network considerable classification accuracy is attained. The research implications reveal the potential of integrating machine learning with a wireless Reflex quantification system that applies a smartphone (iPhone) as a wireless gyroscope platform.

  • EMBC - Implementation of a smartphone as a wireless gyroscope application for the quantification of Reflex response.
    Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Inte, 2014
    Co-Authors: Robert Lemoyne, Timothy Mastroianni
    Abstract:

    The patellar tendon Reflex constitutes a fundamental aspect of the conventional neurological evaluation. Dysfunctional characteristics of the Reflex response can augment the diagnostic acuity of a clinician for subsequent referral to more advanced medical resources. The capacity to quantify the Reflex response while alleviating the growing strain on specialized medical resources is a topic of interest. The quantification of the tendon Reflex response has been successfully demonstrated with considerable accuracy and consistency through using a potential energy impact pendulum attached to a Reflex Hammer for evoking the tendon Reflex with a smartphone, such as an iPhone, application representing a wireless accelerometer platform to quantify Reflex response. Another sensor integrated into the smartphone, such as an iPhone, is the gyroscope, which measures rate of angular rotation. A smartphone application enables wireless transmission through Internet connectivity of the gyroscope signal recording of the Reflex response as an email attachment. The smartphone wireless gyroscope application demonstrates considerable accuracy and consistency for the quantification of the tendon Reflex response.

  • EMBC - Implementation of an iPhone wireless accelerometer application for the quantification of Reflex response
    Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Inte, 2013
    Co-Authors: Robert Lemoyne, Timothy Mastroianni, Warren S. Grundfest, Kiisa C. Nishikawa
    Abstract:

    The patellar tendon Reflex represents an inherent aspect of the standard neurological evaluation. The features of the Reflex response provide initial perspective regarding the status of the nervous system. An iPhone wireless accelerometer application integrated with a potential energy impact pendulum attached to a Reflex Hammer has been successfully developed, tested, and evaluated for quantifying the patellar tendon Reflex. The iPhone functions as a wireless accelerometer platform. The wide coverage range of the iPhone enables the quantification of Reflex response samples in rural and remote settings. The iPhone has the capacity to transmit the Reflex response acceleration waveform by wireless transmission through email. Automated post-processing of the acceleration waveform provides feature extraction of the maximum acceleration of the Reflex response ascertained after evoking the patellar tendon Reflex. The iPhone wireless accelerometer application demonstrated the utility of the smartphone as a biomedical device, while providing accurate and consistent quantification of the Reflex response.

  • Wireless accelerometer Reflex quantification system characterizing response and latency
    2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2009
    Co-Authors: Robert Lemoyne, Cristian Coroian, Timothy Mastroianni
    Abstract:

    The evaluation of the deep tendon Reflex is a standard aspect of a neurological evaluation, which is frequently evoked through the patellar tendon Reflex. Important features of the Reflex are response and latency, providing insight to status for peripheral neuropathy and upper motor neuron syndrome. A wireless accelerometer Reflex quantification system has been developed, tested, and evaluated. The Reflex input is derived from a potential energy setting. Wireless accelerometers characterize the Reflex Hammer strike and Reflex response acceleration waveforms, enabling the quantification of Reflex response and latency. Spectral analysis of the Reflex response acceleration waveform elucidates the frequency domain, opening the potential for new Reflex classification metrics. The wireless accelerometer Reflex quantification system yields accurate and consistent quantification of Reflex response and latency.

  • QUANTIFIED DEEP TENDON Reflex DEVICE FOR RESPONSE AND LATENCY, THIRD GENERATION
    Journal of Mechanics in Medicine and Biology, 2008
    Co-Authors: Robert Lemoyne, Cristian Coroian, Timothy Mastroianni, Warren S. Grundfest
    Abstract:

    Deep tendon Reflex is fundamental for a neurological examination. A hyperactive Reflex response is correlated with spasticity, which can also be associated with the degree of damage to the supraspinal input, essentially assessing the severity of traumatic brain injury. Clinical evaluation of the myotatic stretch Reflex is provided by the National Institute of Neurological Disorders and Stroke (NINDS) Myotatic Reflex Scale (0 to 4); however, the results of the NINDS Myotatic Reflex Scale vary in terms of interpretation and lack temporal data. Deep tendon Reflex can assess the severity and degree of peripheral neuropathy. Subsequent to the neurological examination, suspect patients are often referred to a specialist for definitive electrodiagnostic testing. A study by Cocito found that 28% of the prescriptions for testing were considered to be inappropriate. Therefore, the solution is a fully quantified tendon Reflex evaluation system. The input force of the Reflex Hammer is derived from a predetermined potential energy setting. Tandem wireless three-dimensional (3D) microelectromechanical systems (MEMS) accelerometers quantify the output and latency time of the Reflex. The wireless 3D MEMS accelerometers are positioned to a standard anchor point near the ankle and Reflex Hammer swing arm. Reflex response is quantified by the maximum and minimum components of the acceleration profile. The temporal disparity between Hammer strike and response defines the latency of the Reflex loop. The quantified data collected from wireless 3D MEMS accelerometers are conveyed to a portable computer. Enclosed are the initial test and evaluation and the description of such a device, which quantitatively evaluates the Reflex response and latency using wireless 3D MEMS accelerometers, while demonstrating precision for reproducibility.

James G. Colebatch - One of the best experts on this subject based on the ideXlab platform.

  • head taps evoke a crossed vestibulo ocular Reflex
    Neurology, 2007
    Co-Authors: Shinichi Iwasaki, James G. Colebatch, Ann M Burgess, Leigh A Mcgarvie, G M Halmagyi, Juno Kim, Ian S Curthoys
    Abstract:

    Taps to the forehead on the midline, at the hairline (Fz), with a Reflex Hammer or powerful bone conduction vibrator caused short-latency surface potentials from beneath both eyes in all healthy subjects. The earliest negative responses were invariably absent from the eye contralateral to the side of a previous vestibular nerve section but were preserved despite sensorineural hearing loss. These responses probably reflect vestibular function via crossed otolith–ocular pathways.

  • Tapping the head activates the vestibular system : a new use for the clinical Reflex Hammer
    Neurology, 1995
    Co-Authors: Gabor Michael Halmagyi, R.a. Yavor, James G. Colebatch
    Abstract:

    We investigated the use of skull taps with a modified clinical Reflex Hammer as a method of vestibular activation. Using recently described EMG techniques to measure vestibulocollic Reflexes in response to clicks, we were able to show analogous short-latency potentials to taps. The earliest responses were invariably absent on the side of a previous vestibular nerve section but were preserved in profound sensorineural or conductive hearing loss. We propose that the taps activated the vestibular apparatus directly by a bone-conducted vibration wave.