The effect of topical anesthetics on skin sensation and soleus motoneuron reflex excitability

Agostinucci, James

doi:10.1016/0003-9993(94)90011-6

Cited by 13 publications

(9 citation statements)

References 16 publications

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“…In laboratory studies, it is well known that facilitatory and inhibitory responses of spinal MNs occur with electrical stimulation of cutaneous nerves 6,7) , skin brushing 8,9) and skin anesthesia [10][11][12][13] . These studies have shown that MN excitability is altered by activation of cutaneous afferents.…”

Section: Introductionmentioning

confidence: 99%

Skin Cold Stimulation of the Dermatome Modulates Activation of the Quadriceps

et al. 2012

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Abstract. [Purpose] To examine electromyographic (EMG) activity change during dynamic contraction of the quadriceps with skin cold stimulation (SCS) over the vastus lateralis (VL) and L4 dermatome area on the medial side of the lower leg. [Subjects and Methods] Seventeen healthy male volunteers participated. Dynamic knee extension was performed at 15% maximum voluntary contraction (MVC). SCS is a method used to cool the skin to 25 °C using a gel-cooling pad. The SCS method has no effect on the muscle below the cooled skin. Subjects performed dynamic knee extension under 4 randomly selected conditions: (1) SCS of skin over the VL (SCS VL ), (2)without SCS of skin over the VL (non-SCS VL ), (3) SCS of L4 dermatome area on the medial side of the lower leg (SCS L4 ), and (4) without SCS of L4 dermatome area on the medial side of the lower leg (non-SCS L4 ). Surface EMG from the rectus femoris (RF), VL, and vastus medialis (VM) were recorded using miniature electrodes.[Results] The root mean square of the EMG (rmsEMG) of the VL with SCS was significantly greater than activation without SCS, but was decreased by SCS L4 . However, the activity of RF and VM did not change in any condition.[Conclusion] Our results suggest that the influence of cutaneous input can demonstrably modulate muscle activation.

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Section: Introductionmentioning

confidence: 99%

Skin Cold Stimulation of the Dermatome Modulates Activation of the Quadriceps

et al. 2012

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“…Also in our study, a significant reduction was observed in the threshold of the second facilitation phase, the peak's interstimulus interval and an increase in the area under the curve. The second facilitation phase of the H-reflex recovery curve is an indirect measurement of the suprasegmental control over the spinal cord motor neurons [46]. Thus, the facilitating effects of local anesthetic on the second facilitation phase can also be attributed to supraspinal effects and long loop inputs.…”

Section: Discussionmentioning

confidence: 99%

“…With this method, skin receptors that are involved in changing the motoneurons activity will be numbness. Some evidence shows that the basic activity of skin receptors reduces the presynaptic inhibition of Ia afferents and therefore it has an excitatory effect on the motoneurons activity [27,[45][46][47]. Thus, desen-However, there are some controversies that show the inhibitory effect of the basic discharge of the skin receptors on motoneurons activities [37,48,49].…”

Section: Introductionmentioning

confidence: 99%

The Recovery Curve of Soleus and Gastrocnemius H-Reflex After Applying Tripolar Electrical Stimulation on the Anesthetized Skin of Vertebral Column: An Emphasis on the Early and Secondary Facilitation Phases

Khoshamooz

Torkaman

Sarmadi

2017

Journal of Modern Rehabilitation

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Introduction:Computer modeling studies have shown that depolarization of the posterior and anterior root fibers can be achieved by surface tripolar electrical stimulation. This study investigated the soleus and gastrocnemius H-reflex recovery curve after applying tripolar electrical stimulation on the anesthetized skin of vertebral column. We emphasized on the early and secondary facilitation phases of the H-reflex recovery curve. Materials and Methods:A total of 15 healthy nonathletic female volunteers (mean±SD age: 27.20±3.17 years) were enrolled in this study. H-reflex recovery curves of the soleus and gastrocnemius muscles were recorded before skin anesthesia and then 15 minutes after it (with lidocaine 10%) and finally after application of Transcutaneous Electrical Nerve Stimulator (TENS) or placebo TENS (TENS on/off). Tripolar TENS with pulse width of 300 µs, frequency of 80 Hz and intensity of 1.5 times of the sensory threshold was used for 15 minutes at the level of T11. To record the H-reflex recovery curve, 34 paired stimuli were used with the intensity of 30% H max and interstimulus intervals between 1 and 202 ms. After drawing the H-reflex recovery curve, amplitude, slope, area under the curve, and threshold of the early and secondary facilitation phases were calculated.Results: After application of topical lidocaine, the sensory threshold of the skin vertebral column increased significantly. Fifteen minutes after applying local anesthesia, peak amplitude, slope, and area under the curve of the early facilitation phase significantly decreased in gastrocnemius and soleus muscles. After tripolar TENS application on the anesthetized skin of vertebral column, the slope of the early facilitation phase decreased significantly in the soleus (P=0.047). Also, area under the curve of the secondary facilitation phase significantly increased in both muscles. Conclusion:These findings suggest the excitatory effect of skin anesthesia on the motoneurons activities. Changing the H-reflex recovery curve after application of tripolar TENS on the anesthetized skin may confirm deep penetration of this type of electrical stimulation.

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“…This increase in the SSR amplitude above pressure levels is likely due to a cooling effect of ambient air entering underneath the splint when the splint loosens around the leg. Skin cooling was shown to facilitate both the H reflex and the SSR [39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Effect of Air-Splint Pressure on the Soleus Stretch Reflex during a Voluntary Ramp Plantar Flexion

Agostinucci

2010

Neurophysiology

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Circumferential pressure (CP) applied to the limb has been shown to decrease muscle activity in subjects without neuromuscular disorders and in individuals with spinal cord injury and cerebrovascular accidents. Thus far, studies estimating the CP efficacy with respect to reflex excitability of motoneurons mainly used the H reflex technique on a resting muscle. The purpose of our study, therefore, was to investigate the effect that CP exerts on the soleus stretch reflex (SSR) when superimposed onto a voluntary ramp plantar flexion movement in subjects without neuromuscular disorders. Forty-eight subjects volunteered for this study. SSRs were investigated before, during, and after the application of pressure to the calf. An inflated air-splint connected to a pressure transducer was used to administer and measure the pressure set to 45-50 mm Hg. The SSRs were elicited by dorsiflexing the subject's ankle by 10 deg at 180 deg/sec, while the subject plantarflexed against a moving footplate at 20% of the maximum voluntary contraction through a 30 deg arc at 90 deg/sec. Twenty-five SSRs were recorded and averaged for each experimental phase; peak-to-peak amplitudes were measured and normalized, and reflex latencies were also measured. Friedman Repeated Measures Analysis of Variance on Ranks was used to analyze the differences in the SSR latency and amplitude from the baseline values. No significant general difference in the SSR amplitude was found during pressure application, although individual responses varied widely. The post-pressure values returned to the baseline, and the differences were insignificant. The reflex latencies were also unchanged with respect to the baseline levels. Thus, the CP inhibitory effect on reflex excitability of motoneurons is mild, on average, and variable when a voluntary movement is a condition. The CP technique may not be as efficacious in reducing muscle hyperactivity as was previously thought.

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The effect of topical anesthetics on skin sensation and soleus motoneuron reflex excitability

Cited by 13 publications

References 16 publications

Skin Cold Stimulation of the Dermatome Modulates Activation of the Quadriceps

Skin Cold Stimulation of the Dermatome Modulates Activation of the Quadriceps

The Recovery Curve of Soleus and Gastrocnemius H-Reflex After Applying Tripolar Electrical Stimulation on the Anesthetized Skin of Vertebral Column: An Emphasis on the Early and Secondary Facilitation Phases

Effect of Air-Splint Pressure on the Soleus Stretch Reflex during a Voluntary Ramp Plantar Flexion

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