• A Leroux, M Bélanger, and J P Boucher.
• Department of Kinanthropology, University of Quebec at Montreal, Canada.
• Arch Phys Med Rehabil. 1995 Jun 1; 76 (6): 576-82.

ObjectiveDetermine the electrophysiological effects of anterior knee pain using monosynaptic and polysynaptic reflexes.DesignA pretest/posttest control group experimental design with repeated measures.SettingAll tests were performed in a university laboratory.ParticipantsSix subjects suffering from patello-femoral dysfunction (PFD) composed the experimental group. These patients were diagnosed and referred by medical and chiropractic doctors. Six healthy subjects were recruited for the control group.InterventionPain relief by cold application (10 minutes) on the knee.Main Outcome MeasuresMonosynaptic reflex: H reflex of the superficial portions of the quadriceps femoris. Polysynaptic reflexes: nociceptive flexion response (NFR) of the long head of the biceps femoris.ResultsCold application, producing significant pain relief (p < 0.05), did not change H-reflex amplitude (p > 0.05) for both groups and did not show modulation of the NFR. However, the PFD group showed significantly lower pain (p < 0.05) and NFR thresholds (p < 0.05) than the control group. Finally, nociceptive stimulation was applied at the sural nerve during an isometric extension of the knee (20% of maximum electromyographic contraction). After this stimulation, uni-articular extensors, especially the distal fibers of the vastus medialis, showed a longer and stronger inhibition than the bi-articular rectus femoris.ConclusionsPain episodes do not appear to affect monosynaptic responses. NFR threshold differences found between PFD and control group could be explained by the increased excitability of the nervous system in subjects experimenting painful bouts. Functional implications of these findings are discussed.

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