Contraction response to muscle percussion: A reappraisal of the mechanism of this bedside test
Open accessAbstract
OBJECTIVE: To study whether the contraction evoked by muscle percussion stems from the excitation of the muscle or of the nerve and to discuss the changes of this response in neuromuscular disorders. METHODS: In 30 neurologically healthy patients undergoing surgery (for ear, nose, or throat problems unrelated to the study) under general anesthesia with propofol and sufentanil we measured with an electrogoniometer the maximal dorsiflexion of the ankle evoked by reflex hammer percussion of the tibialis anterior muscle before and under neuromuscular junction blockade with rocuronium bromide. In 3 additional healthy volunteers we searched for F-waves to disclose whether percussion excites axons within the muscle. RESULTS: Responses from 28 neurologically healthy patients (15 women) were analyzed after exclusion of 2 due to technical problems. Mean age (SD) was 28 (9) years. Maximal dorsiflexion of the ankle was not significantly modified by neuromuscular junction blockade (mean difference 0.01 mV [95%CI, -0.07 to 0.08], p=0.879). Muscle percussion evoked F-waves in the 3 healthy volunteers tested. CONCLUSIONS: Maximal contraction response to muscle percussion has a muscular rather than a neural origin. However, percussion also excites axons within the muscle. SIGNIFICANCE: These findings may provide clues to understand the changes observed in neuromuscular disorders.
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- Authors
- Czarnetzki, C., Truffert, A., Mekideche, A., Poncet, A., Lysakowski, C., Tramèr, M. R., & Magistris, M. R.
- Affiliations
- University Hospital of Geneva (CH)
- University of Geneva (CH)
- Corresponding author
- Magistris, Michel R.
- Venue
- Clinical Neurophysiology
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 129
- Issue
- 1
- Pages
- 51-58
- ISSN
- 1388-2457 (ISSN-L)
- OpenAlex
- W2767040737
- Cited by
- 1
- References
- 18
- Citations by year
- 2020: 1
- FWCI
- 0.21
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Neurophysiology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- Division of Anesthesiology and the Division of Neurology, Geneva University Hospitals
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Peripheral Nerve Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Keywords
- ankle dorsiflexion, tibialis anterior, neuromuscular blockade, rocuronium, F-wave, neuromuscular disorders, muscle contraction, nerve excitation
- MeSH terms
- Point-of-Care Testing, Adult, Female, Humans, Male, Muscle Contraction, Myography, Neuromuscular Junction, Percussion, Muscle, Skeletal, Evoked Potentials, Motor
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