F-wave testing, an index of spinal cord anterior horn cell excitability, does not require supramaximal stimulation, submaximal stimulation is sufficient

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Fumiaki Okada, Toshiaki Suzuki, Masaaki Hanaoka, Marina Todo, Yuki Fukumoto, Makiko Tani, Naoki Kado
Purpose:

In the present study, five healthy subjects were used to examine F-wave performance at 90% intensity of the stimulus intensity at which maximum M-wave amplitude is obtained to 120% intensity, which is the maximal upper stimulus, and the variation of F-wave performance when the examination date is changed. We also examined F-wave similarity (Repeater F) using F-wave waveform analysis software developed by Hanaoka et al.In the present study, five healthy subjects were used to examine F-wave performance at 90% intensity of the stimulus intensity at which maximum M-wave amplitude is obtained to 120% intensity, which is the maximal upper stimulus, and the variation of F-wave performance when the examination date is changed. We also examined F-wave similarity (Repeater F) using F-wave waveform analysis software developed by Hanaoka et al.

Methods:

 F-waves were recorded from the left abductor pollicis brevis muscle with median nerve stimulation in 5 healthy subjects. Stimulation conditions for F-wave measurement were as follows: stimulation site was the left median nerve (wrist joint), stimulation frequency was 1 Hz, stimulation duration was 0.2 ms, and the number of stimuli was 64 times. F-wave analysis items were persistence, latency, peak-to-peak amplitude and amplitude ratio of F/M at each stimulus intensity. To examine the reproducibility of the F-wave data for each stimulus intensity, these trials were conducted five times with an interval of at least one day. The mean and coefficient of variation of the results for each individual in the five trials were determined. In addition, the similarity of F-wave (Repeater F occurrence rate and wave form) was examined using F-wave waveform analysis software developed by Hanaoka et al.

Results:

There was no change in the mean and coefficient of variation of all F-wave analysis items with changes in stimulus intensity. The data did not change except for the F-wave similarity when the inspection date was varied, but the F-wave similarity was completely different when the inspection date was varied.

Conclusion(s):

The use of supramaximal stimulation, which is usually used in F-wave testing, is not necessary. Considering the burden on the subject, submaximal stimulation is sufficient. However, examination on different days revealed that the waveforms constituting the F wave were different even among healthy subjects. We would like to discuss this point in the future.

Implications:

This provide  new benchmark for  F-wave testing  to evaluate muscle tone for stroke patients.

Funding acknowledgements:
none
Keywords:
F-wave
wave form
stimulus intensity
Primary topic:
Neurology: stroke
Second topic:
Neurology
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was conducted with the approval of the Kansai University of Health Sciences Research Ethics Review Committee
Provide the ethics approval number:
Approval No. 21-06
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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