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Placement of a Plate Under the Forefoot in Stance: Decreasing the Excitability of the Soleus Motoneuron Pool

Hiraoka, Koichi PT, PhD

American Journal of Physical Medicine & Rehabilitation: November 2003 - Volume 82 - Issue 11 - p 837-841
doi: 10.1097/01.PHM.0000087454.19029.7E
Research Article: Spasticity
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Hiraoka K: Placement of a plate under the forefoot in stance: Decreasing the excitability of the soleus motoneuron pool. Am J Phys Med Rehabil 2003;82:837–841.

Objective To investigate the effect of the placement of a plate under the sole of the forefoot on the excitability of the soleus motoneuron pool in stance.

Design While eight neurologically intact subjects remained in stance, a square plate (30 × 30 mm), either 3 mm or 6 mm in thickness, was placed under the left medial plantar eminence, under the left lateral plantar eminence, or under the left forefoot sole between the eminences, or a rectangular plate (120 × 30 mm), either 3 mm or 6 mm in thickness, was placed under the left metatarsal heads. To investigate the excitability of the soleus motoneuron pool, the Hmax/Mmax ratio was estimated.

Results Analysis of variance revealed that the region under which the plate was placed had a significant effect and that the thickness of the plate had a nonsignificant effect on the Hmax/Mmax ratio, without significant interaction between the two factors. Post hoc analysis revealed a significant decrease in the Hmax/Mmax ratio when the square plate was placed under the lateral plantar eminence.

Conclusions A square plate placed under the lateral plantar eminence inhibited the excitability of the ipsilateral soleus motoneuron pool in stance. This intervention may be useful for reducing spasticity.

From the Department of Physical Therapy, Osaka Prefectural College of Nursing, Habikino, Osaka, Japan.

Supported, in part, by a grant from Okayama Prefectural Government.

All correspondence and requests for reprints should be addressed to Koichi Hiraoka, PT, PhD, Department of Physical Therapy, Osaka Prefecture College of Nursing, 3-7-30 Habikino, Habikino, Osaka 583-8555, Japan.

© 2003 Lippincott Williams & Wilkins, Inc.