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Case Reports
. 2025 Apr 9:12:100324.
doi: 10.1016/j.prdoa.2025.100324. eCollection 2025.

Analysis of patellar reflex in Parkinson disease patients after an acupuncture treatment protocol - Case series study

Catarina Ramos Pereira  1   2   3   4 , Jorge Machado  1   3 , Begoña Criado  3   4   5 , Rubim Santos  6 , Ana Mafalda Reis  7 , Bruno Ramos  1   3 , Maria João Santos  2   4 , Henry Johannes Greten  8   9
Affiliations
Case Reports

Analysis of patellar reflex in Parkinson disease patients after an acupuncture treatment protocol - Case series study

Catarina Ramos Pereira et al. Clin Park Relat Disord. .

Abstract

Introduction: The investigation of rigidity physiology in Parkinson's Disease involves the examination of reflexes. Parkinsonian patients often demonstrate reduced sensitivity in polysynaptic reflexes within the leg extensor muscles, which is correlated with their postural instability. The compensatory mechanisms for impaired proprioceptive reflex function may involve alterations in intrinsic muscle stiffness. The interplay between gait and reflexes is intricately linked to the nervous system's functioning and motor control. Certain reflexes, such as patellar reflex, play a pivotal role in maintaining walking and posture. Ensuring the integrity of these reflexes is essential for facilitating smooth and efficient walking.

Aim: To analyze the behavior of patellar reflex in four Parkinson's Disease patients undergoing an acupuncture treatment protocol.

Methods: This study adopts a case series design. Reflex outcomes based on amplitude and velocity were assessed at six different time moments throughout a month-long treatment protocol using the MP 36, Biopac Systems.

Results: Over the long term, a tendency for an improvement in range of movement and velocity of the patellar reflex, was observed. Nevertheless, in specific cases, a reduction in the amplitude during acute effects was also found.

Conclusion: Our findings suggest that the acupuncture protocol used may lead to a cumulative improvement in efficacy of patellar reflex in patients with Parkinson's disease. However, further in-depth research, including a statistical evaluation with a larger participant pool, is necessary to validate and confirm these promising preliminary results.

Keywords: Acupuncture; Amplitude; Biopac System; Heidelberg Model; Parkinson Disease; Patellar Reflex; Traditional Chinese Medicine.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of participants selection.
Fig. 2
Fig. 2
Biopac Goniometer.
Fig. 3
Fig. 3
Design Study
Legend: M0 = Moment zero; M1 = Moment one; M2 = Moment two; M3 = Moment three; M4 = Moment four; M5 = Moment five; T1 = Treatment one (…) T12 = Treatment 12.
Fig. 4
Fig. 4
Procedure of the patellar reflex. A – Lateral side of goniometer application; B – Front side of patellar stimulation.
Fig. 5
Fig. 5
Graphic of the progression of patient 1 a) amplitude and b) time − right side only.
Fig. 6
Fig. 6
Graphic of the progression of patient 2 − left (LP) and right side (RP).
Fig. 7
Fig. 7
Graphic of the progression of patient 3 − left (LP) and right side (RP).
Fig. 8
Fig. 8
Mechanism of the patellar tendon reflex response, adapted from , , . 1- First phase; 2- Second phase; 3- Thirth fase (temporal sequence).
See this image and copyright information in PMC

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