Abstract
Achilles tendon reflex (ATR) was recorded in 86 diabetic patients by a modified Lawson's electromagnetic method described in the previous paper. The recorded ATR curves were investigated in comparison with those in healthy subjects of corresponding sex and age groups and in relation to the clinical states.
1) According to the prolongation of ATR time (repaesented by SD-interval of the curve) and to the diminishing of M-value (the ratio of contraction height to tapping height), the patients were grouped as follows.
A. ATR time normal: 28 cases (33%).
i. with normal M-value: 20 cases.
ii. with lowered M-valne: 8 cases.
B. ATR time moderately prolonged: 20 cases (23%).
i. with normal M-value: 3 cases.
ii. with lowered M-value: 17 cases.
C. ATR time markedly prolonged: 12 cases (14%).
i. with normal M-value: 5 cases.
ii. with lowered M-value: 7- cases.
D. Areflexia: 26 cases (30%).
i. relaxed type: 14 cases.
ii. rigid type: 12 cases.
2) Based on the previous observations in the healthy subjects, the following conclusions were drawn on diabetics:
a) In general, the SD-interval was prolonged in both sexes, and it was related to the duration of the disease.
b) Diminished amplitude ratio was found in both sexes and especially frequently in the groups of prolonged ATR time with longer duration of the disease.
c) Areflexia was found more than three times as frequently as in normals, and it seemed to be related to the duration of the disease, hyperglycemia, hypercholesterolemia, degenerative complications and poor control. But there were no differences between relaxed type and rigid type of areflexia clinically.
d) Abnormal ATR was improved to some extent by appropriate therapy.
e) The electromyographic abnormalities were found in all of 15 diabetics. It is thought at present that the diminution of ATR showed neurogenic pattern and the prolongation of ATR showed myogenic pattern mainly.
3) The prolongation of SD-interval was caused by the prolongation of reflex latency and contraction phase, but for the most part by the latter which corresponds to the muscle dysfunction considerably. The prolongation of reflex latency was considered to be in agreement with the decrease in nerve conduction velocity reported in literatures.
4) It is assumed that the abnormal ATR in diabetics demonstrates not only diabetic neuropathy but diabetic myopathy.
