Monopolar recording of H reflexes at various sites.

Various monopolar recording electrode sites have been used to record H reflexes and M responses. This investigation revealed a decrease in maximum M response amplitude accompanied by an increase in the H/M amplitude ratio as the active recording electrode was positioned more distally, below the gastrocnemii muscle bellies. H and M latencies were also significantly longer at the most distal recording site, but the latency difference is relatively independent of recording site. Serial variation was least at the most proximal recording site for an immobilized ankle. For an unrestrained ankle, serial variation was greater, but was least at the most distal site. The standard recording site, midway between knee and ankle, was not the best site for minimizing serial variation, and it was the least sensitive to vibration-induced reflex excitability changes. For serial testing of H reflex excitability, an immobilized ankle and measured proximal and distal recording sites are recommended.