H-reflex

The H-reflex (or Hoffmann's reflex) is a reflectory reaction of muscles after electrical stimulation of sensory fibers (Ia afferents stemming from muscle spindles) in their innervating nerves (for example, those located behind the knee). The H-reflex test is performed using an electric stimulator, which gives usually a square-wave current of short duration and small amplitude (higher stimulations might involve alpha fibers, causing an F-wave, compromising the results), and an EMG set, to record the muscle response. That response is usually a clear wave, called H-wave, 28-35 ms after the stimulus, not to be confused with an F-wave. An M-wave, an early response, occurs 3-6 ms after the onset of stimulation. The H and F-waves are later responses. As the stimulus increases, the amplitude of the F-wave increases only slightly, and the H-wave decreases, and at supramaximal stimulus, the H-wave will disappear. The M-wave does the opposite of the H-wave. As the stimulus increases the M-wave increases. There is a point of minimal stimulus where the M-wave is absent and the H-wave is maximal.