Postactivation depression of soleus H-reflex increase with recovery of lower extremities motor functions in patients with subacute stroke.

Only eight patients were studied, and there was no control group, so the observed changes cannot be separated from the passage of time or from usual recovery. All patients received conventional physical and occupational therapy for two hours per day, plus multiple motor exercises such as gait training, balance training, ballistic strength training, and lower limb stretching, so the contribution of any single component cannot be identified. The relationship between PAD change and spasticity was not properly tested because only one of eight subjects changed Modified Ashworth Scale during the investigation. The study was not designed to test whether changing PAD causes balance recovery; it only reports correlations between changes. Measurements were taken only at admission and 50 days later, so the timing and shape of recovery were not examined.

Do not read the correlation between PAD change and eyes-closed sway as proof that a reflex change causes balance recovery. The study had no control group, only a small number of patients, and all received physical and occupational therapy with many exercises together.