Soleus H-reflex modulation during body weight support treadmill walking in spinal cord intact and injured subjects

摘要

The soleus H-reflex modulation pattern was investigated in ten spinal cord intact subjects during treadmill walking at varying levels of body weight support (BWS), and nine spinal cord injured (SCI) subjects at a BWS level that promoted the best stepping pattern. The soleus H-reflex was elicited by tibial nerve stimulation with a single 1-ms pulse at an intensity that the M-waves ranged from 4 to 8% of the maximal M-wave (M_max). During treadmill walking, the H-reflex was elicited every four steps, and stimuli were randomly dispersed across the gait cycle which was divided into 16 equal bins. EMGs were recorded with surface electrodes from major left and right hip, knee, and ankle muscles. M-waves and H-reflexes at each bin were normalized to the M_max elicited at 60–100 ms after the test reflex stimulus. For every subject, the integrated EMG area of each muscle was established and plotted as a function of the step cycle phase. The H-reflex gain was determined as the slope of the relationship between H-reflex and soleus EMG amplitudes at 60 ms before H-reflex elicitation for each bin. In spinal cord intact subjects, the phase-dependent H-reflex modulation, reflex gain, and EMG modulation pattern were constant across all BWS (0, 25, and 50) levels, while tibialis anterior muscle activity increased with less body loading. In three out of nine SCI subjects, a phase-dependent H-reflex modulation pattern was evident during treadmill walking at BWS that ranged from 35 to 60%. In the remaining SCI subjects, the most striking difference was an absent H-reflex depression during the swing phase. The reflex gain was similar for both subject groups, but the y-intercept was increased in SCI subjects. We conclude that the mechanisms underlying cyclic H-reflex modulation during walking are preserved in some individuals after SCI. Keywords Assisted stepping - Body support - H-reflex - Human walking - Spinal cord injury