The journal of spinal cord medicine · 2010
Soleus H-reflex modulation after motor incomplete spinal cord injury: effects of body position and walking speed.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАПоддержка правительства СШАНазвание и аннотация: Перевод в очереди
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Phadke Chetan P, Thompson Floyd J, Kukulka Carl G, Nair Preeti M, Bowden Mark G, Madhavan Sangeetha, Trimble Mark H, Behrman Andrea L
Аннотация
OBJECTIVE: To examine position-dependent (semireclined to standing) and walking speed-dependent soleus H-reflex modulation after motor incomplete spinal cord injury (SCI).
PARTICIPANTS: Twenty-six patients with motor incomplete SCI (mean: 45 +/- 15 years) and 16 noninjured people (mean: 38 +/- 14 years).
METHODS: Soleus H-reflexes were evoked by tibial nerve stimulation. Patients were tested in semireclined and standing positions (experiment 1) and in midstance and midswing positions (experiment 2).
RESULTS: H-reflexes were significantly greater after SCI in all positions compared with noninjured people (P < 0.05). Position-dependent modulation from semireclined to standing (normally observed in noninjured people) was absent after SCI. In SCI patients, H-reflex modulation was not significantly different at 1.2 m/s compared with 0.6 m/s treadmill walking speed; in noninjured people, H-reflex modulation was significantly greater at 1.2 m/s compared with 0.6 m/s treadmill walking speed. There was a significant positive correlation between modified Ashworth scores, a clinical measure of spasticity and soleus H-reflex amplitudes tested in all positions. A significant negative correlation was also found between H-reflexes in standing and midstance positions and the amount of assistance patients required to walk.
CONCLUSIONS: An improvement in position-dependent and walking speed-dependent reflex modulation after SCI may indicate functional recovery. Future studies will use H-reflex testing to track changes as a result of therapeutic interventions.
PARTICIPANTS: Twenty-six patients with motor incomplete SCI (mean: 45 +/- 15 years) and 16 noninjured people (mean: 38 +/- 14 years).
METHODS: Soleus H-reflexes were evoked by tibial nerve stimulation. Patients were tested in semireclined and standing positions (experiment 1) and in midstance and midswing positions (experiment 2).
RESULTS: H-reflexes were significantly greater after SCI in all positions compared with noninjured people (P < 0.05). Position-dependent modulation from semireclined to standing (normally observed in noninjured people) was absent after SCI. In SCI patients, H-reflex modulation was not significantly different at 1.2 m/s compared with 0.6 m/s treadmill walking speed; in noninjured people, H-reflex modulation was significantly greater at 1.2 m/s compared with 0.6 m/s treadmill walking speed. There was a significant positive correlation between modified Ashworth scores, a clinical measure of spasticity and soleus H-reflex amplitudes tested in all positions. A significant negative correlation was also found between H-reflexes in standing and midstance positions and the amount of assistance patients required to walk.
CONCLUSIONS: An improvement in position-dependent and walking speed-dependent reflex modulation after SCI may indicate functional recovery. Future studies will use H-reflex testing to track changes as a result of therapeutic interventions.