Impaired "natural reciprocal inhibition" in patients with spasticity due to incomplete spinal cord injury.

Experiments were performed to compare the ability of normal subjects and patients with spinal spasticity to suppress antagonist H reflexes during isometric ankle contractions. Soleus H reflex suppression was examined during tonic pretibial muscle contractions in which the torque levels were constant and during dynamic pretibial muscle contractions in which the torque followed a predetermined ramp. As well, subjects were instructed to alternately contract ankle plantarflexors and dorsiflexors at various frequencies to examine patterns of EMG activity during rhythmically alternating isometric contractions in antagonist muscles. Patients with incomplete spinal cord injury demonstrated reduced ability to suppress soleus H reflexes during pretibial muscle contraction. At slow speeds of alternating contraction, spinal cord injured patients retained the ability to perform alternating isometric pretibial/soleus muscle contractions. The patients demonstrated abnormal coactivation in soleus muscle during faster alternating isometric ankle muscle contractions. Furthermore, the patients who demonstrated the greatest impairment in natural reciprocal inhibition, also displayed the largest amount of coactivation. In general, the results would suggest that impairment of natural reciprocal inhibition is correlated with an increase in the amount of antagonist muscle coactivation seen during alternating isometric muscle contractions.