Soleus H-reflex size versus stimulation rate in the presence of background muscle activity: a methodological study.

Hoffmann reflex (HR) operant conditioning (HROC) is an important intervention for neurorehabilitation. Current HROC paradigms elicit HRs at low rates (~ 0.2 Hz), minimizing rate-dependent depression (RDD). We investigated the impact of higher stimulation rates on HR size. Fifteen healthy participants maintained low background soleus electromyographic activity (EMG) while standing. Soleus HR and M-wave recruitment curves were obtained at rates of 0.2, 1, and 2 Hz twice, from which Mmax and Hmax were calculated. Seventy-five HRs were collected for each rate at a target M-wave size (~ 10 to 20% of Mmax). HR depression was minimal at higher stimulation rates. The mean HR amplitude was reliable across the two repetitions and three rates, with high intraclass correlation coefficient (ICC) values. HROC could be performed consistently at rates up to 2 Hz with minimal HR depression. Faster rates enable more conditioning trials per session, reducing session duration and/or number, thereby potentially accelerating conditioning and reducing participant burden.