Soleus Stretch Reflex Inhibition in the Early Swing Phase of Gait Using Deep Peroneal Nerve Stimulation in Spastic Stroke Participants
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H-reflex
Stimulus (psychology)
Common peroneal nerve
Stretch reflex
Muscle stiffness
H-reflex
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Presynaptic inhibition (PI) is instrumental in enabling the nervous system to respond to environmental changes. Subjects who demonstrate little change in PI of the soleus muscle have been shown to have a decreased ability to adapt to environmental changes (i.e. uneven surface conditions). Little research has been done to examine changes in PI during various surface and stance conditions. PURPOSE: this study utilized H-reflex measures to examine extrinsic PI in the soleus muscle during single- and double-legged stance, under stable and unstable surface conditions. Design & settings: A 2 × 2 fully repeated measures design was employed with leg (single vs. double) and support surface (foam, no foam) serving as the independent variables. subjects: Ten healthy subjects (age = 23.±1.7 yr, mass = 75.2±6.4 kg, ht = 172.1±8.5 cm) with no known acute or chronic neurological or lower extremity musculoskeletal injury 6 months prior to the study served as volunteers. Measurements: The tibial nerve was stimulated using an extrinsic PI conditioning protocol. The ratio of the unconditioned H-reflex amplitude to the conditioned H-reflex amplitude represented extrinsic PI. All subjects completed a total of 7 trials for the conditioned and unconditioned soleus H-reflex response for each treatment. RESULTS: No interaction was found between leg and surface condition on soleus PI (p > 0.05). Main effects testing revealed that a significant increase in soleus PI for the single-legged stance compared the double-legged stance (P=0.001). Surface variation did not affect soleus PI (p > 0.05). CONCLUSIONS: The increase in soleus PI during a single-legged stance suggests inhibition of the motoneuron pool may aid in making postural corrections, while maintaining upright stance during less stable positions. Moreover, maintenance of upright stance on an unstable foam surface does not appear to influence extrinsic PI modulation of the soleus muscle.
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We investigated whether the modulatory effects of segmental and descending inputs on the soleus H reflex are modified by postural conditions. Fourteen healthy volunteers received a transcranial magnetic stimulus (TMS) or percutaneous electrical stimulation of the posterior tibial nerve (PTN), preceding by 0 to 400 ms the elicitation of the soleus H reflex in supine, sitting, and standing positions. In all positions, TMS induced an early period of facilitation at interstimulus intervals (ISIs) ranging between 5 and 35 ms. In supine and sitting positions, there was a second period of facilitation at ISIs between 60 and 90 ms, which was absent or significantly reduced in the standing position. PTN induced a strong inhibition of the H reflex in all positions up to 125 ms. In supine and sitting positions, inhibition continued up to 400 ms, whereas it was significantly reduced or completely absent beyond 125 ms in the standing position. These results demonstrate posture-related differences in the modulatory effects of descending and segmental inputs on the excitability of the H-reflex circuit. © 2000 John Wiley & Sons, Inc. Muscle Nerve 23: 925–932, 2000
H-reflex
Supine position
Sitting
Facilitation
Triceps reflex
Stimulus (psychology)
Interstimulus interval
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H-reflex
Facilitation
Muscle spindle
Stimulus (psychology)
Reciprocal inhibition
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Recurrent inhibition in the spinal cord has been suggested to serve as a variable gain regulator to allow for optimal muscle force control, to influence alpha-motoneuron firing rate, and to contribute to task related motor synergies between muscles at the same or different joints. The purpose of this study was to examine the resting recurrent inhibition levels in the soleus motoneuron pool of 20 elderly and 21 young adult subjects. To assess recurrent inhibition, a conditioning electrical stimulus was used to activate group Ia afferent fibers and elicit a reflex response in some of the a-motoneurons innervating the soleus muscle; producing both activation of Renshaw interneurons excited by those involved soleus a-motoneurons via a recurrent branch of the a-motoneuron axon, and an H-reflex response in the soleus muscle. A H' test reflex elicited by a successive supramaximal stimulus to the same nerve 10 ms after the conditioning stimulus evaluated the resulting inhibitory effect. There was no difference in the H' test reflex amplitude when comparing the young and elderly adult subjects. This result was found following two different methods employed to control for a possible effect on the H' test reflex amplitude of a smaller maximum H-reflex amplitude in the elderly subjects. These results indicate that the level of recurrent inhibition in the motoneuron pool of the resting soleus muscles of the young and elderly adults examined was not significantly different.
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Renshaw cell
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The purpose of our work was to investigate in detail the influence of pair stimulation of tibial nerve (n.tibialis) on human soleus H-reflex amplitude at rest and after long-lasting voluntary contraction of calf muscle (m.m. gastrocnemius-soleus), which caused the fatigue of soleus muscle. The method of H-reflex of soleus muscle was used. Test and conditioned responses (by pair stimulation of n. tibialis) were registered. Homosynaptic postactivation depression led to inhibition of H-reflex at rest. After fatiguing voluntary static contraction the amplitudes of test and conditioned soleus H-reflex were significantly reduced. Then both H-reflex amplitudes subsequently recovered. Soleus H-reflex inhibition might be due to the activation of the groups III and IV afferent nerves under the influence of mechanical and metabolic changes in the muscle.
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Tibial nerve
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H reflexes were evoked in human soleus by stimulating the tibial nerve at a constant intensity. Each trial was then assigned to one of three groups on the basis of the amplitude of its H reflex; all trials in each group were then full-wave rectified and reaveraged. There was a strong positive relationship between the amplitude of the H reflex and the level of electromyographic activity in the muscle at the time of onset of the H reflex, which reflects the activity of the motoneuronal pool when the afferent volley arrived. Thus, much of the variability of the H reflex is due to small changes in the level of activation of the motoneuronal pool during repeated trials. The steady torque preceding the H reflex was a poor predictor of the H-reflex amplitude, presumably because of the delay between the changes in the electrical activity of motoneurons and the mechanical outcome thereof. © 1999 John Wiley & Sons, Inc. Muscle Nerve 22: 341–346, 1999
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Tibial nerve
Stretch reflex
Triceps reflex
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The factors that are responsible for the relationship between motoneuron excitability and muscle length may have both mechanical and/or neurophysiologic origins. The aim of the study was to investigate the changes in the level of presynaptic inhibition, as measured with a soleus H-reflex conditioning protocol, and muscle length. Ten healthy volunteers were measured at three different ankle angles: 30 degrees plantar flexion, neutral position (0 degrees) and 15 degrees dorsiflexion. At each position the soleus H-reflex and the maximum M-wave were measured while the limb was relaxed. The H-reflex was conditioned by a stimulation of the common peroneal nerve, 100 ms prior to the tibial nerve stimulation. The results revealed that the level of presynaptic inhibition was higher at the neutral position in comparison to the dorsiflexed or plantarflexed positions. Additionally, the HMAX/MMAX ratio was significantly decreased when the joint position was set at dorsiflexion. Further, there was a significant correlation, independent of ankle joint angle, between presynaptic inhibition levels and the HMAX/MMAX ratio. The above findings support the concept that peripheral feedback from passive, static modifications in the joint angle and consequently in muscle length, can modify the input/output threshold of the motoneurons on a presynaptic level.
H-reflex
Common peroneal nerve
Tibial nerve
Plantar flexion
Ankle jerk reflex
Tibialis anterior muscle
Ankle dorsiflexion
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