Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-06T12:14:33.134Z Has data issue: false hasContentIssue false
  • English
  • Français

H-Reflex Modulation During Walking in Spastic Paretic Subjects

Published online by Cambridge University Press:  18 September 2015

J.F. Yang ,
J. Fung ,
M. Edamura ,
R. Blunt ,
R.B. Stein  and
H. Barbeau
J.F. Yang*
Affiliation:
Division of Neuroscience, University of Alberta, Edmonton Department of Physical Therapy, University of Alberta, Edmonton
J. Fung
Affiliation:
School of Physical Occupational Therapy, McGill University, Montreal
M. Edamura
Affiliation:
Department of Physiology, University of Alberta, Edmonton
R. Blunt
Affiliation:
Department of Physiology, University of Alberta, Edmonton School of Physical Occupational Therapy, McGill University, Montreal
R.B. Stein
Affiliation:
Division of Neuroscience, University of Alberta, Edmonton Department of Physiology, University of Alberta, Edmonton
H. Barbeau
Affiliation:
School of Physical Occupational Therapy, McGill University, Montreal
*
Division of Neuroscience, 513 Heritage Medical Research Ctr., University of Alberta, Edmonton, Alberta, Canada T6G 2S2
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Hoffmann (H) reflexes were elicited from the soleus muscle during treadmill walking in 21 spastic paretic patients. The soleus and tibialis anterior muscles were reciprocally activated during walking in most patients, much like that observed in healthy individuals. The pattern of H-reflex modulation varied considerably between patients, from being relatively normal in some patients to a complete absence of modulation in others. The most common pattern observed was a lack of H-reflex modulation through the stance phase and slight depression of the reflex in the swing phase, considerably less modulation than that of normal subjects under comparable walking conditions. The high reflex amplitudes during periods of the step cycle such as early stance seems to be related to the stretch-induced large electromyogram bursts in the soleus in some subjects. The abnormally active reflexes appear to contribute to the clonus encountered during walking in these patients. In three patients who were able to walk for extended periods, the effect of stimulus intensity was examined. Two of these patients showed a greater degree of reflex modulation at lower stimulus intensities, suggesting that the lack of modulation observed at higher stimulus intensities is a result of saturation of the reflex loop. In six other patients, however, no reflex modulation could be demonstrated even at very low stimulus intensities.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 18 , Issue 4 , November 1991 , pp. 443 - 452
Copyright
Copyright © Canadian Neurological Sciences Federation 1991

References

REFERENCES

1.Akazawa, K, Aldridge, JW, Steeves, JD,et al.modulation of stretch reflexes during locomotion in the mesencephalic cat.J Physiol(Lond) 1982;329:553–567Google ScholarPubMed
2.Forssberg, H, Grillner, S, Rossignol, S. Phasic gain control of reflexes from the dorsum of the paw during spinal locomotion. BrainRes 1977; 132:121–139Google ScholarPubMed
3.Capaday, C, Stein, RB. Amplitude modulation of the soleus H-reflex in the human during walking and standing.J Neurosci 1986; 6: 1308–1313.CrossRefGoogle ScholarPubMed
4.Crenna, P, Frigo, C. Excitability of the soleus H-reflex arc during walking and stepping in man. Exp Brain Res 1987; 66: 49–60.CrossRefGoogle ScholarPubMed
5.Capaday, C, Stein, RB. Difference in the amplitude of the human soleus H-reflex during walking and running. J Physiol (Lond) 1987; 392: 513–522.CrossRefGoogle ScholarPubMed
6.Forssberg, H. Stumbling corrective reaction: a phase dependent compensatory reaction during locomotion. J Neurophysiol 1979; 42: 936–953.CrossRefGoogle ScholarPubMed
7.Ashby, P, McCrea, DNeurophysiology of spinal spasticity. In: Davidoff, RA (editor). Handbook of the Spinal Cord. New York: Marcel Dekker, 1987: 119–143.Google Scholar
8.Dietrichson, P. The role of the fusimotor system in spasticity and Parkinsonian rigidity. In: Desmedt, JE (editor). New Developments in Electromyography and Clinical Neurophysiology. Basel: Karger, 1973: 496–507.Google Scholar
9.Ashby, P, Verrier, M, Lightfoot, E. Segmental reflex pathways in spinal shock and spinal spasticity in man. J Neurol Neurosurg Psychiatry 1974; 37: 1352–1360.CrossRefGoogle ScholarPubMed
10.Taylor, S, Ashby, P, Verrier, M. Neurophysiological changes following traumatic spinal lesions in man. J Neurol Neurosurg Psychiatry 1984; 47: 1102–1108.CrossRefGoogle ScholarPubMed
11.Little, JW, Halar, EM. H-reflex changes following spinal cord injury. Arch Phys Med Rehabil 1985; 66: 19–22.Google ScholarPubMed
12.McLellan, DL. Co-contraction and stretch reflexes in spasticity during treatment with baclofen. J Neurol Neurosurg Psychiatry 1977; 40: 30–38.CrossRefGoogle Scholar
13.Corcos, DM, Gottlieb, GL, Penn, RDet al. Movement deficits caused by hyperexcitable stretch reflexes in spastic humans. Brain 1986; 109: 1049–10558.CrossRefGoogle ScholarPubMed
14.Young, RR, Delwaide, PJDrug therapy: spasticity. New Engl J Med 1981; 304: 28–33.Google ScholarPubMed
15.Wainberg, M, Barbeau, H, Gauthier, S. Quantitative assessment of the effect of cyproheptadine on spastic paretic gait: a preliminary study. J Neurol 1986; 233: 311–314.CrossRefGoogle ScholarPubMed
16.Wainberg, M, Barbeau, H, Gauthier, S. The effects of cyproheptadine on locomotion and on spasticity in spinal cord injured patients. J Neurol Neurosurg Psychiatry 1990; 53: 754–763.CrossRefGoogle Scholar
17.Yang, JF, Stein, RB, Edamura, M. CEdamura M. Monosynaptic reflexes during walking in patients with spasticity. Can J Physiol Pharmacol 1989; 67:A41.Google Scholar
18.Fung, J, Blunt, R, Barbeau, H. The soleus H-reflex modulation pat-tern in spastic paretic subjects during standing and walking. In: Brandt, Th, Pauluo, W, Bleo, W,Dieterich, M, Krafczyk, S, Straube, A, (editor). Disorders of Posture and Gait. New York: Thieme 1990; 398–401.Google Scholar
19.Hugon, M. Methodology of the Hoffmann reflex in man. In: Desmedt, JE (editor). New Developments in Electromyography and Clinical Neurophysiology. Basel: Karger, 1973,3: 277–293.Google Scholar
20.Yang, JF, Winter, DA. Surface EMG profiles during different walk-ing cadences in humans. Electroencephalogr Clin Neurophysiol 1985; 60: 485–491.CrossRefGoogle Scholar
21.Fung, J, Barbeau, H. A dynamic EMG profile index to quantify mus-cular activation disorder in spastic paretic gait. Electroen-cephalogr Clin Neurophysiol 1989; 73: 233–244.CrossRefGoogle ScholarPubMed
22.Stein, RB, Lee, RTremor and Clonus. In: Brook, V (editor). Handbook of Physiology, Sec I, Vol. II Part 1, Baltimore: Waverly Press, 1981; 325–344.Google Scholar
23.Peat, M, Dubo, HIC, Winter, DA, et al. Electromyographic temporal analysis of gait: hemiplegic locomotion. Arch Phys Med Rehabil 1976; 57: 421–425.Google ScholarPubMed
24.Knutsson, E, Richards, C. Different types of disturbed motor control in gait of hemiparetic patients. Brain 1979; 102: 405–430.CrossRefGoogle ScholarPubMed
25.Somerville, J, Ashby, P. Hemiplegic spasticity: neurophysiologic studies. Arch Phys Med Rehabil 1978; 59: 592–596.Google ScholarPubMed
26.Burke, D, Ashby, P. Are spinal "presynaptic" inhibitory mechanisms suppressed in spasticity?. J Neurol Sci 1972; 15: 321–326.CrossRefGoogle ScholarPubMed
27.Ashby, P, Stalberg, E, Winkler, T, et al. Further observations on the depression of group la facilitation of motoneurons by vibration in man. Exp Brain Res 1987; 69: 1–6.CrossRefGoogle Scholar
28.Ashby, P, Wiens, M. M Reciprocal inhibition following lesions of the spinal core in man. J Physiol (Lond) 1989; 414: 145–157.CrossRefGoogle Scholar
29.Edamura, E, Yang, JF, Stein, RB. Factors that determine the magnitude and time course of human H-reflexes in locomotion. J Neurosci 1991; 11: 420–427.CrossRefGoogle ScholarPubMed
30.Dubuc, R, Cabelguen, J-M, Rossignol, S. Rhythmic fluctuations of dorsal root potentials and antidromic discharges of primary afferents during fictive locomotion in the cat. J Neurophysiol 1988; 60: 2014–2036.CrossRefGoogle ScholarPubMed
31.Matthews, PBR. Evolving views of the internal operation and func-tional role of the muscle spindle. J Physiol (Lond) 1981; 320: 130.CrossRefGoogle Scholar
32.Magladery, JW, McDougal, DB Jr.Electrophysiological studies of nerve and reflex activity in normal man. I. Identification of certain reflexes in the electromyogram and the conduction velocity of peripheral nerve fibres. Bull Johns Hopkins Hosp 1950; 86: 265–290.Google Scholar
33.Davidoff, RA. Antispasticity drugs: mechanisms of action. Ann Neurol 1985; 17: 107–116.CrossRefGoogle ScholarPubMed
34.Penn, RD, Kroin, JS. Long-term intrathecal baclofen infusion for treatment of spasticity. J Neurosurgl 1987; 66: 181–185.CrossRefGoogle ScholarPubMed
35.Nance, PW, Shears, AH, Nance, DMReflex changes induced by Clonidine in spinal cord injured patients. Paraplegia 1989; 27: 296–301.Google ScholarPubMed
36.Stewart, JE, Barbeau, H, Gauthier, S. Modulation of locomotor patterns and spasticity with Clonidine in spinal cord injured patients. Can J Neurol Sci 1991; 18: 321–331.CrossRefGoogle ScholarPubMed
37.Fung, J, Stewart, JE, Barbeau, H. The combined effects of Clonidine and cyproheptadine with interactive training on the modulation of locomotion in spinal cord injured subjects. J Neurol Sci 1990; 100: 85–93.CrossRefGoogle ScholarPubMed
38.Fung, J, Barbeau, H. The effects of conditioning musculo-cutaneous stimulation on the soleus H-reflex during walking in spastic paretic subjects. Soc Neurosci Abstr 1991; 16(2): 1262.Google Scholar