Motor control in patients with incomplete spinal cord injuries and various voluntary movement capabilities.
BACKGROUND
In this study, we attempted to verify the hypothesis that further improvements in volitional movement of patients with a spinal cord injury would diminish and ultimately suppress the segmental responses, while enhancing the supraspinal inhibitory influence.


METHODS
Eleven patients with an incomplete spinal cord injury and partial preservation of motor function (ASIS grades C and D) were recruited. Their lower limbs were evaluated using polyelectromyography (PEMG) during voluntary movements, reinforcement maneuvers, tonic vibratory reflex, passive stretch reflex, irradiation of the passive stretch reflex (PSRirrad), and plantar reflex suppression.


RESULTS
The reinforcement maneuver response, tonic vibratory response, passive stretch reflex, and PSRirrad were most active in limbs with partially preserved volitional movement, but for which patients were still incapable of lifting their heel off the examination table. In contrast, plantar reflex suppression was strongest in limbs with partially preserved volitional movement, for which patients were capable of lifting the heel off the examination table.


CONCLUSIONS
Supraspinal inhibitory effects were most active in those limbs which were capable of lifting the heel off the examination table, compared to limbs with partially preserved volitional activity but without visible movement or which were incapable of lifting the heel off the examination table. The capability for volitional activity paralleled the supraspinal inhibitory effects.
Chou
Shih-Wei
SW
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taiwan, ROC. f91033@cgmh.org.tw
Pei
Yu-Cheng
YC
Lai
Cheng-Hsiu
CH
Kuo
Chia-Hua
CH
Fu
Tieh-Cheng
TC
Hong
Wei-Hsien
WH
D000328:Adult; D000368:Aged; D004576:Electromyography; D006801:Humans; D008875:Middle Aged; D009068:Movement; D012026:Reflex, Stretch; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014732:Vibration