Comparison of soleus H-reflex modulation after incomplete spinal cord injury in 2 walking environments: treadmill with body weight support and overground.
OBJECTIVE
To investigate a walking environment effect on soleus H-reflex modulation during walking in persons with motor incomplete spinal cord injury (SCI) and noninjured controls.


METHODS
Pretest and posttest repeated-measures quasi-experimental controlled design.


METHODS
Locomotor training laboratory.


METHODS
Eight adults with incomplete SCI and 8 noninjured age- and speed-matched controls.


METHODS
Walking overground with a customary assistive device and brace at a self-selected, comfortable walking speed was compared with walking on treadmill with 40% body weight support (BWS) and manual trainers for leg and trunk movement guidance.


METHODS
Mean soleus H-reflex amplitude (H/M ratio) was recorded during midstance and midswing phases of walking.


RESULTS
The H/M ratio was 33% smaller in stance phase (P=.078) and 56% smaller in the swing phase (P=.008) of walking on the treadmill with BWS and manual assistance compared with overground in the incomplete SCI group. The H/M ratio in the incomplete SCI group was significantly greater compared with noninjured controls in the stance and swing phases of overground walking (P=.001, P=.007, respectively). Soleus H-reflex modulation in the 2 walking environments did not differ significantly in the noninjured population.


CONCLUSIONS
Training walking on a treadmill with BWS and manual assistance to approximate the kinematics and spatiotemporal pattern of walking may be a more optimal environment to aid in normalizing reflex modulation after incomplete SCI when compared with conventional gait training overground.
Department of Physical Therapy, University of Florida, Gainesville, FL 32610-0154, USA.
Chetan P
CP
Phadke
Samuel S
SS
Wu
Floyd J
FJ
Thompson
Andrea L
AL
Behrman
D000328:Adult; D002183:Canes; D004558:Electric Stimulation; D004576:Electromyography; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D009989:Orthotic Devices; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D016138:Walking