title: Plantar cutaneous afferents normalize the reflex modulation patterns during stepping in chronic human spinal cord injury.
abstract: Plantar cutaneous afferent transmission is critical for recovery of locomotion in spinalized animals, whereas a phase-dependent reflex modulation is apparent during fictive or real locomotion. In nine people with a chronic spinal cord injury (SCI) the effects of foot sole stimulation on the soleus H-reflex and tibialis anterior (TA) flexion reflex modulation patterns during assisted stepping were established on different days. The soleus H-reflex was elicited by posterior tibial nerve stimulation followed by a supramaximal stimulus 100 ms after the test H-reflex to control for movement of recording electrodes. The flexion reflex was evoked by sural nerve stimulation with a 30-ms pulse train, recorded from the ipsilateral TA muscle, and elicited at 1.2- to twofold the reflex threshold. During assisted stepping, spinal reflexes were conditioned by percutaneous stimulation of the ipsilateral metatarsals at threefold perceptual threshold with a 20-ms pulse train delivered at 9- to 11-ms conditioning-test intervals. Stimuli were randomly dispersed across the step cycle, which was divided into 16 equal bins. The conditioned soleus H-reflex was significantly facilitated at midstance and depressed during midswing when compared with the unconditioned soleus H-reflex recorded during stepping. Foot sole stimulation induced a significant facilitation of the long-latency TA flexion reflex before, during, and after stance-to-swing transition when compared with the unconditioned long-latency TA flexion reflex during stepping. This study provides evidence that plantar cutaneous afferents remarkably influence the soleus H-reflex and TA flexion reflex modulation patterns during stepping and support that actions of plantar cutaneous afferents onto spinal interneuronal circuits engaged in locomotion are manifested in a phase-dependent manner in chronic SCI subjects.
authors.affiliation: Health Sciences Doctoral Programs, The Graduate Center, City University of New York, 2800 Victory Boulevard, 5N-207, Staten Island, NY 10314, USA. Maria.Knikou@csi.cuny.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Knikou
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D005260:Female; D005528:Foot / Q000294:innervation*; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000502:physiology; D009475:Neurons, Afferent / Q000502:physiology*; D012867:Skin / Q000294:innervation*; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D055815:Young Adult