title: Short-term locomotor adaptation to a robotic ankle exoskeleton does not alter soleus Hoffmann reflex amplitude.
abstract: BACKGROUND
  To improve design of robotic lower limb exoskeletons for gait rehabilitation, it is critical to identify neural mechanisms that govern locomotor adaptation to robotic assistance. Previously, we demonstrated soleus muscle recruitment decreased by approximately 35% when walking with a pneumatically-powered ankle exoskeleton providing plantar flexor torque under soleus proportional myoelectric control. Since a substantial portion of soleus activation during walking results from the stretch reflex, increased reflex inhibition is one potential mechanism for reducing soleus recruitment when walking with exoskeleton assistance. This is clinically relevant because many neurologically impaired populations have hyperactive stretch reflexes and training to reduce the reflexes could lead to substantial improvements in their motor ability. The purpose of this study was to quantify soleus Hoffmann (H-) reflex responses during powered versus unpowered walking.
  
  
  METHODS
  We tested soleus H-reflex responses in neurologically intact subjects (n=8) that had trained walking with the soleus controlled robotic ankle exoskeleton. Soleus H-reflex was tested at the mid and late stance while subjects walked with the exoskeleton on the treadmill at 1.25 m/s, first without power (first unpowered), then with power (powered), and finally without power again (second unpowered). We also collected joint kinematics and electromyography.
  
  
  RESULTS
  When the robotic plantar flexor torque was provided, subjects walked with lower soleus electromyographic (EMG) activation (27-48%) and had concomitant reductions in H-reflex amplitude (12-24%) compared to the first unpowered condition. The H-reflex amplitude in proportion to the background soleus EMG during powered walking was not significantly different from the two unpowered conditions.
  
  
  CONCLUSIONS
  These findings suggest that the nervous system does not inhibit the soleus H-reflex in response to short-term adaption to exoskeleton assistance. Future studies should determine if the findings also apply to long-term adaption to the exoskeleton.
authors.affiliation: School of Kinesiology, University of Michigan, Ann Arbor, Michigan 48109-2214, USA. kaop@umich.edu
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Kao
authors.forename: Cara L
authors.initials: CL
authors.lastname: Lewis
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Ferris
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000842:Ankle / Q000502:physiology*; D000843:Ankle Joint / Q000502:physiology; D001696:Biomechanical Phenomena; D004558:Electric Stimulation; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D011214:Practice, Psychological; D012021:Reflex, Abnormal / Q000502:physiology*; D012371:Robotics / Q000295:instrumentation*; D016138:Walking / Q000502:physiology; D055815:Young Adult