title: The effect of active pedaling combined with electrical stimulation on spinal reciprocal inhibition.
abstract: OBJECTIVE
  Pedaling is widely used for rehabilitation of locomotion because it induces muscle activity very similar to locomotion. Afferent stimulation is important for the modulation of spinal reflexes. Furthermore, supraspinal modulation plays an important role in spinal plasticity induced by electrical stimulation. We, therefore, expected that active pedaling combined with electrical stimulation could induce strong after-effects on spinal reflexes.
  
  
  METHODS
  Twelve healthy adults participated in this study. They were instructed to perform 7 min of pedaling. We applied electrical stimulation to the common peroneal nerve during the extension phase of the pedaling cycle. We assessed reciprocal inhibition using a soleus H-reflex conditioning-test paradigm. The magnitude of reciprocal inhibition was measured before, immediately after, 15 and 30 min after active pedaling alone, electrical stimulation alone and active pedaling combined with electrical stimulation (pedaling + ES).
  
  
  RESULTS
  The amount of reciprocal inhibition was significantly increased after pedaling + ES. The after-effect of pedaling + ES on reciprocal inhibition was more prominent and longer lasting compared with pedaling or electrical stimulation alone.
  
  
  CONCLUSIONS
  Pedaling + ES could induce stronger after-effects on spinal reciprocal inhibitory neurons compared with either intervention alone. Pedaling + ES might be used as a tool to improve locomotion and functional abnormalities in the patient with central nervous lesion.
authors.affiliation: Department of Rehabilitation Medicine, Keio University School of Medicine, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Kei
authors.initials: K
authors.lastname: Saito
authors.forename: Shigeo
authors.initials: S
authors.lastname: Tanabe
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muraoka
authors.forename: Yohei
authors.initials: Y
authors.lastname: Otaka
authors.forename: Rieko
authors.initials: R
authors.lastname: Osu
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tsuji
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Hase
authors.forename: Meigen
authors.initials: M
authors.lastname: Liu
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000328:Adult; D001642:Bicycling / Q000502:physiology*; D004558:Electric Stimulation / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008297:Male; D009433:Neural Inhibition / Q000502:physiology*; D009473:Neuronal Plasticity; D010543:Peroneal Nerve / Q000502:physiology; D013116:Spinal Cord / Q000502:physiology*