title: Plantar pressure trigger for reliable nerve stimulus application during dynamic H-reflex measurements.
abstract: In dynamic H-reflex measurements, the standardisation of the nerve stimulation to the gait cycle is crucial to avoid misinterpretation due to altered pre-synaptic inhibition. In this pilot study, a plantar pressure sole was used to trigger the stimulation of the tibialis nerve with respect to the gait cycle. Consequently, the intersession reliability of the soleus muscle H-reflex during treadmill walking was investigated. Seven young participants performed walking trials on a treadmill at 5 km/h. The stimulating electrode was placed on the tibial nerve in the popliteal fossa. An EMG was recorded from the soleus muscle. To synchronize the stimulus to the gait cycle, initial heel strike was detected with a plantar pressure sole. Maximum H-reflex amplitude and M-wave amplitude were obtained and the Hmax/Mmax ratio was calculated. Data reveals excellent reliability, ICC=0.89. Test-retest variability was 13.0% (±11.8). The Bland-Altman analysis showed a systematic error of 2.4%. The plantar pressure sole was capable of triggering the stimulation of the tibialis nerve in a reliable way and offers a simple technique for the evaluation of reflex activity during walking.
authors.affiliation: University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10, Haus 12, 14469 Potsdam, Germany. nkoenig@uni-potsdam.de
authors.forename: Niklas
authors.initials: N
authors.lastname: König
authors.forename: Antje
authors.initials: A
authors.lastname: Reschke
authors.forename: Martin
authors.initials: M
authors.lastname: Wolter
authors.forename: Steffen
authors.initials: S
authors.lastname: Müller
authors.forename: Frank
authors.initials: F
authors.lastname: Mayer
authors.forename: Heiner
authors.initials: H
authors.lastname: Baur
mesh_terms: D000328:Adult; D004558:Electric Stimulation / Q000379:methods; D004576:Electromyography; D005260:Female; D005684:Gait / Q000502:physiology*; D006181:H-Reflex / Q000502:physiology*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation; D009433:Neural Inhibition; D010865:Pilot Projects; D011312:Pressure; D015203:Reproducibility of Results; D013979:Tibial Nerve; D055815:Young Adult