Modulation of coordinated muscle activity during imposed sinusoidal hip movements in human spinal cord injury.

Individuals with chronic spinal cord injury (SCI) often demonstrate multijoint reflex activity that is clinically classified as an extensor spasm. These responses are commonly observed in conjunction with an imposed extension movement of the hips, such as movement from a sit to a supine position. Coincidentally, afferent feedback from hip proprioceptors has also been implicated in the control of locomotion in the spinalized cat. Because of this concurrence, we postulated that extensor spasms that are triggered by hip extension might involve activation of organized interneuronal circuits that also have a role in locomotion. If true, imposed oscillations of the hip would be expected to produce activity of the leg musculature in a locomotor pattern. Furthermore, this muscle activity would be entrained to the hip movement. The right hip joints of 10 individuals with chronic SCI, consisting of both complete [American Spinal Injury Association (ASIA) A] and incomplete (ASIA B,C) injuries, were subjected to ramp and hold (10 s) movements at 60 degrees /s and sinusoidal oscillations at 1.2, 1.88, and 2.2 rad/s over ranges from 40 to -15 degrees (+/-5 degrees ) using a custom servomotor system. Surface EMG from seven lower extremity muscles and sagittal-plane joint torques were recorded to characterize the response. Ramp and hold perturbations produced coactivation at the hip, knee, and ankle joints, with a long duration (5-10 s). Sinusoidal perturbations yielded consistent muscle timing patterns that resulted in alternating flexor and extensor joint torques. EMG and joint torques were commonly entrained to the frequency of movement, with rectus femoris, vastus medialis, and soleus activity coinciding with hip extension and medial hamstrings activity occurring during hip flexion. Individual muscle timing patterns were consistent with hip position during normal gait, except for the vastus medialis. These results suggest that reflexes associated with extensor spasms may occur through organized interneuronal pathways, such as spinal centers for locomotion.