Duysens J, Bastiaanse C M, Smits-Engelsman B C M, Dietz V
Department of Medical Physics and Biophysics, University of Nijmegen, Geert Grooteplein 21, 6525 EZ Nijmegen, The Netherlands.
Can J Physiol Pharmacol. 2004 Aug-Sep;82(8-9):715-22. doi: 10.1139/y04-071.
During human gait, electrical stimulation of the foot elicits facilitatory P2 (medium latency) responses in TA (tibialis anterior) at the onset of the swing phase, while the same stimuli cause suppressive responses at the end of swing phase, along with facilitatory responses in antagonists. This phenomenon is called phase-dependent reflex reversal. The suppressive responses can be evoked from a variety of skin sites in the leg and from stimulation of some muscles such as rectus femoris (RF). This paper reviews the data on reflex reversal and adds new data on this topic, using a split-belt paradigm. So far, the reflex reversal in TA could only be studied for the onset and end phases of the step cycle, simply because suppression can only be demonstrated when there is background activity. Normally there are only 2 TA bursts in the step cycle, whereas TA is normally silent during most of the stance phase. To know what happens in the stance phase, one needs to have a means to evoke some background activity during the stance phase. For this purpose, new experiments were carried out in which subjects were asked to walk on a treadmill with a split-belt. When the subject was walking with unequal leg speeds, the walking pattern was adapted to a gait pattern resembling limping. The TA then remained active throughout most of the stance phase of the slow-moving leg, which was used as the primary support. This activity was a result of coactivation of agonistic and antagonistic leg muscles in the supporting leg, and represented one of the ways to stabilize the body. Electrical stimulation was given to a cutaneous nerve (sural) at the ankle at twice the perception threshold. Nine of the 12 subjects showed increased TA activity during stance phase while walking on split-belts, and 5 of them showed pronounced suppressions during the first part of stance when stimuli were given on the slow side. It was concluded that a TA suppressive pathway remains open throughout most of the stance phase in the majority of subjects. The suggestion was made that the TA suppression increases loading of the ankle plantar flexors during the loading phase of stance.
在人类步态中,在摆动期开始时对足部进行电刺激会在胫前肌(TA)中引发易化性P2(中等潜伏期)反应,而相同刺激在摆动期末会引起抑制性反应,同时在拮抗肌中引发易化性反应。这种现象被称为相位依赖性反射逆转。抑制性反应可从腿部的多种皮肤部位以及通过刺激某些肌肉(如股直肌(RF))诱发。本文回顾了关于反射逆转的数据,并使用分带范式补充了关于该主题的新数据。到目前为止,TA中的反射逆转只能在步周期的开始和结束阶段进行研究,仅仅是因为只有在存在背景活动时才能证明抑制作用。正常情况下,步周期中TA只有两次爆发,而在大部分站立期TA通常是静息的。为了了解站立期发生了什么,需要有一种方法在站立期诱发一些背景活动。为此,进行了新的实验,让受试者在分带跑步机上行走。当受试者以不等的腿部速度行走时,行走模式会适应类似跛行的步态模式。然后,TA在缓慢移动腿部的大部分站立期内保持活跃,该腿部用作主要支撑。这种活动是支撑腿中主动肌和拮抗肌共同激活的结果,代表了稳定身体的一种方式。在踝关节处对腓肠皮神经给予两倍感觉阈值的电刺激。12名受试者中有9名在分带行走时站立期TA活动增加,其中5名在慢侧给予刺激时在站立期的第一部分表现出明显的抑制。得出的结论是,在大多数受试者中,TA抑制通路在大部分站立期内保持开放。有人提出,TA抑制在站立期的加载阶段增加了踝关节跖屈肌的负荷。