Hoque Maruf M, Ardizzone Melissa A, Sabatier Manning, Borich Michael R, Kesar Trisha M
Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, Georgia, USA.
Neurology (ECronicon). 2018 Aug;10(8):761-770. Epub 2018 Jul 27.
The Hoffman-reflex (H-reflex) is an electrophysiological technique used to evaluate the excitability of the monosynaptic spinal reflex arc. In individuals with upper motor neuron lesions who show elevated spinal excitability, a depression of spinal excitability may indicate adaptive spinal plasticity. Downslope walking (DSW), an exercise intervention comprising repetitive eccentric muscle activity, has been shown to induce depression of soleus H-reflex amplitudes while seated, however, the dose-response time-course of H-reflex modulation during DSW has not been characterized. The objectives of this study were twofold: (1) to evaluate DSW-induced soleus H-reflex depression in the standing posture and during walking, and (2) to investigate the effect of walking duration (20 minutes and 40 minutes) of DSW (-15% decline) on soleus H-reflexes, (with level walking (LW) as a control intervention).
Soleus H-reflexes were collected Pre, Post-20 minutes, and Post-40 minutes of walking in the standing position; and H-reflexes were also measured at 4 different time points during the terminal stance phase of walking.
Our results showed that soleus H-reflexes evaluated in standing showed a greater % depression after DSW compared to LW, with a statistical trend for greater depression with longer durations (40-minutes). H-reflexes measured during walking showed greater depression after 40 minutes of walking compared to 20- or 30-minutes for both DSW and LW.
Longer duration treadmill walking (40-minutes) may induce a greater acute depressive effect on soleus H-reflex excitability compared to shorter durations (20-minutes) of treadmill walking. Future work will investigate the potential for DSW as a gait training intervention in people with upper motor neuron lesions such as multiple sclerosis and stroke.
霍夫曼反射(H反射)是一种用于评估单突触脊髓反射弧兴奋性的电生理技术。在上运动神经元损伤且脊髓兴奋性升高的个体中,脊髓兴奋性降低可能表明脊髓具有适应性可塑性。下坡行走(DSW)是一种包含重复性离心肌肉活动的运动干预,已被证明在坐位时可诱发比目鱼肌H反射波幅降低,然而,DSW过程中H反射调制的剂量反应时间进程尚未得到描述。本研究的目的有两个:(1)评估DSW在站立姿势和行走过程中诱发的比目鱼肌H反射降低情况,(2)研究DSW(-15%下降)的行走持续时间(20分钟和40分钟)对比目鱼肌H反射的影响,(将水平行走(LW)作为对照干预)。
在站立位行走前、行走20分钟后和行走40分钟后收集比目鱼肌H反射;并且在行走末期支撑相的4个不同时间点测量H反射。
我们的结果表明,与LW相比,站立位评估的比目鱼肌H反射在DSW后显示出更大的降低百分比,且有随着持续时间延长(40分钟)降低幅度更大的统计趋势。行走过程中测量的H反射在行走40分钟后比DSW和LW的20分钟或30分钟后显示出更大的降低。
与较短持续时间(20分钟)的跑步机行走相比,较长持续时间(40分钟)的跑步机行走可能对比目鱼肌H反射兴奋性产生更大的急性抑制作用。未来的工作将研究DSW作为上运动神经元损伤患者(如多发性硬化症和中风患者)步态训练干预的潜力。