Spencer Jacob, Aloba Fisayo K, Slusarenko Alexandra, Leone Taylor, Patel Jay, Eyvazzadeh Lily, Lynch Anna-Lee, Borich Michael R, Kesar Trisha M
Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA.
Exp Brain Res. 2025 May 4;243(6):136. doi: 10.1007/s00221-025-07042-7.
The neural processes underlying gait retraining interventions that combine stepping practice with electrical stimulation are poorly understood. The purpose of this study was to compare acute changes in corticomotor excitability measured by motor evoked potential (MEP) amplitude, monosynaptic stretch reflex excitability measured by H/M ratio, and propulsive force generation during gait measured by anterior ground reaction forces (AGRF), induced by 30-minutes of fast walking (Fast) and 30-minutes of fast walking with functional electrical stimulation of the ankle plantarflexors and dorsiflexors (FastFES) in 14 able-bodied young adults. Our results showed that FastFES, but not Fast elicited a significant acute decrease in tibialis anterior MEP amplitude (p = .01). Furthermore, the practice-induced acute decrease in tibialis anterior MEP amplitudes was significantly larger for FastFES than Fast (p = .04). FastFES also elicited a statistically significant increase in the AGRF in the tested limb (p = .01), which was significantly larger than the change induced by Fast (p = .04). Additionally, baseline soleus MEP amplitude was positively correlated with within-session change in AGRF (p = .04, r = 0.16). Acute decrease in tibialis anterior MEP amplitude for the FastFES condition relative to the Fast condition may be caused by fatigue, while the greater increase in AGRF for the FastFES condition signify that stepping practice facilitated alterations of gait patterns. More research is needed to confirm neural mechanisms and investigate the acute as well as long-term effects of Fast and FastFES on clinical populations.
将步行练习与电刺激相结合的步态再训练干预措施背后的神经过程，目前还知之甚少。本研究的目的是比较14名身体健全的年轻人在进行30分钟快速行走（快速组）和30分钟对踝跖屈肌和背屈肌进行功能性电刺激的快速行走（快速电刺激组）后，通过运动诱发电位（MEP）幅度测量的皮质运动兴奋性的急性变化、通过H/M比值测量的单突触牵张反射兴奋性，以及通过前足底反作用力（AGRF）测量的步态推进力产生情况。我们的结果表明，快速电刺激组而非快速组引起胫前肌MEP幅度显著急性降低（p = 0.01）。此外，快速电刺激组因练习导致的胫前肌MEP幅度急性降低显著大于快速组（p = 0.04）。快速电刺激组还使受试肢体的AGRF出现统计学上的显著增加（p = 0.01），且该增加显著大于快速组引起的变化（p = 0.04）。此外，比目鱼肌基线MEP幅度与AGRF的组内变化呈正相关（p = 0.04，r = 0.16）。相对于快速组，快速电刺激组胫前肌MEP幅度的急性降低可能是由疲劳引起的，而快速电刺激组AGRF的更大增加表明步行练习促进了步态模式的改变。需要更多研究来证实神经机制，并调查快速行走和快速电刺激对临床人群的急性和长期影响。
