Abstract

Motorized assessment of the stretch reflex is instrumental to gain understanding of the stretch reflex, its physiological origin and to differentiate effects of neurological disorders, like spasticity. Both short-latency (M1) and medium-latency (M2) stretch reflexes have been reported to depend on the velocity and acceleration of an applied ramp-and-hold perturbation. In the upper limb, M2 has also been reported to depend on stretch duration. However, wrong conclusions might have been drawn in previous studies as the interdependence of perturbation parameters (amplitude, duration, velocity, and acceleration) possibly created uncontrolled, confounding effects. We disentangled the duration-, velocity-, and acceleration-dependence and their interactions of the M1 and M2 stretch reflex in the ankle plantarflexors. To disentangle the parameter interdependence, 49 unique ramp-and-hold joint perturbations elicited reflexes in 10 healthy volunteers during a torque control task. Linear mixed model analysis showed that M1 depended on acceleration, not velocity or duration, whereas M2 depended on acceleration, velocity, and duration. Simulations of the muscle spindle Ia afferents coupled to a motoneuron pool corroborated these experimental findings. In addition, this simulation model did show a nonlinear M1 velocity- and duration-dependence for perturbation parameters outside the experimental scope. In conclusion, motorized assessment of the stretch reflex or spasticity using ramp-and-hold perturbations should be systematically executed and reported. Our systematic motorized and simulation assessments showed that M1 and M2 depend on acceleration, velocity, and duration of the applied perturbation. The simulation model suggested that these dependencies emerge from: muscle-tendon unit and muscle cross-bridge dynamics, Ia sensitivity to force and yank, and motoneuron synchronization.NEW & NOTEWORTHY Previous research and definitions of the stretch reflex and spasticity have focused on velocity-dependence. We showed that perturbation acceleration, velocity, and duration all shape the M1 and M2 response, often via nonlinear or interacting dependencies. Consequently, systematic execution and reporting of stretch reflex and spasticity studies, avoiding uncontrolled parameter interdependence, is essential for proper understanding of the reflex neurophysiology.

Highlights

  • Reflexes are an important mechanism within human movement control to cope with external perturbations during daily living

  • We investigated the M1 and M2 stretch reflex response to disentangle previously reported acceleration, velocity, and duration-dependence

  • A total of 49 perturbation profiles were used to elicit stretch reflexes, across 2 acceleration levels, 3 velocity levels, and 10 duration levels

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Summary

Introduction

Reflexes are an important mechanism within human movement control to cope with external perturbations during daily living. The stretch reflex is the rapid motor response to counteract an unexpected lengthening of a muscle. An exaggerated stretch reflex, that is, hyperreflexia or spasticity, is often present in people with brain or neural injuries, such as cerebral palsy or spinal cord injury (1, 2). Hyperreflexia contributes to the movement disorder observed in these people, limiting their functional independence. Motorized assessment of the stretch reflex involves imposing a joint movement and measuring the subsequent response in muscle activity. Motorized assessment is important to gain understanding of the stretch reflex, its physiological origin and to differentiate effects of neurological disorders

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