Modulation of spinal reflex by assisted locomotion in humans with chronic complete spinal cord injury

Abstract

Objective In healthy subjects, spinal reflexes (SR) evoked by non-noxious tibial nerve stimulation consist of an early (60–120 ms latency) and an occasional late-appearing (120–450 ms latency) component in the ipsilateral tibialis anterior. In chronic (>1 year) complete spinal cord injured (cSCI) subjects early components are small or lacking while late components are dominant. Here we report on the modulation of SR by assisted locomotion in healthy and chronic motor cSCI subjects. Methods SR was evoked by tibial nerve stimulation at the terminal stance phase during assisted locomotion and was compared to SR recorded during upright stance. Results In chronic cSCI subjects only a late SR component was consistently present during upright stance. However during assisted locomotion, an early SR component appeared, while amplitude of the late SR component became small. In contrast, in healthy subjects the early SR component dominated in all conditions, but a small late component appeared during assisted locomotion. Conclusion A more balanced activity of early and late SR components occurred in both subject groups if an appropriate proprioceptive input was provided. Significance Early and late SR components are assumed to reflect the activity of separate neuronal circuits, which are associated with the locomotor circuitry possibly by shaping the pattern.