Soleus H-reflex modulation in response to change in percentage of leg loading in standing after incomplete spinal cord injury

Abstract

Body weight support (BWS) is frequently used to retrain standing and walking in persons post spinal cord injury (SCI), but the effects of leg unloading using BWS on H-reflex excitability in this population are unknown. The purpose of the study was to assess the effect of two different loading conditions on soleus H-reflex while standing in persons with motor incomplete SCI (i-SCI) and non-injured persons. Eight persons with motor i-SCI (mean age 50.25 years) and five non-injured persons (mean age 48.6 years) participated in the study. Specific control of the loading conditions was achieved using a BWS system. To compare reflex modulation at 40% versus 0% BWS, soleus H-reflexes were evoked during standing and normalized to the maximum M wave amplitude. These studies revealed that (1) H-reflex excitability is significantly greater after SCI and is exhibited even during quiet standing; and (2) no significant modulation in reflex excitability was observed by change in loading conditions in either the non-injured or the i-SCI subjects. These findings suggest that non-injured persons and persons with i-SCI respond similarly to bilateral limb unloading during standing with no change in H-reflex amplitude. Our results suggest that BWS of up to 40% does not produce detectable changes in the excitability of the soleus H-reflex in persons with i-SCI.