Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 12 , Pages 1606-1613, December 2007

Comparison of Soleus H-Reflex Modulation After Incomplete Spinal Cord Injury in 2 Walking Environments: Treadmill With Body Weight Support and Overground

  • Chetan P. Phadke, PhD

      Affiliations

    • Department of Physical Therapy, University of Florida, Gainesville, FL
    • McKnight Brain Institute, University of Florida, Gainesville, FL
    • ,
  • Samuel S. Wu, PhD

      Affiliations

    • Division of Biostatistics, College of Medicine, University of Florida, Gainesville, FL
    • VA Rehabilitation Outcomes Research Center, Malcolm Randall VAMC, Gainesville, FL
    • ,
  • Floyd J. Thompson, PhD

      Affiliations

    • McKnight Brain Institute, University of Florida, Gainesville, FL
    • ,
  • Andrea L. Behrman, PhD

      Affiliations

    • Department of Physical Therapy, University of Florida, Gainesville, FL
    • VA Brain Rehabilitation Research Center, Malcolm Randall VAMC, Gainesville, FL.
    • Corresponding Author InformationReprint requests to Andrea L. Behrman, PhD, Dept of Physical Therapy, PO Box 100154, University of Florida, Gainesville, FL 32610-0154

Abstract 

Phadke CP, Wu SS, Thompson FJ, Behrman AL. Comparison of soleus H-reflex modulation after incomplete spinal cord injury in 2 walking environments: treadmill with body weight support and overground.

Objective

To investigate a walking environment effect on soleus H-reflex modulation during walking in persons with motor incomplete spinal cord injury (SCI) and noninjured controls.

Design

Pretest and posttest repeated-measures quasi-experimental controlled design.

Setting

Locomotor training laboratory.

Participants

Eight adults with incomplete SCI and 8 noninjured age- and speed-matched controls.

Intervention

Walking overground with a customary assistive device and brace at a self-selected, comfortable walking speed was compared with walking on treadmill with 40% body weight support (BWS) and manual trainers for leg and trunk movement guidance.

Main Outcome Measure

Mean soleus H-reflex amplitude (H/M ratio) was recorded during midstance and midswing phases of walking.

Results

The H/M ratio was 33% smaller in stance phase (P=.078) and 56% smaller in the swing phase (P=.008) of walking on the treadmill with BWS and manual assistance compared with overground in the incomplete SCI group. The H/M ratio in the incomplete SCI group was significantly greater compared with noninjured controls in the stance and swing phases of overground walking (P=.001, P=.007, respectively). Soleus H-reflex modulation in the 2 walking environments did not differ significantly in the noninjured population.

Conclusions

Training walking on a treadmill with BWS and manual assistance to approximate the kinematics and spatiotemporal pattern of walking may be a more optimal environment to aid in normalizing reflex modulation after incomplete SCI when compared with conventional gait training overground.

Key Words: H-reflex, Locomotor activity, Recovery of function, Rehabilitation, Spinal cord injuries, Treadmill test, Walking

 

 Supported by the National Institutes of Health (grant no. KO1 HD01348) and VA Rehabilitation Research and Development Service (grant no. F2182C).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)01484-0

doi:10.1016/j.apmr.2007.07.031

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 12 , Pages 1606-1613, December 2007

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