Comparison of Soleus H-Reflex Modulation After Incomplete Spinal Cord Injury in 2 Walking Environments: Treadmill With Body Weight Support and Overground
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.
aDepartment of Physical Therapy, University of Florida, Gainesville, FL
bMcKnight Brain Institute, University of Florida, Gainesville, FL
cDivision of Biostatistics, College of Medicine, University of Florida, Gainesville, FL
dVA Rehabilitation Outcomes Research Center, Malcolm Randall VAMC, Gainesville, FL
eVA Brain Rehabilitation Research Center, Malcolm Randall VAMC, Gainesville, FL.
Reprint requests to Andrea L. Behrman, PhD, Dept of Physical Therapy, PO Box 100154, University of Florida, Gainesville, FL 32610-0154
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.
ABSTRACT