Locomotor training modifies soleus monosynaptic motoneuron responses in human spinal cord injury

Exp Brain Res, 2015 · DOI: 10.1007/s00221-014-4094-7 · Published: January 1, 2015

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study investigates how locomotor training affects the reflexes in the soleus muscle (calf muscle) of people with spinal cord injuries. Specifically, it looks at the H-reflex, which tests the communication between nerves and muscles. The researchers measured the H-reflex in participants while they were seated and standing, both before and after a period of locomotor training. Locomotor training involves practicing walking with body weight support. The study found that locomotor training can change the H-reflex, but the change depends on the person's spinal cord injury level (AIS scale) and whether they are standing or sitting. This suggests that locomotor training can help the spinal cord adapt to different motor tasks.

Study Duration

1.0 to 3.5 months

Participants

15 individuals with chronic clinical motor complete or incomplete SCI

Evidence Level

Not specified

Key Findings

1
Soleus H-reflex excitability was increased during standing in both legs in AIS C subjects after training.
2
Soleus H-reflex excitability was decreased during seated in AIS C and D subjects after training.
3
Locomotor training modifies the amplitude of the soleus monosynaptic motoneuron responses in a body position-dependent manner.

Research Summary

This study demonstrated that locomotor training modifies the amplitude of the soleus monosynaptic motoneuron responses in a body position-dependent manner. The soleus H-reflex excitability was increased during standing in the right and left leg in AIS C subjects, and was decreased during seated in AIS C and D subjects. These findings demonstrate that the injured human spinal cord can adjust the reflex excitability level after locomotor training, presumably based on the demands of the motor task.

Practical Implications

Rehabilitation Strategies

The findings suggest that locomotor training can be used to improve motor function in individuals with SCI by modifying spinal reflex excitability.

Personalized Therapy

Therapy should be tailored to the individual's SCI level (AIS grade) and the specific motor task (standing vs. sitting) to maximize benefits.

Understanding Neuroplasticity

Further research into the mechanisms underlying these changes could lead to new therapeutic interventions.

Study Limitations

1
Small sample size, particularly in AIS A-B subjects
2
The study did not comprehensively investigate the source of neuronal reorganization
3
The study did not control for conventional physical therapy or participation in other research studies during the study duration.

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