Modulation of Lower Limb Withdrawal Reflexes During Gait: A Topographical Study

Spaich, Erika G.; Arendt‐Nielsen, Lars; Andersen, Ole Kæseler

doi:10.1152/jn.00360.2003

Cited by 59 publications

(70 citation statements)

References 37 publications

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“…The TA responses are facilitatory during the swing phase and suppressive during the transition phase from swing to stance (Yang and Stein, 1990), mediated probably by group II muscle afferents (Van Wezel et al, 2000). A similar modulation pattern has also been demonstrated for the nociceptive flexion reflex (Spaich et al, 2004). Our current findings are in agreement with the reflex modulation pattern postulated during human walking, suggesting that the TA flexion reflex will be modulated by signals mediating hip position before swing phase commences.…”

Section: Interaction Of Fra Pathways With Signals Registering Hip Possupporting

confidence: 90%

“…The stimulus intensity during which the initial EMG TA activity was induced was identified as the reflex threshold (RT). This reflex response was categorized as SRL if its latency was less than 100 ms, and as LRL when its latency was beyond 120 ms (Spaich et al, 2004). Further increments in stimulus strengths were delivered so to observe if the expression of the flexion reflex changed with increments in the stimulation intensity.…”

Section: Ta Non-nociceptive Flexion Reflex Elicitation and Recording mentioning

confidence: 99%

“…Because of the similar action of these afferents (excitation of flexors and inhibition of extensors) they were grouped under the collective term of flexion reflex afferents (FRA) (see review of Lundberg, 1979). Excitation of FRA induces two distinct responses, a short and a long reflex loop response (SRL and LRL, respectively) (Spaich et al, 2004), while their latency and amplitude depend on the stimulus intensity strength and site of stimulation (Andersen et al, 2001;Spaich et al, 2004). In spinal-intact subjects, the nociceptive flexion withdrawal reflex, which combines flight and defense movements (Sherrington, 1910), has a short central conduction time observed at latencies of 40-60 ms, while the long-latency response occurs at latencies of 85-120 ms or beyond (Shahani and Young, 1971;Hagbarth and Finer, 1963).…”

Section: Introductionmentioning

confidence: 99%

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Hip-phase-dependent flexion reflex modulation and expression of spasms in patients with spinal cord injury

Knikou

2007

Experimental Neurology

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The flexion reflex in human spinal cord injury (SCI) is believed to incorporate interneuronal circuits that consist elements of the stepping generator while ample evidence suggest that hip proprioceptive input is a controlling signal of locomotor output. In this study, we examined the expression of the non-nociceptive flexion reflex in response to imposed sinusoidal passive movements of the ipsilateral hip in human SCI. The flexion reflex was elicited by low-intensity stimulation (300 Hz, 30 ms pulse train) of the right sural nerve at the lateral malleolus, and recorded from the tibialis anterior (TA) muscle. Sinusoidal hip movements were imposed to the right hip joint at 0.2 Hz by a Biodex system while subjects were supine. The effects of leg movement on five leg muscles along with hip, knee, and ankle joint torques were established simultaneously with the modulation pattern of the flexion reflex during hip oscillations. Phase-dependent modulation of the flexion reflex was present during hip movement, with the reflex to be significantly facilitated during hip extension and suppressed during hip flexion. The phase-dependent flexion reflex modulation coincided with no changes in TA pre-and post-stimulus background ongoing activity during hip extension and flexion. Reflexive muscle and joint torque responses, induced by the hip movement and substantiated by excitation of flexion reflex afferents, were entrained to specific phases of hip movement. Joint torque responses were consistent with multi-joint spasmodic muscle activity, which was present mostly during the transition phase of the hip from flexion to extension and from mid-to peak extension. Our findings provide further evidence on the interaction of hip proprioceptors with spinal interneuronal circuits engaged in locomotor pathways, and such interaction should be considered in rehabilitation protocols employed to restore sensorimotor function in people with SCI.

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Section: Interaction Of Fra Pathways With Signals Registering Hip Possupporting

confidence: 90%

Section: Ta Non-nociceptive Flexion Reflex Elicitation and Recording mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hip-phase-dependent flexion reflex modulation and expression of spasms in patients with spinal cord injury

Knikou

2007

Experimental Neurology

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“…The nociceptive withdrawal reflex (NWR) proved to be a useful tool for investigating changes in spinal cord function during rhythmic lower limb movements in humans (Duysens et al, 1990(Duysens et al, , 1992Rossi and Decchi, 1994;Andersen et al, 2001Andersen et al, , 2003Spaich et al, 2004;Sandrini et al, 2005). It is easily recorded in several limb muscles as a clear and stable EMG response after painful electrical stimulation of several nerves (Willer, 1977(Willer, , 1983(Willer, , 1990Sandrini et al, 1993Sandrini et al, , 2005Skljarevski, and Ramadan, 2002).…”

Section: Introductionmentioning

confidence: 99%

Kinematic and Electromyographic Study of the Nociceptive Withdrawal Reflex in the Upper Limbs during Rest and Movement

Serrao¹,

Pierelli²,

Don³

et al. 2006

J. Neurosci.

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This study set out to evaluate nociceptive withdrawal reflex (NWR) excitability and the corresponding mechanical response in the upper limbs during rest and movement. We used a three-dimensional motion analysis system and a surface EMG system to record, in 10 healthy subjects, the NWR in eight upper limb muscles and the corresponding mechanical response in two experimental conditions: rest and movement (reaching for, picking up, and moving a cylinder). The NWR was elicited through stimulation of the index finger with trains of pulses delivered at multiples of the pain threshold (PT). We correlated movement types (reach-to-grasp, grasp-and-lift), movement phases (acceleration, deceleration), and muscle activity types (shortening, lengthening, isometric) with the presence/absence of the NWR (reflex-muscle pattern), with NWR size values, and with the mechanical responses.At rest, when the stimulus was delivered at 4ϫ PT, the NWR was present, in all muscles, in Ͼ90% of trials, and the mechanical response consisted of wrist adduction, elbow flexion, and shoulder anteflexion. At this stimulus intensity, during movement, the reflex-muscle pattern, reflex size, and mechanical responses were closely modulated by movement type and phase and by muscle activity type. We did not find, during movement, significant correlations with the level of EMG background activity.Our findings suggest that a complex functional adaptation of the spinal cord plays a role in modulating the NWR in the transition from rest to movement and during voluntary arm movement freely performed in three-dimensional space. Study of the upper limb NWR may provide a window onto the spinal neural control mechanisms operating during movement.

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“…The stimulus intensity required to induce the initial EMG activity in the TA was identified as the reflex threshold (RT). Reflex responses were categorized as short reflex loop (SRL) responses when their latency was less than 100 ms or long reflex loop (LRL) responses when their latency was beyond 120 ms (Spaich et al, 2004;Knikou and Conway, 2005). During testing, the sural nerve was stimulated at 1.5 times the RT and ranged from 12 to 45 mA (32 ±13.7) across subjects.…”

Section: Stimulation and Recording Protocols Of The Spinal Reflexesmentioning

confidence: 99%

Parallel facilitatory reflex pathways from the foot and hip to flexors and extensors in the injured human spinal cord

Knikou

Kay

Schmit

2007

Experimental Neurology

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Spinal integration of sensory signals associated with hip position, muscle loading, and cutaneous sensation of the foot contributes to movement regulation. The exact interactive effects of these sensory signals under controlled dynamic conditions are unknown. The purpose of the present study was to establish the effects of combined plantar cutaneous afferent excitation and hip movement on the Hoffmann (H) and flexion reflexes in people with a spinal cord injury (SCI). The flexion and Hreflexes were elicited through stimulation of the right sural (at non-nociceptive levels) and posterior tibial nerves respectively. Reflex responses were recorded from the ipsilateral tibialis anterior (TA) (flexion reflex) and soleus (H-reflex) muscles. The plantar cutaneous afferents were stimulated at three times the perceptual threshold (200 Hz, 24-ms pulse train) at conditioning-test intervals that ranged from 3 to 90 ms. Sinusoidal movements were imposed to the right hip joint at 0.2 Hz with subjects supine. Control and conditioned reflexes were recorded as the hip moved in flexion and extension. Leg muscle activity and sagittal-plane joint torques were recorded. We found that excitation of plantar cutaneous afferents facilitated the soleus H-reflex and the long latency flexion reflex during hip extension. In contrast, the short latency flexion reflex was depressed by plantar cutaneous stimulation during hip flexion. Oscillatory joint forces were present during the transition phase of the hip movement from flexion to extension when stimuli were delivered during hip flexion. Hip-mediated input interacts with feedback from the foot sole to facilitate extensor and flexor reflex activity during the extension phase of movement. The interactive effects of these sensory signals may be a feature of impaired gait, but when they are appropriately excited, they may contribute to locomotion recovery in these patients.

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Modulation of Lower Limb Withdrawal Reflexes During Gait: A Topographical Study

Cited by 59 publications

References 37 publications

Hip-phase-dependent flexion reflex modulation and expression of spasms in patients with spinal cord injury

Hip-phase-dependent flexion reflex modulation and expression of spasms in patients with spinal cord injury

Kinematic and Electromyographic Study of the Nociceptive Withdrawal Reflex in the Upper Limbs during Rest and Movement

Parallel facilitatory reflex pathways from the foot and hip to flexors and extensors in the injured human spinal cord

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