Suppression of cutaneous reflexes by a conditioning pulse during human walking

Acoustic pre-stimulation modulates startle and postural reactions during sudden release of standing support surface in aging

Falls contribute to injuries and reduced level of physical activity in older adults. During falls, the abrupt sensation of moving downward triggers a startle-like reaction that may interfere with protective response movements necessary to maintain balance. Startle reaction could be dampened by sensory pre-stimulation delivered immediately before a startling stimulus. This study investigated the neuromodulatory effects of pre-stimulation on postural/startle responses to drop perturbations of the standing support surface in relation to age. Ten younger and 10 older adults stood quietly on an elevated computer-controlled moveable platform. At an unpredictable time, participants were dropped vertically to elicit a startle-like response. Reactive drop perturbation trials without a pre-stimulus (control) were alternated with trials with acoustic pre-stimulus tone (PSI). A two-way mixed design analysis of variance comparing condition (control vs. PSI) X group (younger vs. older) was performed to analyze changes in muscle activation patterns, ground reaction force, and joint angular displacements. Compared to younger adults, older adults showed lower neck muscle electromyography amplitude reduction rate and incidence of response. Peak muscle activation in neck, upper arm, and hamstring muscles were reduced during PSI trials compared to control trials in both groups (p < 0.05). In addition, knee and hip joint flexion prior to ground contact was reduced in PSI trials compared to control (p < 0.05). During post-landing balance recovery, increased knee and hip flexion displacement and time to peak impact force were observed in PSI trials compared to control condition (p < 0.05). PSI reduced startle-induced muscle activation at proximal body segments and likely decreased joint flexion during abrupt downward vertical displacement perturbations of the body. Older adults retained the ability to modulate startle and postural responses but their neuromodulatory capacity was reduced compared with younger adults. Further research on the potential of applying PSI as a possible therapeutic tool to reduce the risk of fall-related injury is needed.

Modulation of soleus stretch reflexes during walking in people with chronic incomplete spinal cord injury

In people with spasticity due to chronic incomplete spinal cord injury (SCI), it has been presumed that the abnormal stretch reflex activity impairs gait. However, locomotor stretch reflexes across all phases of walking have not been investigated in people with SCI. Thus, to understand modulation of stretch reflex excitability during spastic gait, we investigated soleus stretch reflexes across the entire gait cycle in nine neurologically normal participants and nine participants with spasticity due to chronic incomplete SCI (2.5–11 year post-injury). While the participant walked on the treadmill at his/her preferred speed, unexpected ankle dorsiflexion perturbations (6° at 250°/s) were imposed every 4–6 steps. The soleus H-reflex was also examined. In participants without SCI, spinal short-latency “M1”, spinal medium latency “M2”, and long-latency “M3” were clearly modulated throughout the step cycle; the responses were largest in the mid-stance and almost completely suppressed during the stance-swing transition and swing phases. In participants with SCI, M1 and M2 were abnormally large in the mid–late-swing phase, while M3 modulation was similar to that in participants without SCI. The H-reflex was also large in the mid–late-swing phase. Elicitation of H-reflex and stretch reflexes in the late swing often triggered clonus and affected the soleus activity in the following stance. In individuals without SCI, moderate positive correlation was found between H-reflex and stretch reflex sizes across the step cycle, whereas in participants with SCI, such correlation was weak to non-existing, suggesting that H-reflex investigation would not substitute for stretch reflex investigation in individuals after SCI.

Cutaneous reflex modulation and self-induced reflex attenuation in cerebellar patients

Modulation of cutaneous reflexes is important in the neural control of walking, yet knowledge about underlying neural pathways is still incomplete. Recent studies have suggested that the cerebellum is involved. Here we evaluated the possible roles of the cerebellum in cutaneous reflex modulation and in attenuation of self-induced reflexes. First we checked whether leg muscle activity during walking was similar in patients with focal cerebellar lesions and in healthy control subjects. We then recorded cutaneous reflex activity in leg muscles during walking. Additionally, we compared reflexes after standard (computer triggered) stimuli with reflexes after self-induced stimuli for both groups. Biceps femoris and gastrocnemius medialis muscle activity was increased in the patient group compared with the control subjects, suggesting a coactivation strategy to reduce instability of gait. Cutaneous reflex modulation was similar between healthy control subjects and cerebellar patients, but the latter appeared less able to attenuate reflexes to self-induced stimuli. This suggests that the cerebellum is not primarily involved in cutaneous reflex modulation but that it could act in attenuation of self-induced reflex responses. The latter role in locomotion would be consistent with the common view that the cerebellum predicts sensory consequences of movement.

Rapid feedback corrections during a bimanual postural task

An important observation in motor physiology is that even the fastest feedback responses can be modified in a task-dependent manner. However, whether or not such responses in one limb can be modulated based on online sensory feedback from other limbs is still unknown. We tested this using a bimanual postural control task, in which the two hands either controlled two separate cursors (double-cursor task) or a single cursor displayed at the spatial average between the hands (single-cursor task). In the first experiment, the two hands were symmetrically perturbed outwards. In the double-cursor task, the participants therefore had to return their hands to the targets, whereas in the single-cursor task no correction was necessary. Within 50 ms, the electromyographic activity showed significantly smaller responses in the single- compared with the double-cursor task. In the second experiment, the perturbation direction of the left hand (inward/outward) was randomized, such that participants could not preplan their response before perturbation onset. Results show that the behavior of the right arm in the one-cursor task depended on online feedback coming from the left arm: the muscular response was modulated within 75 ms based on directionally specific information of the left arm. These results suggest that sensory feedback from one limb can quickly modify the perturbation response of another limb in a task-dependent manner.

Selective bilateral activation of leg muscles after cutaneous nerve stimulation during backward walking

During human locomotion, cutaneous reflexes have been suggested to function to preserve balance. Specifically, cutaneous reflexes in the contralateral leg's muscles (with respect to the stimulus) were suggested to play an important role in maintaining stability during locomotor tasks where stability is threatened. We used backward walking (BW) as a paradigm to induce unstable gait and analyzed the cutaneous reflex activity in both ipsilateral and contralateral lower limb muscles after stimulation of the sural nerve at different phases of the gait cycle. In BW, the tibialis anterior (TA) reflex activity in the contralateral leg was markedly higher than TA background EMG activity during its stance phase. In addition, in BW a substantial reflex suppression was observed in the ipsilateral biceps femoris during the stance-swing transition in some participants, while for medial gastrocnemius the reflex activity was equal to background activity in both legs. To test whether the pronounced crossed responses in TA could be related to instability, the responses were correlated with measures of stability (short-term maximum Lyapunov exponents and step width). These measures were higher for BW compared with forward walking, indicating that BW is less stable. However, there was no significant correlation between these measures and the amplitude of the crossed TA responses in BW. It is therefore proposed that these crossed responses are related to an attempt to briefly slow down (TA decelerates the center of mass in the single-stance period) in the light of unexpected perturbations, such as provided by the sural nerve stimulation.

Adaptation of cutaneous stumble correction when tripping is part of the locomotor environment

We recently showed that cutaneous reflexes evoked by stimulating the superficial peroneal (SP; innervates foot dorsum) nerve are modulated according to the level of postural threat. Context-related modulation was observed mainly in contralateral (c) responses but not in the ipsilateral responses. This lack of effect on ipsilateral (i) cutaneous reflexes might have been caused by the general nature of the whole body perturbation. We therefore hypothesized that context-relevant mechanical perturbations applied to the dorsum of the foot by an instrumented rod at early swing during walking would produce differences in ipsilateral cutaneous reflex amplitudes, consistent with the functional relevance of the SP nerve in stumble correction responses. Subjects walked on a motorized treadmill under four conditions: 1) normal, 2) normal with mechanical perturbations at the foot dorsum, 3) arms crossed, and 4) arms crossed with mechanical perturbations at the foot dorsum. Electrical stimulation of the SP nerve was delivered at five phases of the step cycle, and cutaneous reflexes were compared between all conditions for each phase of the step cycle. Reflex responses were generally found to be modulated in amplitude during walking conditions in which mechanical perturbations were delivered, particularly in ipsilateral tibialis anterior (iTA), which showed a marked reduction in inhibition. The results indicated cutaneous reflexes in iTA and contralateral medial gastrocnemius (cMG) were influenced by the threat of a trip, induced by applying mechanical perturbations to the foot dorsum during walking. This task-related gating of cutaneous reflexes was not generalized to all muscles, thus suggesting a functional role in the maintenance of stability during locomotion.