Affiliations: [a] Toledo Physiotherapy Research Group (GIFTO), Nursing and Physiotherapy School, Castilla La Mancha University, Toledo, Spain
| [b] Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| [c] Stoke Mandeville Spinal Research, National Spinal Injuries Centre, Buckinghamshire Healthcare Trust, NHS, Aylesbury, UK
| [d] Harris Manchester College, Oxford University, UK
Correspondence:
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Address for correspondence: Julio Gómez-Soriano, E.U. Enfermería y Fisioterapia de Toledo, Avda Carlos III s/n 45071, Toledo, Spain. Tel.: +34 925 268800/Ext. 5845; E-mail: julio.soriano@uclm.es.
Abstract: BACKGROUND:Tibialis Anterior (TA) cutaneous reflex (CR) activity evoked following cutaneous stimulation of the plantar (Pl) surface (Pl-TA CR) has demonstrated hyperreflexia and damage of inhibitory mechanisms in subjects with spinal cord injury (SCI) and spasticity. OBJECTIVES:To modulate Pl-TA CR and Soleus H-reflex activity with transcutaneous electrical nerve stimulation (TENS) and vibratory stimulation of the plantar pad during rest and controlled isometric plantarflexion. METHODS:Non-injured subjects (n = 11) and individuals with incomplete SCI with (n = 14) and without spasticity (n = 14) were recruited. The effect of TENS and vibratory stimuli on Pl-TA CR and soleus H-reflex activity were assessed during rest and controlled ramp-and-hold plantarflexion. RESULTS:Vibration failed to inhibit H-reflex activity during rest or plantarflexoin following SCI compared to healthy subjects. In contrast, vibration-induced inhibition of Pl-TA CR was specifically detected in SCI spastic subjects during both rest and the hold phase of plantarflexion. TENS inhibited Pl-TA CR activity in the SCI spasticity group only during hold plantarflexion. CONCLUSIONS:Plantar vibratory stimuli inhibited the pl-TA CR, but not the H reflex, during rest and controlled movement in SCI spastic subjects. Assessment of Pl-TA CR modulation should contribute to the development of modality-specific sensory stimuli programmes for the neurorehabilitation of SCI spasticity.
