Affiliations: [a] Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| [b] Shepherd Center, Atlanta, GA, USA
Correspondence:
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Address for correspondence: Trisha M. Kesar, DPT, PhD, Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, 1441 Clifton Rd NE, R205, Atlanta, GA 30322, USA. E-mail: trisha.m.kesar@emory.edu.
Abstract: BACKGROUND:Downslope walking (DSW) is an eccentric-based exercise intervention that promotes neuroplasticity of spinal reflex circuitry by inducing depression of Soleus Hoffman (H)-reflexes in young, neurologically unimpaired adults. OBJECTIVE:The objective of the study was to evaluate the effects of DSW on spinal excitability (SE) and walking function (WF) in people with multiple sclerosis (PwMS). METHODS:Our study comprised two experiments on 12 PwMS (11 women; 45.3±11.8 years). Experiment 1 evaluated acute effects of a single 20-minute session of treadmill walking at three different walking grades on SE, 0% or level walking (LW), – 7.5% DSW, and – 15% DSW. Experiment 2 evaluated the effects of 6 sessions of DSW, at – 7.5% DSW (with second session being – 15% DSW) on SE and WF. RESULTS:Experiment 1 showed significantly greater acute % H-reflex depression following – 15% DSW compared to LW (p = 0.02) and – 7.5% DSW (p = 0.05). Experiment 2 demonstrated significant improvements in WF. PwMS who showed greater acute H-reflex depression during the – 15% DSW session also demonstrated greater physical activity, long-distance WF, and the ability to have greater H-reflex depression after DSW training. Significant changes were not observed in regards to SE. CONCLUSIONS:Though significant changes were not observed in SE after DSW training, we observed an improvement in WF which merits further investigation of DSW in PwMS.
