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Medical & Biological Engineering & Computing

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17-01-2018 | Original Article

Assessing sensorimotor excitability after spinal cord injury: a reflex testing method based on cycling with afferent stimulation

Authors: Stefano Piazza, Diego Torricelli, Julio Gómez-Soriano, Diego Serrano-Muñoz, Gerardo Ávila-Martín, Iriana Galán-Arriero, José Luis Pons, Julian Taylor

Published in: Medical & Biological Engineering & Computing | Issue 8/2018

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Abstract

Several studies have examined spinal reflex modulation during leg cycling in healthy and spinal cord injury (SCI) subjects. However, the effect of cutaneous plantar afferent input on spinal excitability during leg cycling after SCI has not been characterised. The aim of the study was to test the feasibility of using controlled leg cycling in combination with plantar cutaneous electrical stimulation (ES) cycling to assess lower limb spinal sensorimotor excitability in subjects with motor complete or incomplete SCI. Spinal sensorimotor excitability was estimated by measuring cutaneomuscular-conditioned soleus H-reflex activity. Reflex excitability was tested before and after a 10-min ES cycling session in 13 non-injured subjects, 6 subjects with motor incomplete SCI (iSCI) who had moderately impaired gait function, 4 subjects with motor iSCI who had severely impaired gait function, and 5 subjects with motor complete SCI (cSCI). No modulation of soleus H-reflex with plantar cutaneous stimuli was observed after either iSCI or cSCI when compared to non-injured subjects. However, after ES cycling, reflex excitability significantly increased in subjects with iSCI and moderately impaired gait function. ES cycling facilitated spinal sensorimotor excitability only in subjects with motor iSCI with residual gait function. Increased spinal excitability induced with a combination of exercise and afferent stimulation could be adopted with diagnostic and prognostic purposes to reveal the activity-based neurorehabilitation profile of individual subjects with motor iSCI.

Trial registration: ISRCTN26172500; retrospectively registered on 15 July 2016

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Title: Assessing sensorimotor excitability after spinal cord injury: a reflex testing method based on cycling with afferent stimulation
Authors: Stefano Piazza
Diego Torricelli
Julio Gómez-Soriano
Diego Serrano-Muñoz
Gerardo Ávila-Martín
Iriana Galán-Arriero
José Luis Pons
Julian Taylor
Publication date: 17-01-2018
Publisher: Springer Berlin Heidelberg
Published in: Medical & Biological Engineering & Computing / Issue 8/2018
Print ISSN: 0140-0118
Electronic ISSN: 1741-0444
DOI: https://doi.org/10.1007/s11517-018-1787-2

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