Optimizing assessment of low frequency H-reflex depression in persons with spinal cord injury

PLOS ONE, 2024 · DOI: 10.1371/journal.pone.0300053 · Published: May 14, 2024

Spinal Cord Injury Physiology Rehabilitation

Simple Explanation

This study investigates how to best measure changes in spinal reflexes after repeated stimulation in people with spinal cord injuries (SCI). These reflex changes can tell us how well the spinal cord is modulating signals, which is important for managing spasticity and improving movement after SCI. The researchers compared different ways of stimulating the spinal cord and measuring the reflex response. They wanted to find a method that is quick, reliable, and comfortable for people with SCI. The study found that using a short series of five pulses of stimulation provides similar information to a longer, more traditional method. This shorter method could reduce discomfort and time spent in testing for people with SCI.

Study Duration

Participant recruitment: March 20th, 2017 - March 5th, 2020

Participants

20 participants with incomplete SCI

Evidence Level

Not specified

Key Findings

1
The amount of depression produced by paired-pulse depression (PPD) was less than an 11-pulse train.
2
A 5-pulse train for assessing LFD elicits modulation similar to the 11-pulse train.
3
The 2-pulse train (PPD) produced a response amplitude that had the greatest difference when compared to LFD (mean difference = 0.137).

Research Summary

This study compared different methods of assessing low-frequency depression (LFD) of H-reflexes in individuals with incomplete spinal cord injury (SCI). The goal was to identify a shorter, more efficient method that provides similar information to the traditional 11-pulse LFD protocol. The researchers found that a 5-pulse train elicits modulation similar to the 11-pulse train, suggesting it can be used in place of longer trains. PPD produced less depression than the 11-pulse train. The study recommends using a 5-pulse LFD train in lieu of longer trains to improve efficiency and reduce participant burden when assessing spinal reflex excitability in persons with incomplete SCI.

Practical Implications

Improved Assessment Efficiency

Using a 5-pulse train instead of an 11-pulse train can reduce testing time and participant discomfort.

Enhanced Data Quality

Shorter protocols may reduce the likelihood of muscle spasms or other reflex responses that can compromise data quality.

Wider Application of Neuromodulation

Efficient and valid methods to assess the effects of neuromodulation can promote its broader use in clinical settings.

Study Limitations

1
Findings may not be generalizable to other neurologic populations.
2
Participants had a wide range of injury severities and clinical presentations.
3
Application limited to LFD protocols utilizing 1 Hz of stimulation.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury