Impaired Ability to Suppress Excitability of Antagonist Motoneurons at Onset of Dorsiflexion in Adults with Cerebral Palsy

We recently showed that impaired gait function in adults with cerebral palsy (CP) is associated with reduced rate of force development in ankle dorsiflexors. Here, we explore potential mechanisms. We investigated the suppression of antagonist excitability, calculated as the amount of soleus H-reflex depression at the onset of ankle dorsiflexion compared to rest, in 24 adults with CP (34.3 years, range 18–57; GMFCS 1.95, range 1–3) and 15 healthy, age-matched controls. Furthermore, the central common drive to dorsiflexor motoneurons during a static contraction in the two groups was examined by coherence analyses. The H-reflex was significantly reduced by 37% at the onset of dorsiflexion compared to rest in healthy adults (P<0.001) but unchanged in adults with CP (P=0.91). Also, the adults with CP had significantly less coherence. These findings suggest that the ability to suppress antagonist motoneuronal excitability at movement onset is impaired and that the central common drive during static contractions is reduced in adults with CP.

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Explosive Resistance Training Increases Rate of Force Development in Ankle Dorsiflexors and Gait Function in Adults With Cerebral Palsy

The Journal of Strength and Conditioning Research ◽

10.1519/jsc.0000000000001376 ◽

2016 ◽

Vol 30 (10) ◽

pp. 2749-2760 ◽

Cited By ~ 13

Author(s):

Henrik Kirk ◽

Svend S. Geertsen ◽

Jakob Lorentzen ◽

Kasper B. Krarup ◽

Thomas Bandholm ◽

...

Keyword(s):

Cerebral Palsy ◽

Resistance Training ◽

Rate Of Force Development ◽

Force Development ◽

Gait Function ◽

Ankle Dorsiflexors

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Failure of normal development of central drive to ankle dorsiflexors relates to gait deficits in children with cerebral palsy

Journal of Neurophysiology ◽

10.1152/jn.00218.2012 ◽

2013 ◽

Vol 109 (3) ◽

pp. 625-639 ◽

Cited By ~ 28

Author(s):

Tue Hvass Petersen ◽

Simon F. Farmer ◽

Mette Kliim-Due ◽

Jens Bo Nielsen

Keyword(s):

Cerebral Palsy ◽

Frequency Domain ◽

Frequency Domain Analysis ◽

Response To Therapy ◽

Typically Developing ◽

Control Subjects ◽

Children With Cerebral Palsy ◽

Common Drive ◽

The Common ◽

Central Drive

Neurophysiological markers of the central control of gait in children with cerebral palsy (CP) are used to assess developmental response to therapy. We measured the central common drive to a leg muscle in children with CP. We recorded electromyograms (EMGs) from the tibialis anterior (TA) muscle of 40 children with hemiplegic CP and 42 typically developing age-matched controls during static dorsiflexion of the ankle and during the swing phase of treadmill walking. The common drive to TA motoneurons was identified through time- and frequency-domain cross-correlation methods. In control subjects, the common drive consists of frequencies between 1 and 60 Hz with peaks at beta (15–25 Hz) and gamma (30–45 Hz) frequencies known to be caused by activity within sensorimotor cortex networks: this drive to motoneurons strengthens during childhood. Similar to this drive in control subjects, this drive to the least affected TA in the CP children tended to strengthen with age, although compared with that in the control subjects, it was slightly weaker. For CP subjects of all ages, the most affected TA muscle common drive was markedly reduced compared with that of their least affected muscle as well as that of controls. These differences between the least and most affected TA muscles were unrelated to differences in the magnitude of EMG in the two muscles but positively correlated with ankle dorsiflexion velocity and joint angle during gait. Time- and frequency-domain analysis of ongoing EMG recruited during behaviorally relevant lower limb tasks provides a noninvasive and important measure of the central drive to motoneurons in subjects with CP.

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Fatigue-incduced modulation of human soleus Hoffmann reflex under conditions of homosynaptic postactivation depression due to pair tibial nerve stimulation

Bulletin of Taras Shevchenko National University of Kyiv Series Biology ◽

10.17721/1728_2748.2017.74.55-59 ◽

2017 ◽

Vol 74 (2) ◽

pp. 55-59

Author(s):

O. Kolosova

Keyword(s):

Soleus Muscle ◽

Tibial Nerve ◽

Voluntary Contraction ◽

H Reflex ◽

Afferent Nerves ◽

Tibial Nerve Stimulation ◽

Static Contraction ◽

Conditioned Responses ◽

Postactivation Depression ◽

Stimulation Of

The purpose of our work was to investigate in detail the influence of pair stimulation of tibial nerve (n.tibialis) on human soleus H-reflex amplitude at rest and after long-lasting voluntary contraction of calf muscle (m.m. gastrocnemius-soleus), which caused the fatigue of soleus muscle. The method of H-reflex of soleus muscle was used. Test and conditioned responses (by pair stimulation of n. tibialis) were registered. Homosynaptic postactivation depression led to inhibition of H-reflex at rest. After fatiguing voluntary static contraction the amplitudes of test and conditioned soleus H-reflex were significantly reduced. Then both H-reflex amplitudes subsequently recovered. Soleus H-reflex inhibition might be due to the activation of the groups III and IV afferent nerves under the influence of mechanical and metabolic changes in the muscle.

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The Effects of Different Force Directions and Resistance Levels during Unilateral Resistive Static Contraction of the Lower Trunk Muscles on the Ipsilateral Soleus H-reflex in the Side-lying Position

Journal of Novel Physiotherapies ◽

10.4172/2165-7025.1000290 ◽

2016 ◽

Vol 06 (03) ◽

Author(s):

Arai Mitsuo

Keyword(s):

H Reflex ◽

Trunk Muscles ◽

Lower Trunk ◽

Static Contraction

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Is the Knee the Key to Long-Term Gait Function in Cerebral Palsy?

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.17.01357 ◽

2018 ◽

Vol 100 (1) ◽

pp. e6 ◽

Cited By ~ 1

Author(s):

H. Kerr Graham ◽

Pam Thomason ◽

Morgan Sangeux

Keyword(s):

Cerebral Palsy ◽

Gait Function

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Effects of opposite directional resistive static contraction of the muscles around the scapulae on the unexercised contralateral soleus H-reflex

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2018.05.821 ◽

2018 ◽

Vol 61 ◽

pp. e352

Author(s):

N. Ide ◽

T. Shiratani ◽

R. Hobara ◽

M. Arai

Keyword(s):

H Reflex ◽

Static Contraction

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Changes in Ankle Range of Motion, Gait Function and Standing Balance in Children with Bilateral Spastic Cerebral Palsy after Ankle Mobilization by Manual Therapy

Children ◽

10.3390/children7090142 ◽

2020 ◽

Vol 7 (9) ◽

pp. 142

Author(s):

Pong Sub Youn ◽

Kyun Hee Cho ◽

Shin Jun Park

Keyword(s):

Cerebral Palsy ◽

Range Of Motion ◽

Ankle Joint ◽

Center Of Pressure ◽

Standing Balance ◽

Spastic Cerebral Palsy ◽

Control Group ◽

Walk Test ◽

Joint Mobilization ◽

Gait Function

The aim of this study was to investigate the effect of ankle joint mobilization in children with cerebral palsy (CP) to ankle range of motion (ROM), gait, and standing balance. We recruited 32 children (spastic diplegia) diagnosed with CP and categorized them in two groups: the ankle joint mobilization (n = 16) group and sham joint mobilization (n = 16) group. Thus, following a six-week ankle joint mobilization, we examined measures such as passive ROM in ankle dorsiflexion in the sitting and supine position, center of pressure (COP) displacements (sway length, area) with eyes open (EO) and closed (EC), and a gait function test (timed up and go test (TUG) and 10-m walk test). The dorsiflexion ROM, TUG, and 10-m walk test significantly increased in the mobilization group compared to the control group. Ankle joint mobilization can be regarded as a promising method to increase dorsiflexion and improve gait in CP-suffering children.

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