Patterned sensory nerve stimulation enhances the reactivity of spinal Ia inhibitory interneurons

Participant attention on the intervention target during repetitive passive movement improved spinal reciprocal inhibition enhancement and joint movement function

This study aimed to evaluate the effects of the participant's attention target during repetitive passive movement (RPM) intervention on reciprocal inhibition (RI) and joint movement function. Twenty healthy adults participated in two experiments involving four attention conditions [control (forward attention with no RPM), forward attention (during RPM), monitor attention (monitor counting task during RPM), ankle joint attention (ankle movement counting task during RPM)] during 10-min RPM interventions on the ankle joint. Counting tasks were included to ensure the participant's attention remained on the target during the intervention. In Experiment 1, RI was measured before, immediately after, and 5, 10, 15, 20, and 30 min after the RPM intervention. In Experiment 2, we evaluated ankle joint movement function at the same time points before and after RPM intervention. The maximum ankle dorsiflexion movement (from 30° plantar flexion to 10° dorsiflexion) was measured, reflecting RI. In Experiment 1, the RI function reciprocal Ia inhibition was enhanced for 10 min after RPM under all attention conditions (excluding the control condition. D1 inhibition was enhanced for 20 min after RPM in the forward and monitor attention conditions and 30 min after RPM in the ankle joint attention condition. In Experiment 2, the joint movement function decreased under the forward and monitor attention conditions but improved under the ankle joint attention condition. This study is the first to demonstrate that the participant's attention target affected the intervention effect of the RI enhancement method, which has implications for improving the intervention effect of rehabilitation.

Effects of patterned electrical sensory nerve stimulation and static stretching on joint range of motion and passive torque

Static stretching and proprioceptive neuromuscular facilitation stretching techniques can modulate specific neural mechanisms to improve the range of motion. However, the effects of modulation of these neural pathways on changes in the range of motion with static stretching remain unclear. Patterned electrical stimulation of the sensory nerve induces plastic changes in reciprocal Ia inhibition. The present study examined the effects of patterned electrical stimulation and static stretching on a range of motion and passive torque in plantarflexion muscles. The subjects were 14 young men (age 20.8 ± 1.3 years). The effects of patterned electrical stimulation (10 pulses at 100 Hz every 1.5 s) or uniform electrical stimulation (one pulse every 150 ms) to the common peroneal nerve for 20 min on reciprocal Ia inhibition of the Hoffman reflex (H-reflex) were examined. Reciprocal Ia inhibition was evaluated as short-latency suppression of the soleus H-reflex by conditioning stimulation of the common peroneal nerve. Then, the effects of transcutaneous electrical nerve stimulation (patterned electrical stimulation or uniform electrical stimulation) or prolonged resting (without electrical stimulation) and static 3-min stretching on the maximal dorsiflexion angle and passive torque were investigated. The passive ankle dorsiflexion test was performed on an isokinetic dynamometer. Stretch tolerance and stiffness of the muscle-tendon unit were evaluated by the peak and slope of passive torques, respectively. Patterned electrical stimulation significantly increased reciprocal Ia inhibition of soleus H-reflex amplitude (9.7 ± 6.1%), but uniform electrical stimulation decreased it significantly (19.5 ± 8.8%). The maximal dorsiflexion angle was significantly changed by patterned electrical stimulation (4.0 ± 1.4°), uniform electrical stimulation (3.8 ± 2.3°), and stretching without electrical stimulation (2.1 ± 3.3°). The increase in stretch tolerance was significantly greater after patterned electrical stimulation and uniform electrical stimulation than after stretching without electrical stimulation. Stiffness of the muscle-tendon unit was significantly decreased by patterned electrical stimulation, uniform electrical stimulation, and stretching without electrical stimulation. Transcutaneous electrical nerve stimulation and static stretching improve stretch tolerance regardless of the degree of reciprocal Ia inhibition.

Activation of the Supplementary Motor Areas Enhances Spinal Reciprocal Inhibition in Healthy Individuals

The supplementary motor area (SMA) may modulate spinal reciprocal inhibition (RI) because the descending input from the SMA is coupled to interneurons in the spinal cord via the reticulospinal tract. Our study aimed to verify whether the anodal transcranial direct current stimulation (anodal-tDCS) of the SMA enhances RI. Two tDCS conditions were used: the anodal stimulation (anodal-tDCS) and sham stimulation (sham-tDCS) conditions. To measure RI, there were two conditions: one with the test stimulus (alone) and the other with the conditioning-test stimulation intervals (CTIs), including 2 ms and 20 ms. RI was calculated at multiple time points: before the tDCS intervention (Pre); at 5 (Int 5) and 10 min; and immediately after (Post 0); and at 5, 10 (Post 10), 15, and 20 min after the intervention. In anodal-tDCS, the amplitude values of H-reflex were significantly reduced for a CTI of 2 ms at Int 5 to Post 0, and a CTI of 20 ms at Int 5 to Pot 10 compared with Pre. Stimulation of the SMA with anodal-tDCS for 15 min activated inhibitory interneurons in RIs by descending input from the reticulospinal tract via cortico–reticulospinal projections. The results showed that 15 min of anodal-tDCS in the SMA enhanced and sustained RI in healthy individuals.

An affordable, adaptable, and hybrid assistive device for upper-limb neurorehabilitation

The paper presents a multisensory and multimodal device for neuromuscular rehabilitation of the upper limb, designed to enable enriched rehabilitation treatment in both clinical and home environments. Originating from an existing low-cost, variable-stiffness rehabilitation device, it expands its functionalities by integrating additional modules in order to augment application scenarios and applicable clinical techniques. The newly developed system focuses on the integration of a wearable neuromuscular electrical stimulation system, a virtual rehabilitation scenario, a low-cost unobtrusive sensory system and a patient model for adapting training task parameters. It also monitors the user behavior during each single session and its evolution throughout the entire training period. The result is a modular, integrated and affordable rehabilitation device, enabling a biomechanical, neurological, and physiological-based training of patients, including innovative features currently unavailable within off-the-shelf rehabilitation devices.