Hisayoshi Ogata

Invariable H-reflex and sustained facilitation of stretch reflex with heightened sympathetic outflow

Stretch reflex shows sustained (3-min) increase with heightened sympathetic outflow [Hjortskov N, Skotte J, Hye-Knudsen C, Fallentin N. Sympathetic outflow enhances the stretch reflex response in the relaxed soleus muscle in humans. J Appl Physiol 2005;98:1366-70], but it is unknown if it accompanies a sustained increase in H-reflex. The purpose of the study was to test if there is a sustained facilitation in the H-reflex in the human soleus muscle during a variety of sustained tasks that are known to elevate sympathetic outflow. Mean arterial blood pressure, heart rate, and H- and stretch reflexes in the relaxed soleus muscle were obtained in healthy young adults who performed mental arithmetic, static handgrip exercise, post-handgrip ischemia, and cold stimulation. Each task lasted 3 min with a 3-min rest in between tasks. Data were analyzed for the initial 30 s and entire 3 min of each task. There was a heightened cardiovascular response in all tasks for both durations of analysis. An increase in H-reflex amplitude was not observed for either the initial or entire duration of the analysis. The tasks increased stretch reflex amplitude for both durations of analysis. Invariable H-reflex and sustained facilitation of stretch reflex with heightened sympathetic outflow would imply sympathetic modulation of muscle spindle sensitivity.

Effects of Passive Leg Movement on the Oxygenation Level of Lower Limb Muscle in Chronic Stroke Patients

Objective. To evaluate the effects of passive leg movements on the muscle oxygenation level and electromyographic (EMG) activity in the lower limbs in chronic stroke patients. Methods. With a gait training apparatus, passive movements were imposed on the lower limbs of 15 chronic stroke patients at a frequency of 0.8 Hz for 10 minutes. During the passive leg movements, muscle oxygenation level and muscular EMG activity of the paretic and nonparetic calf muscles were assessed. Results. The passive leg movements caused increases in the EMG activity and muscle oxygenation level in both paretic and nonparetic lower limbs. Although a significant difference was found in the concentration changes of the oxygenated hemoglobin (Oxy-Hb), both paretic and nonparetic sides of the muscle showed enhancement of the tissue oxygenation level (TOI). The degree of the changes of the Oxy-Hb depended on the level of motor recovery after stroke; subjects with good motor recovery showed less difference in the Oxy-Hb level between the paretic and nonparetic sides of the muscle. Conclusion. Passive leg movements have the capacity to induce muscular activity and enhance oxygen metabolism, even in the paretic lower limb muscle of chronic stroke patients. This type of exercise might be a useful and efficient method for the prevention of metabolic deterioration in the lower limb paretic muscles of chronic stroke patients.

Suppression of cardiocirculatory responses to orthostatic stress by passive walking-like leg movement in healthy young men

BackgroundAlthough passive walking-like leg movement in the standing posture (PWM) has been used in the clinical field, the safety of PWM has not been fully determined despite the risks of orthostatic intolerance due to standing posture. The aim of the present study was to examine cardiocirculatory response during PWM in healthy young men.MethodsThe subjects (n = 13) spent 5 min in a sitting position and then 5 min in a quiet standing position to determine baseline levels. Thereafter, they underwent 25-min rhythmic PWM at 1 Hz while standing. In another bout, subjects experienced the same protocol except that they underwent 25-min quiet standing (QS) instead of 25-min PWM. Two subjects dropped out of the 25-min QS due to feeling of discomfort. Thus, data obtained in the remaining eleven subjects are presented.ResultsIn the PWM trial, systolic arterial blood pressure (SAP) decreased from 112 ± 8 mmHg during the sitting baseline period to 107 ± 8 mmHg during the standing baseline period (p <0.05), while heart rate (HR) increased from 73 ± 9 bpm during the sitting baseline period to 84 ± 10 bpm during the standing baseline period (p <0.001). After the imposition of PWM, SAP increased from 107 ± 8 mmHg in the standing baseline period to 120 ± 6 mmHg (p <0.001), while HR decreased from 84 ± 10 bpm in the standing baseline period to 76 ± 9 bpm (p <0.05). In the QS trial, SAP, which had decreased during the standing baseline period compared to that during the sitting baseline period, remained lowered during the 25-min QS period, while HR, which had increased during the standing baseline period compared to that during the sitting baseline period, remained elevated during the 25-min QS period. In both bouts, HR showed almost mirror-image changes in the high-frequency component of HR variability, suggesting that the changes in HR were due to change in parasympathetic activation. Double product (HR × SAP), as a predictor of myocardial oxygen consumption, during the 25-min QS period tended to increase with time, but double product remained almost constant during the 25-min PWM period.ConclusionsThe results suggest that PWM is effective for suppressing cardiocirculatory responses to orthostatic stress.

Effect of spinal cord injury and its lesion level on stretch reflex modulation by cold stimulation in humans.

OBJECTIVE To determine how short-latency stretch reflex amplitude in the soleus muscle is modulated by cold stimulation in able-bodied individuals and individuals with complete spinal cord injury. METHODS An initial 100-s baseline period was followed by 50-s cold stimulation periods. Stretch reflex of the right soleus muscle was elicited for 10-s intervals, while cold stimulation was applied to the left thigh. RESULTS Peak-to-peak amplitude of the stretch reflex increased significantly during cold stimulation up to 127 ± 21% of the baseline in the able-bodied group (n=9, P<0.01). Similarly, stretch reflex increased up to 125 ± 11% in a group with injury level at or below thoracic 10 (n=4), although this increase was not significant. On the other hand, stretch reflex decreased significantly down to 78 ± 20% in a group with injury level at or above thoracic 6 (n=8, P<0.05). CONCLUSIONS Effect of afferent inputs induced by cold stimulation on stretch reflex modulation is different depending on the extent of central nervous systems participating in the modulation. SIGNIFICANCE Our findings provide a better understanding of some basic changes in afferent-efferent spinal reflex pathways which are probably not monosynaptic in nature.

Hypoventilation during passive leg movement in spinal cord-injured humans

We examined ventilatory response during passive walking-like exercise in the standing posture in complete spinal cord-injured humans and found that ventilatory equivalent for O2 uptake, which would be related to the sensation of breathlessness, was lower during passive exercise than during quiet standing.

Unusual blood pressure response during standing therapy in tetraplegic man

We report a case of an individual with cervical spinal cord injury who showed a unique blood pressure response during passive standing and passive walking-like leg movement, i.e., hypertension with standing and hypotension with leg movement.