Maintenance of cutaneomuscular neuronal excitability after leg-cycling predicts lower limb muscle strength after incomplete spinal cord injury

Stefano Piazza, Julio Gómez-Soriano, Elisabeth Bravo-Esteban, Diego Torricelli, Gerardo Avila-Martin, Iriana Galan-Arriero, Jose L Pons, Julian Taylor*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective: Controlled leg-cycling modulates H-reflex activity after spinal cord injury (SCI). Preserved cutaneomuscular reflex activity is also essential for recovery of residual motor function after SCI. Here the effect of a single leg-cycling session was assessed on cutaneomuscular-conditioned H-reflex excitability in relation to residual lower limb muscle function after incomplete SCI (iSCI). Methods: Modulation of Soleus H-reflex activity was evaluated following ipsilateral plantar electrical stimulation applied at 25-100 ms inter-stimulus intervals (ISI's), before and after leg-cycling in ten healthy individuals and nine subjects with iSCI. Results: Leg-cycling in healthy subjects increased cutaneomuscular-conditioned H-reflex excitability between 25 and 75 ms ISI (p < 0.001), compared to a small loss of excitability at 75 ms ISI after iSCI (p < 0.05). In addition, change in cutaneomuscular-conditioned H-reflex excitability at 50 ms and 75 ms ISI in subjects with iSCI after leg-cycling predicted lower ankle joint hypertonia and higher Triceps Surae muscle strength, respectively. Conclusion: Leg-cycling modulates cutaneomuscular-conditioned spinal neuronal excitability in healthy subjects and individuals with iSCI, and is related to residual lower limb muscle function. Significance: Cutaneomuscular-conditioned H reflex modulation could be used as a surrogate biomarker of both central neuroplasticity and lower limb muscle function, and could benchmark lower-limb rehabilitation programs in subjects with iSCI.

Original languageEnglish (US)
Pages (from-to)2402-2409
Number of pages8
JournalClinical Neurophysiology
Issue number6
StatePublished - Jun 1 2016


  • Ankle joint hypertonia
  • Cutaneomuscular-conditioned H-reflex activity
  • Leg-cycling
  • SCI spasticity syndrome
  • Spinal cord injury
  • Triceps Surae manual muscle score

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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