Reliability of Soleus H-Reflexes in Standing and Walking Post-Incomplete Spinal Cord Injury

ABSTRACT

Objective: To establish the reliability of soleus H-reflex in individuals with incomplete spinal cord injury (SCI) during the standing and the swing and stance phases of overground walking. Methods: Fourteen SCI (40 ± 10 years) and eight noninjured subjects (32 ± 9 years) participated. The noninjured and SCI subjects walked at self-selected speed overground. H-reflexes in the soleus muscle (at M-wave 7%%–13%% maximum-M) were tested on two separate days by stimulating the tibial nerve. Intraclass correlation coefficients (two-way mixed model-ICC (1, 2)) and standard error of measurement (SEM) were calculated. Results: Relative reliability of the H-reflexes was good to excellent; intra-class correlation coefficients (ICCs) ranged from 0.64–0.91 in noninjured and SCI subjects. SEM expressed as percentage of the mean H-reflex was 13%%–62%% in noninjured and 12%%–18%% in SCI individuals. Conclusions: H-reflexes can be reliably assessed in standing and walking in post-SCI and noninjured subjects. Significance: H-reflexes can be reliably used in longitudinal studies to investigate mechanisms of recovery post-SCI.

KEYWORDS: :

• reliability
• SCI
• soleus H-reflex
• spinal cord injury
• standing
• test-retest
• walking