Sural Nerve Stimulation for H-Reflex Facilitation

Stimulation of the sural nerve was evoked using surface electrodes placed 1–2 cm posterior-inferior to the lateral malleolus of the fibula of the right leg. Similar to previous studies (Dragert and Zehr 2011 (link), 2013 (link); Loadman and Zehr 2007 (link); Pearcey et al. 2017 (link); Zehr et al. 2012 (link)) a Grass S88 stimulator with SIU5 stimulus isolation and a CCU1 constant current unit (Astro-Med Grass Instrument, West Warwick, RI, USA) was used to deliver stimuli with a single 15 ms duration train consisting of 5 × 1.0 ms square pulses at 300 Hz (P511 Astro-Med Grass Instrument). Perceptual and radiating thresholds (RT) were determined as the minimal stimulation intensity to produce a perceptible sensation and the point at which a stimulus produced radiating paresthesia in the entire cutaneous receptive field (lateral border and heel). Non-noxious intensities (2 × RT) were found for each participant. The cutaneous conditioning was delivered at 100 ms prior to the tibial nerve stimulation for the H-reflex, because this time point was determined to be optimal for reflex facilitation (Frigon et al. 2004 (link)).

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Noble S., Pearcey G.E., Quartly C, & Zehr E.P. (2019). Robot controlled, continuous passive movement of the ankle reduces spinal cord excitability in participants with spasticity: a pilot study. Experimental Brain Research, 237(12), 3207-3220.

Publication 2019

Grass S88 stimulator

Fibula Grass H reflex Heel Isolation Paresthesia Pulses Reflex Sural nerve Tibial nerve

Corresponding Organization :

Other organizations : University of Victoria, Island Health

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Variable analysis

independent variables

Stimulation of the sural nerve using surface electrodes placed 1–2 cm posterior-inferior to the lateral malleolus of the fibula of the right leg

dependent variables

Perceptual and radiating thresholds (RT)
Non-noxious intensities (2 × RT)
Reflex facilitation

control variables

Similar to previous studies (Dragert and Zehr 2011, 2013; Loadman and Zehr 2007; Pearcey et al. 2017; Zehr et al. 2012), a Grass S88 stimulator with SIU5 stimulus isolation and a CCU1 constant current unit (Astro-Med Grass Instrument, West Warwick, RI, USA) was used to deliver stimuli with a single 15 ms duration train consisting of 5 × 1.0 ms square pulses at 300 Hz (P511 Astro-Med Grass Instrument)
Cutaneous conditioning was delivered at 100 ms prior to the tibial nerve stimulation for the H-reflex, because this time point was determined to be optimal for reflex facilitation (Frigon et al. 2004)

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