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1 Aalborg University, Center for Sensory-Motor Interaction (SMI), Aalborg, Denmark
2 Istituto Neurologico Carlo Besta, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milano, Italy
3 Department of Experimental Medicine, University of Pavia, Section of Human Physiology, Pavia, Italy; Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS), Scientific Institute of Pavia, Human Movement Laboratory (CSAM), Pavia, Italy
* To whom correspondence should be addressed. E-mail: nazarena{at}mazzaro.dk.
The aim of this study was to investigate the contribution of feedback from large-diameter sensory fibers to the adaptation of soleus muscle activity following small ankle trajectory modifications during human walking. Small-amplitude and slow-velocity ankle dorsiflexion enhancements and reductions were applied during the stance phase of the gait cycle in order to mimic the normal variability of the ankle trajectory during walking. Patients with demyelination of large sensory fibers (CMT1A and anti-MAG neuropathy) and age-matched controls participated in this study. The patients had absent light-touch sense in the toes and feet and absent quadriceps and Achilles tendon reflexes, indicating functional loss of large sensory fibers. Moreover, their soleus stretch reflex response consisted of a single EMG burst with delayed onset and longer duration (p < 0.01) than the short and medium latency reflex responses observed in healthy subjects. In healthy subjects the soleus EMG gradually increased or decreased when the ankle dorsiflexion was, respectively, enhanced or reduced. In the patients the soleus EMG increased during the dorsiflexion enhancements; however the velocity sensitivity of this response was decreased compared with the healthy volunteers. When the dorsiflexion was reduced, the soleus EMG was unchanged. These results indicate that the enhancement of the soleus EMG is mainly sensitive to feedback from primary and secondary muscle spindle afferents, and that the reduction may be mediated by feedback from the group Ib pathways. This study provides evidence for the role of sensory feedback in the continuous adaptation of the soleus activity during the stance phase of human walking.
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