Frequency response characteristics of ankle plantar flexors in humans following spinal cord injury: relation to degree of spasticity.

Abstract

Frequency response characteristics of the ankle plantar flexors were studied in adults both with and without spinal cord injury (SCI) to determine how the muscle contractile properties change after SCI. and to see if there is a relation between the severity of spasticity and how the properties change. Ten controls and ten complete, chronic spinal cord injured subjects were tested, where the tibial nerve was stimulated electrically in a stochastic manner with the ankle fixed isometrically at various joint angles. A nonparametric linear frequency response function was derived, from which a second-order transfer function was calculated. The contractile dynamics were then characterized by the three classic second-order parameters: gain, damping ratio, and natural frequency. We found that in subjects with low degrees of spasticity (as determined by clinical evaluation), the contractile dynamics presented the largest changes, in which the speed of contraction increased significantly while there were no statistical differences in the gains between the two groups. This similarity emerged even though there was noticeable atrophy in the SCI patient group. Differences between the controls and subjects with high levels of spasticity were markedly different, in that these SCI subjects had slower contractile speeds than the controls, but significantly lower gains. Moderately spastic subjects fell somewhere in between, where the speed of muscle contraction increased modestly yet the gain was significantly smaller than that of the control subjects. These findings indicate that in subjects with chronic spinal cord injury, the severity of spasticity can significantly influence the degree of change in muscle contractile properties. It appears that high degrees of spasticity tend to preserve contractile dynamics, while in less spastic subjects, muscle contractile properties may display faster response characteristics.