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Sensorimotor integration in the human spinal cord Open Access


Other title
neuromuscular electrical stimulation
sensorimotor integration
spinal cord injury
Type of item
Degree grantor
University of Alberta
Author or creator
Clair, Joanna
Supervisor and department
Collins, David F. (Physical Education and Recreation/ Centre for Neuroscience)
Examining committee member and department
Yang, Jaynie (Physical Therapy/ Centre for Neuroscience)
Misiaszek, John (Occupational Therapy/ Centre for Neuroscience)
Shields, Richard (Physical Therapy and Rehabilitation, University of Iowa)
Gordon, Tessa (Physical Medicine and Rehabilitation/ Centre for Neuroscience)
Centre for Neuroscience

Date accepted
Graduation date
Doctor of Philosophy
Degree level
In this thesis sensorimotor integration in the human spinal cord was investigated in the intact (Chapters 2 and 3) and injured nervous systems (Chapter 4-stroke; Chapter 5-spinal cord injury (SCI)). In Chapter 2, I characterized a short-latency reflex pathway between sensory receptors of the lower leg and the erector spinae (ES) muscles of the lower back that may play a role in the maintenance of posture and balance. The ES reflexes were evoked bilaterally by taps applied to the Achilles’ tendon and were modulated by task. Furthermore, these reflexes involved a larger contribution from cutaneous receptors in the lower limb, rather than muscle spindles. In Chapter 3, I investigated changes in reflex transmission along the H-reflex pathway throughout 10 s trains of neuromuscular electrical stimulation (NMES) using physiologically relevant frequencies (5-20 Hz) and during functionally relevant tasks (sitting and standing) and background contraction amplitudes (up to 20% MVC). The results of this study revealed strong post-activation depression of reflex amplitudes, followed by significant recovery during the stimulation, both of which were influenced by stimulation frequency and background contraction amplitude, but not task. During 10 Hz stimulation, reflex amplitudes showed complete recovery (i.e. back to their initial values), and at times, complete recovery occurred by the third reflex in the train. These results demonstrate that transmission along the H-reflex pathway is modulated continuously during periods of repetitive input. In Chapters 4 and 5, I studied the extent to which a novel stimulation protocol that incorporated wide pulse widths (1 ms) and high frequencies (up to 100 Hz) (wide-pulse NMES; WP-NMES), could enhance electrically-evoked contractions through a “central contribution” in individuals with stroke or SCI. This central effect arises from the electrical activation of sensory axons, which in turn, reflexively recruit motoneurons in the spinal cord. After stroke, contractions evoked by WP-NMES were larger in the paretic arm than the non-paretic arm. After SCI, transmission along the H-reflex pathway was observed throughout trains of WP-NMES; direct evidence of a central contribution. These results suggest that maximizing the central contribution during WP-NMES may be useful for maintaining muscle quality after neurological injury.
License granted by Joanna Clair ( on 2010-09-16T22:15:47Z (GMT): Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of the above terms. The author reserves all other publication and other rights in association with the copyright in the thesis, and except as herein provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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