Reflex control could improve walking after incomplete spinal injuries

A training regimen to adjust the body’s motor reflexes may help improve mobility for some people with incomplete spinal cord injuries, according to a study supported by the National Institutes of Health.

During training, the participants were instructed to suppress a knee jerk-like reflex elicited by a small shock to the leg. Those who were able to calm hyperactive reflexes – a common effect of spinal cord injuries – saw improvements in their walking.

The study was led by Aiko Thompson, Ph.D., and Jonathan Wolpaw, M.D., both of whom hold appointments at the New York state Department of Health and the State University of New York in Albany, and at Columbia University in New York City. The study took place at Helen Hayes Hospital in West Haverstraw, N. Y. It was funded in part by NIH’s National Institute of Neurological Disorders and Stroke (NINDS), and published in the Journal of Neuroscience.

"People tend to think of reflexes as fixed, but in reality, normal movement requires constant fine tuning of reflexes by the brain. Loss of that fine-tuning is an important part of the disability that comes with a spinal cord injury," said Dr. Wolpaw, a research physician and professor at the Wadsworth Center, the state health department’s public health laboratory.

When the brain makes a decision to move, it sends signals that travel through the spinal cord to the appropriate muscles. Spinal reflexes – controlled by local circuits of nerve cells in the spinal cord – provide a way for the body to react and move quickly without a conscious decision from the brain. “They enable you to jerk your hand away from a hot stove before you’ve registered the pain and experienced severe burns,” Dr. Wolpaw said. “The brain can gradually enhance or suppress reflexes as needed,” he said.