Soleus H-reflex gain in elderly and young adults: Modulation due to body position

Background. The control of posture and balance in the elderly is a primary health concern. Postural instability directly leads to a greater incidence of falling in the elderly population. One important neuromuscular mechanism instrumental in the control of posture and balance is the reflex system. The purpose of this study was to examine the gain of the soleus H-reflex in young and elderly adults in two different body positions: standing and prone. Methods. Eighteen neurologically healthy volunteers were categorized by age in two groups: young (n = 9, mean age = 23.3 yr) and elderly (n = 9, mean age = 71.7 yr). In each position, the resting H-max/M-max ratio was determined. The gain of the reflex was also assessed by instructing the subject to perform voluntary contractions of 10, 20 and 30% of their maximum voluntary contraction, using real-time EMG biofeedback. Data were sampled on-line using custom designed software (sample rate = 2 kHz). Dependent variables included the average background EMG of the soleus muscle (40 ms window prior to stimulation) and the peak-to-peak amplitude of the elicited soleus H-reflex, To examine the gain of the reflex, the peak-to-peak amplitude of the H-reflex was plotted against the background EMG activity for each contraction intensity. Results. Results indicated the following: young subjects significantly depressed the H-max/M-max ratio when standing (69.3% prone, 55.1% standing), whereas elderly subjects increased the ratio (36.1% prone, 54.54% standing). Also, the young subjects modulated the gain of the reflex from prone to standing (3.30 prone, 3.68 standing), and the elderly subjects demonstrated no gain modulation in the different body positions (2.23 prune, 1.91 standing). In both body positions the young subjects demonstrated significantly higher gain than the elderly subjects. Conclusions. The results demonstrate different control strategies for young and elderly subjects between prone and standing body positions.