Key result
Dynamic balance perturbations significantly increased the M-wave normalized V-wave/H-reflex ratio from 0.056 at 40 ms to 0.179 at 70 ms, indicating enhanced efferent motoneuronal output.
Why the study?
It was unknown how motor control is organized, how H-reflex and V-wave responses modulate, and how repeatable these responses are during dynamic balance perturbations.
The V-wave method is a valid and repeatable technique for assessing efferent motoneuronal output during dynamic balance perturbations, showing enhanced activation as early as 70 ms.
Answers are grounded in this paper and cite their sources.
V-wave offers reliable motoneuron measures in balance perturbations; leaves open H-reflex utility and clinical adoption pending validation.
Motoneuron excitability is possible to measure using H-reflex and V-wave responses. However, it is not known how the motor control is organized, how the H-reflex and V-wave responses modulate and how repeatable these are during dynamic balance perturbations. To assess the repeatability, 16 participants (8 men, 8 women) went through two, identical measurement sessions with ~ 48 h intervals, where maximal isometric plantar flexion (IMVC) and dynamic balance perturbations in horizontal, anterior-posterior direction were performed. Soleus muscle (SOL) neural modulation during balance perturbations were measured at 40, 70, 100 and 130 ms after ankle movement by using both H-reflex and V-wave methods. V-wave, which depicts the magnitude of efferent motoneuronal output (Bergmann et al. in JAMA 8:e77705, 2013), was significantly enhanced as early as 70 ms after the ankle movement. Both the ratio of M-wave-normalized V-wave (0.022-0.076, p < 0.001) and H-reflex (0.386-0.523, p < 0.001) increased significantly at the latency of 70 ms compared to the latency of 40 ms and remained at these levels at latter latencies. In addition, M-wave normalized V-wave/H-reflex ratio increased from 0.056 to 0.179 (p < 0.001). The repeatability of V-wave demonstrated moderate-to-substantial repeatability (ICC = 0.774-0.912) whereas the H-reflex was more variable showing fair-to-substantial repeatability (ICC = 0.581-0.855). As a conclusion, V-wave was enhanced already at 70 ms after the perturbation, which may indicate that increased activation of motoneurons occurred due to changes in descending drive. Since this is a short time-period for voluntary activity, some other, potentially subcortical responses might be involved for V-wave increment rather than voluntary drive. Our results addressed the usability and repeatability of V-wave method during dynamic conditions, which can be utilized in future studies.
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Nevanperä et al. (2023) studied Healthy (n=16). Dynamic balance perturbations vs. 40 ms latency was evaluated on M-wave normalized V-wave/H-reflex ratio at 70 ms vs 40 ms latency (p=<0.001). Dynamic balance perturbations significantly increased the M-wave normalized V-wave/H-reflex ratio from 0.056 at 40 ms to 0.179 at 70 ms, indicating enhanced efferent motoneuronal output.
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