Journal of Human Sport and Exercise

Effects of age vestibular and visual systems on the soleus H-reflex

Aksel Celik, Francisco Javier Rojas-Ruiz, Mar Cepero-Gonzalez, David M. Koceja, Kohichi Kitano



The vestibular system, visual and proprioceptive pathways provide information about control of posture, movement and balance. Loss of postural control directly leads to a greater incidence of falling in the elderly population causing serious health problems. One important neuromuscular mechanism instrumental in the control of posture and balance is the reflex system. However, the age-related changes of vestibular and visual systems and their relationship with the reflex system are not clear. The purpose of this study was to investigate the effects of age, the vestibular and the visual systems on the modulation pattern of the soleus H reflex. Seventeen neurologically healthy volunteers were categorized by age in two groups: young (n = 8, mean age = 22.1 ± 5.0 yr.) and elderly (n = 9, mean age = 59.3 ± 12.8 yr.). Maximal soleus H-reflex (H-max) and motor response (M-max) amplitudes were determined prior to testing at each condition while subjects were lying supine on a tilt table for standardization. Stimulation intensity was set to evoke a 5-10% M-wave on each trial. Participants received 5 test H-reflex stimuli in two conditions, static 60º and dynamic 60º on a tilt table. Both tilt conditions were performed with vision and no vision. A 3-way repeated-measures analysis of variance (ANOVA) 2 (groups: young/old) x 2 (condition: static/dynamic) x 2(vision: vision/no vision) was used to assess changes in H-reflexes. All data were expressed relative to the H-reflex amplitude at 0º static on the tilt table. The results showed a significant 3-way interaction (p = .038). The old group showed greater H-reflex amplitude in the no vision condition at static 60º (vision:0.97; no vision:1.23) whereas in the young group less modulation was demonstrated in the same condition (vision:1.15; no vision:1.12). These results suggest in young subjects the vestibular system produced a suppression of the H-reflex with or without visual input; however, in the old group vision was necessary for this suppression. The interaction between the visual and vestibular systems as we age needs to be further explored.


Balance; Elderly; Electromyography; Motor response; H-reflex suppression


Angulo-Kinzler RM, Mynark RG, Koceja DM. (1998) Soleus H-Reflex Gain in Elderly and Young Adults: Modulation Due To Body Position. Journal of Gerontology 53A(2): M120-MI25.

Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB (2009) Disorders of Balance and Vestibular Function in US Adults: Data From the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med 169(10):938-44.

Appiah-Kubi KO, Wright WG (2019) Vestibular Training Promotes Adaptation of Multisensory Integration in Postural Control. Gait Posture 73:215-220.

Baloh RW, Ying SH, Jacobson KM (2003) A longitudinal study of gait and balance dysfunction in normal older people. Arch Neurol. 60(6):835-9.

Baudry S, Duchateau J (2012) Age-related influence of vision and proprioception on Ia presynaptic inhibition in soleus muscle during upright stance. Journal of Physiology-London 590(21):5541-5554.

Baudry S, Penzer F, Duchateau J (2014) Input-output characteristics of soleus homonymous Ia afferents and corticospinal pathways during upright standing differ between young and elderly adults. Acta Physiol (Oxf) 210(3):667-77.

Crone C, Hultborn H, Mazières L, Morin L, Nielsen J, Pierrot-Deseilligny E (1990) Sensitivity of monosynaptic test reflexes to facilitation and inhibition as a function of the test reflex size: a study in man and the cat. Exp Brain Res. 81(1):35-45.

Dizio PA, Lackner JR (1986) Perceived orientation, motion, and configuration of the body during viewing of an off-vertical, rotating surface. Perception & Psychophysics 39(1):39-46.

Enrietto JA, Jacobson KM, Baloh RW (1999) Aging effects on auditory and vestibular responses: a longitudinal study. Am J Otolaryngol 20:371-378.

Hultborn H, Meunier S, Pierrot‐Deseilligny E, Shindo M (1987) Changes in presynaptic inhibition of Ia fibres at the onset of voluntary contraction in man. J.Physiol. 389:757-772.

Iwasaki S, Yamasoba T (2015) Dizziness and Imbalance in the Elderly: Age-related Decline in the Vestibular System. Aging Dis. 6(1):38-47.

Keshner EA, Allum JHJ, Pfaltz CR (1987) Postural coactivation and adaptation in the sway stabilizing responses of normals and patients with bilateral vestibular deficit, Exp Brain Res. 69:77-92.

Kido A, Tanaka N, Stein RB (2004) Spinal excitation and inhibition decrease as humans age. Can J Physiol Pharmacol 82:238-48.

Knikou M, Rymer WZ (2003) Static and dynamic changes in body orientation modulate spinal reflex excitability in humans. Experimental Brain Research 152(4):466-475.

Koceja DM, Markus CA, Trimble MH (1995) Postural modulation of the soleus H-reflex in young and old subjects. Electroencephal Clin Neurophysiol. 97:387-393.

Koceja DM, Mynark RG (2000) Comparison of Heteronymous Monosynaptic Ia Facilitation in Young and Elderly Subjects in Supine and Standing Positions. International Journal of Neuroscience 104(1),1-15.

Le Mouel C, Brette R (2019) Anticipatory coadaptation of ankle stiffness and sensorimotor gain for standing balance. PLoS Comput Biol. 15(11):1-28.

Meunier S, Pierrot‐Deseilligny E (1989) Gating of the afferent volley of the monosynaptic stretch reflex during movement in man. Journal of Physiology 419:753-763.

Misiaszek JE (2003) The h-reflex as a tool ın neurophysıology: ıts lımıtatıons and uses ın understandıng nervous system function. Muscle Nerve 28:144 -160.

Mynark RG (2005) Reliability of the soleus H-reflex from supine to standing in young and elderly. Clinical Neurophysiology 116(6):1400-1404.

Osoba MY, Rao AK, Agrawal SK, Lalwani AK (2019) Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol. 4(1):143-153.

Paige GD (1992) Senescence of human visual-vestibular interactions, I: vestibulo-ocular reflex and adaptive plasticity with aging. Exp Brain Res. 2:133-151.

Papegaaij S, Taube W, Baudry S, Otten E, Hortobagyi T (2014) Aging causes a reorganization of cortical and spinal control of posture. Front. Aging Neurosci.

Paterka RJ, Black FO, Schoenhoff MB (1990) Age-related changes in human vestibulo- ocular reflexes: sinusoidal rotation and caloric tests. J Vestib Res.;1:49- 59.

Penzer F, Duchateau J, Baudry S (2015) Effects of short-term training combining strength and balance exercises on maximal strength and upright standing steadiness in elderly adults. Exp Gerontol. 61:38-46.

Pierrot-Deseilligny E, Burke D (2005) The Circuitry of the Human Spinal Cord: Its Role in Motor Control and Movement Disorders: Cambridge University Press, New York.

Pinar S, Kitano K, Koceja DM (2010) Role of vision and task complexity on soleus H-reflex gain. Journal of Electromyography and Kinesiology 20(2):354-358.

Schrager MA, Kelly VE, Price R, Ferrucci L, Shumway-Cook A (2008) The effects of age on medio-lateral stability during normal and narrow base walking. Gait Posture 28:466-71.

Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M et al. (2011) Gait speed and survival in older adults. JAMA 305:50-8.

Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC (2008) Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 56(12):2234-4.

Schieppati M (1987) The Hoffmann reflex: a means of assessing spinal reflex excitability and its descending control in man. Prog Neurobiol. 28(4):345-76.

Teasdale N, Stelmach GE, Breunig A (1991) Postural sway characteristics of the elderly under normal and altered visual and support surface conditions. J Gerontol. 46(6):B238-244.

Tsuruike M, Kitano K, Koceja DM, Riley ZA (2012) Differential control of H-reflex amplitude in different weight-bearing conditions in young and elderly subjects. Clinical Neurophysiology 123(10):2018-2024.

Vanspauwen R (2018) Dizziness and (Fear of) Falling in The Elderly: A Few Facts. J Int Adv Otol. 14(1):1-2.

Zehr EP (2002) Considerations for use of the Hoffmann reflex in exercise studies. Eur J Appl Physiol. 86(6):455-68.

Zehr EP ( 2006) Training-induced adaptive plasticity in human somatosensory reflex pathways. 101(6):1783-94.


Copyright (c) 2018 Journal of Human Sport and Exercise

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.