Academic bridge to the community: the ABCs of a service-learning model.

The purpose of this report is to outline the process, obstacles, and outcomes for the development and successful implementation of a service-learning experience between the Department of Physical Therapy at the University of Texas Southwestern Medical Center and the Muscular Dystrophy Association of Dallas. The rationale for initiation of the partnership is outlined, and curriculum planning concerns and integration are presented. These include development of community partnerships, identification of curricular placement, and development of academic and community roles, including didactic and clinical objectives for the participants. The importance of understanding the service-learning philosophy and evaluation of the student and community impact is emphasized. Outcomes report students' assessments encompassing issues of both prior and future didactic education, development of clinical skills and problem solving, and evaluation of professional and personal issues. It is suggested that this model of service learning project has the ability to be implemented across a wide spectrum of allied health care curricula.

Synchronous stimulation and monitoring of soleus H reflex during robotic body weight-supported ambulation in subjects with spinal cord injury.

We evaluated the accuracy of a novel method for recording the soleus H reflex at specific points in the gait cycle during robotic locomotor training in subjects with spinal cord injury (SCI). Hip goniometric information from the Lokomat system defined midstance and midswing points within the gait cycle. Soleus H reflex stimulation was synchronized to these points during robotic-assisted ambulation at 1.8 and 2.5 km/h. Motor stimulus intensity was monitored and adjusted in real time. Analysis of 50 H reflex cycles during each speed and gait phase showed that stimulation accuracy was within 0.5 degrees of the defined hip joint position and that >85% of the H reflex cycles met the +/-10% M wave criterion that was established during quiet standing. This method allows increased consistency of afferent information into the segmental spinal and supraspinal circuitry and, thus, evaluation of H reflex characteristics during robotic ambulation in subjects with SCI.

Partial blockade of skeletal muscle somatosensory afferents attenuates baroreflex resetting during exercise in humans.

During exercise, the carotid baroreflex is reset to operate around the higher arterial pressures evoked by physical exertion. The purpose of this investigation was to evaluate the contribution of somatosensory input from the exercise pressor reflex to this resetting during exercise. Nine subjects performed seven minutes of dynamic cycling at 30% of maximal work load and three minutes of static one-legged contraction at 25% maximal voluntary contraction before (control) and after partial blockade of skeletal muscle afferents with epidural anaesthesia. Carotid baroreflex function was assessed by applying rapid pulses of hyper- and hypotensive stimuli to the neck via a customised collar. Using a logistic model, heart rate (HR) and mean arterial pressure (MAP) responses to carotid sinus stimulation were used to develop reflex function stimulus-response curves. Compared with rest, control dynamic and static exercise reset carotid baroreflex-HR and carotid baroreflex-MAP curves vertically upward on the response arm and laterally rightward to higher operating pressures. Inhibition of exercise pressor reflex input by epidural anaesthesia attenuated the bi-directional resetting of the carotid baroreflex-MAP curve during both exercise protocols. In contrast, the effect of epidural anaesthesia on the resetting of the carotid baroreflex-HR curve was negligible during dynamic cycling whereas it relocated the curve in a laterally leftward direction during static contraction. The data suggest that afferent input from skeletal muscle is requisite for the complete resetting of the carotid baroreflex during exercise. However, this neural input appears to modify baroreflex control of blood pressure to a greater extent than heart rate.