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Effect of aging on H-reflex response to fatigue


Injury as a result of tripping is relatively common among older people. The risk of falling increases with fatigue and of importance is the ability to dorsiflex the foot through timely activation of the tibialis anterior (TA) muscle to ensure the foot clears the ground, or an obstacle, during the swing phase of walking. We, therefore, questioned whether the muscle spindle input to the motoneurons alters with ongoing fatigue in older people. We electrically stimulated the common peroneal nerve to assess the TA primary afferent efficacy using H-reflex before, immediately following and after a fatiguing maximal isometric contraction. M-response was kept unchanged throughout the experiment to ensure a similar stimulus intensity was delivered across time points. H-reflex increased significantly while the TA muscle was in a state of fatigue for the younger participants but tended to decrease with increasing age. The main contributor to the tonicity of TA muscle, i.e., excitatory synapses of spindle primary endings of motoneurons that innervate TA muscle, tend to lose their efficacy during fatigue in the older individuals but increased efficiency in the majority of the younger people. Since TA muscle is the main dorsiflexor of the foot and it needs to be active during the swing phase of stepping to prevent tripping, older individuals become more susceptible to falling when their muscles are fatigued. This finding may help improve devices/treatments to overcome the problem of tripping among older individuals.

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Body-mass index


Hoffmann reflex


Maximum direct motor response


Direct motor response


Maximum voluntary contraction


Range of motion


Standard deviation


Surface electromyography


Tibialis anterior


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We would like to thank participants who attended this study. In addition, we acknowledge the role of Koç University School of Medicine for supporting this study. We also thank the Scientific and Technological Research Council of Turkey (TÜBİTAK) for funding Mustafa Görkem Özyurt under 2211-A programme. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

APL, MGO, BT, IK, AMH and KST conceived the study design. APL, SB, MGO, BT, and IB performed the experiments. SB, MGO, BT, and IB analyzed the results. APL, MGO, IK and KST wrote the first draft of the manuscript and all the authors approved the final version of the manuscript.

Correspondence to Kemal Sitki Türker.

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Lavender, A.P., Balkozak, S., Özyurt, M.G. et al. Effect of aging on H-reflex response to fatigue. Exp Brain Res 238, 273–282 (2020). https://doi.org/10.1007/s00221-019-05708-7

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  • Fatigue
  • Aging
  • H-reflex
  • Tibialis anterior
  • Human