When the neural connectivity is lost in the central nervous system, it becomes difficult to increase force production in a specific muscle in limbs. In a person with neurological injuries or disorders, it can be difficult to create long-lasting effects simply by targeting muscle strength. It has been shown that Operant Conditioning of muscle responses to transcranial magnetic stimulation (TMS) can improve recruitment of a target muscle. Follow-up sessions have shown maintenance of therapeutic gains.

Operant conditioning of motor evoked potential (MEP; the muscle response) elicited by TMS includes individualized set-up and targets to encourage improvement of brain-to-spinal cord connection.

Effects On Gait

The up-conditioning of tibialis anterior (TA) MEP can improve the connection between the brain and the ankle dorsiflexor. The diagrams below show an improvement of TA activation during swing-phase and swing-stance transition as well as increased soleus activation during push-off. This allows for more efficient gait and better coordination of antagonistic muscles around the ankle. Furthermore, 6-month follow-up showed maintenance of changes that were made from operant conditioning.