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Hasan A, Moustafa I, Shousha T. Effect of Russian current expert modes on quadriceps muscle torque in healthy adults: A single-blinded randomized controlled trial. PLoS One 2024; 19:e0297136. [PMID: 38271360 PMCID: PMC10810422 DOI: 10.1371/journal.pone.0297136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/25/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Russian current (RC), a well-known neuromuscular electrical stimulation operating at 2500 Hz, has demonstrated significant strength improvement over traditional exercises due to its high tolerance and low pain provocation. Despite extensive NMES parameter research, the specific effects of expert modes, particularly ON2 and Rest, remain unexplored. This study investigates the direct effect of these expert modes on quadriceps muscle strength in healthy adults. METHODS This is a single-blind, randomization-controlled trial. Forty-eight healthy university students (31 females, 17 males) were assigned in two randomized experimental groups either the ON2 or Rest mode for a 15-minute electrical stimulation session. Quadriceps maximum voluntary isokinetic contraction measurements were taken before and directly after RC application using Biodex Medical Systems 4 pro isokinetic dynamometer. RESULTS Both RC modes significantly increased the quadriceps muscle torque in healthy adults compared to baseline (p<0.05). Baseline mean torque was 123.28 (SD = 38.8), and post- RC mean torque was 136.67 (SD = 45.76). Deviation from normality was observed at baseline (p = 0.034) and persisted post-RC application (p = 0.017). The Wilcoxon test reported significant increases in quadriceps muscle knee torque for both ON2 and Rest groups (p < 0.001). The lack of ties in ranks and negative Z-values highlight the robustness of the observed effects. CONCLUSION The findings of this study align with previous research on NMES and RC supporting the idea that electrical stimulation enhances muscle strength, selecting the appropriate RC expert modes can assist physiotherapist in tailoring rehabilitation program to achieve their specific strength goals.
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Affiliation(s)
- Ansam Hasan
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
| | - Ibrahim Moustafa
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
- Neuromusculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Tamer Shousha
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
- Neuromusculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- University of Sharjah Center of Excellence for Healthy Aging, Sharjah, UAE
- Healthy Aging, Longevity and Sustainability Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
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Effects of Kilohertz Frequency, Burst Duty Cycle, and Burst Duration on Evoked Torque, Perceived Discomfort and Muscle Fatigue: A Systematic Review. Am J Phys Med Rehabil 2023; 102:175-183. [PMID: 35121683 DOI: 10.1097/phm.0000000000001982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
ABSTRACT Kilohertz-frequency alternating current is used to minimize muscle atrophy and muscle weakness and improve muscle performance. However, no systematic reviews have evaluated the best Kilohertz-frequency alternating current parameters for this purpose. We investigated the effects of the carrier frequency, burst duty cycles, and burst durations on evoked torque, perceived discomfort, and muscle fatigue. A search of eight data sources by two independent reviewers resulted in 13 peer-reviewed studies being selected, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and rated using the PEDro scale to evaluate the methodological quality of the studies. Most studies showed that carrier frequencies up to 1 kHz evoked higher torque, while carrier frequencies between 2.5 and 5 kHz resulted in lower perceived discomfort. In addition, most studies showed that shorter burst duty cycles (10%-50%) induced higher evoked torque and lower perceived discomfort. Methodological quality scores ranged from 5 to 8 on the PEDro scale. We conclude that Kilohertz-frequency alternating current develops greater evoked torque for carrier frequencies between 1 and 2.5 kHz and burst duty cycles less than 50%. Lower perceived discomfort was generated using Kilohertz-frequency alternating currents between 2.5 and 5 kHz and burst duty cycles less than 50%.
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Kilohertz Frequency Alternating Current Induces Less Evoked Torque and Less Neuromuscular Efficiency Than Pulsed Current in Healthy People: A Randomized Crossover Trial. J Sport Rehabil 2023:1-9. [PMID: 36812919 DOI: 10.1123/jsr.2022-0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/29/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023]
Abstract
CONTEXT Pulsed current and kilohertz frequency alternating current are 2 types of neuromuscular electrical stimulation (NMES) currents often used by clinicians during rehabilitation. However, the low methodological quality and the different NMES parameters and protocols used in several studies might explain their inconclusive results in terms of their effects in the evoked torque and the discomfort level. In addition, the neuromuscular efficiency (ie, the NMES current type that evokes the highest torque with the lowest current intensity) has not been established yet. Therefore, our objective was to compare the evoked torque, current intensity, neuromuscular efficiency (evoked torque/current intensity ratio), and discomfort between pulsed current and kilohertz frequency alternating current in healthy people. DESIGN A double-blind, randomized crossover trial. METHODS Thirty healthy men (23.2 [4.5] y) participated in the study. Each participant was randomized to 4 current settings: 2 kilohertz frequency alternating currents with 2.5 kHz of carrier frequency and similar pulse duration (0.4 ms) and burst frequency (100 Hz) but with different burst duty cycles (20% and 50%) and burst durations (2 and 5 ms); and 2 pulsed currents with similar pulse frequency (100 Hz) and different pulse duration (2 and 0.4 ms). The evoked torque, current intensity at the maximal tolerated intensity, neuromuscular efficiency, and discomfort level were evaluated. RESULTS Both pulsed currents generated higher evoked torque than the kilohertz frequency alternating currents, despite the similar between-currents discomfort levels. The 2 ms pulsed current showed lower current intensity and higher neuromuscular efficiency compared with both alternated currents and with the 0.4 ms pulsed current. CONCLUSIONS The higher evoked torque, higher neuromuscular efficiency, and similar discomfort of the 2 ms pulsed current compared with 2.5-kHz frequency alternating current suggests this current as the best choice for clinicians to use in NMES-based protocols.
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de Carvalho AR, Reginato A, Reginato GA, Schuck KSR, Neves M, Bertolini GRF. Aussie current and quadriceps muscle endurance: a randomized clinical trial. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00918-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nuhu JM, Yakasai AM, Danazumi MS, Nazeef F, Zakari UU, Usman Z, Mohammed J. Effect of aerobic exercise and burst-modulated biphasic pulsed current on glycemic control, central obesity and body image in individuals with type 2 diabetes mellitus: study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bispo VA, Bastos JAI, Almeida CCD, Modesto KAG, Dantas LO, Cipriano Júnior G, Durigan JLQ. The effects of neuromuscular electrical stimulation on strength, pain, and function in individuals with knee osteoarthritis: a systematic review with meta-analysis. FISIOTERAPIA E PESQUISA 2021. [DOI: 10.1590/1809-2950/20028528042021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT We aimed to investigate the effects of neuromuscular electrical stimulation on muscle strength, pain relief, and improvement in function in patients with knee osteoarthritis. Databases were searched from December 2017 to July 2020 and included PubMed, Embase, LILACS, and the Cochrane Central Register of Controlled Trials. A manual search was also performed by checking the reference lists of eligible articles. The PRISMA guidelines were followed. The studies selected compared NMES with an exercise program on isometric muscle strength as a primary outcome. The secondary outcomes were pain and function. The quality of the studies was assessed using the Risk of Bias assessment and PEDro scale, and the overall quality of the evidence was assessed using the GRADE approach. Eight studies were included in this systematic review. A total of 571 patients were analyzed. Neuromuscular electrical stimulation associated with exercise promoted an increase in isometric strength of the quadriceps muscle compared to the active control group, demonstrating heterogeneity and statistical difference (95% CI=1.16 to 5.10, I2=97%, p=0.002; very low-certainty evidence). NMES associated with exercise did not improve physical function (95% CI=−0.37 to 0.59, I2=0%, p=0.67; low-certainty evidence) and showed controversial results for pain compared to an active control group (qualitative assessment). In conclusion, NMES induces an increase in muscle strength in patients with osteoarthritis compared to an active control group. No differences were found for physical function and pain outcomes. Further research is needed due to the uncertain level of evidence.
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Pinto Damo NL, Modesto KA, Neto IVDS, Bottaro M, Babault N, Durigan JLQ. Effects of different electrical stimulation currents and phase durations on submaximal and maximum torque, efficiency, and discomfort: a randomized crossover trial. Braz J Phys Ther 2021; 25:593-600. [PMID: 33840592 PMCID: PMC8536851 DOI: 10.1016/j.bjpt.2021.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/02/2020] [Accepted: 03/11/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) is an important therapeutic tool for rehabilitation. However, best stimulation parameters remain to be determined. OBJECTIVE To determine the influence of different electrical stimulation currents and phase durations on torque, efficiency, and discomfort. METHODS Using a cross-over design, kHz frequency alternating currents (KFAC) and pulsed currents (PC) with narrow (200 µs) or wide (500 µs) phase durations were randomly applied on knee extensor muscles of healthy participants with a minimum of seven days between sessions. The NMES-evoked torque, NMES-efficiency, and discomfort (visual 0-10 cm analogue scale) were measured for each stimulation intensity increments (10 mA). Statistics were conducted using a three-way analysis of variances (phase duration x current x intensity), followed by Tukey post-hoc. RESULTS Twenty-four males (age 22.3 ± 3.5years) were included. No effect of NMES current was observed for torque, efficiency, and discomfort. For wide phase durations (500 µs), torque significantly increased for all stimulation intensities. For narrow phase durations (200 µs) evoked torque significantly increased only after 40% of maximal stimulation intensity. Phase durations of 500 µs produced greater torque than 200 µs. Discomfort was greater with 500 µs when compared to 200 µs. Submaximal relative torque, for example 40% of maximum voluntary contraction (MVC), was obtained with ∼ 60% and ∼ 80% of the maximal current intensity for 500 µs and 200 µs, respectively. CONCLUSION KFAC and PC current applied with the same phase duration induced similar relative submaximal and maximum evoked-torque, efficiency, and perceived discomfort. However, currents with 500 µs induced higher evoked-torque, current efficiency, and perceived discomfort.
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Affiliation(s)
| | | | - Ivo Vieira de Sousa Neto
- Graduate Program of Sciences and Technology of Health, Universidade de Brasília, Brasília, DF, Brazil
| | - Martim Bottaro
- College of Physical Education Department, Universidade de Brasília, Brasília, DF, Brazil
| | - Nicolas Babault
- INSERM U1093 CAPS, Faculty of Sport Sciences, University of Burgundy, Dijon, France
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Paz IDA, Rigo GT, Sgarioni A, Baroni BM, Frasson VB, Vaz MA. Alternating Current Is More Fatigable Than Pulsed Current in People Who Are Healthy: A Double-Blind, Randomized Crossover Trial. Phys Ther 2021; 101:6131761. [PMID: 33561279 DOI: 10.1093/ptj/pzab056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/12/2020] [Accepted: 12/27/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Tolerance level and rapid fatigue onset are limitations in the use of neuromuscular electrical stimulation (NMES) as an electrotherapeutic resource in rehabilitation and training protocols; however, it is unclear if pulsed current (PC) and alternating current (AC) produce different fatigue levels when applied at submaximal contraction level. The purpose of this study was to compare fatigue and discomfort levels between PC and AC during a submaximal contraction protocol in people who are healthy. METHODS In this double-blind, randomized crossover trial conducted in a laboratory setting, 30 male volunteers [23.23 years of age (SD = 4.59)] performed 2 submaximal fatigue protocols (with a 7-day interval) in a randomized order: PC (pulse duration = 2 milliseconds, pulse frequency = 100 Hz) and AC (2.5 kHz, pulse duration = 0.4 milliseconds, burst frequency = 100 Hz). NMES currents were applied to the knee extensor motor point of the dominant limb. The NMES protocol consisted of 80 evoked contractions (time on:off = 5:10 seconds) and lasted 20 minutes. The current was maintained at a constant intensity throughout the NMES protocol. The primary outcome measures were maximal voluntary isometric contraction, fatigue index (evoked torque decline), fatigability (number of contractions for a 50% drop in evoked-torque from the protocol start), total evoked torque-time integral (TTI), decline in TTI, and discomfort level. RESULTS AC at 2.5 kHz demonstrated higher maximal voluntary isometric contraction decline post-fatigue, higher fatigue index, higher fatigability (ie, fewer contractions to reach the 50% evoked torque decline from the protocol start), smaller total TTI, and higher TTI decline compared with PC. No between-currents difference was observed in discomfort level. CONCLUSION PC is less fatigable than AC at 2.5 kHz. IMPACT Based on this study, PC is the preferred current choice when the NMES goal is to generate higher muscle work, higher mechanical load, and smaller fatigability during training both for athletes who are healthy and for rehabilitation programs for people with disease or injury.
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Affiliation(s)
- Isabel de Almeida Paz
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Graciane Taglian Rigo
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Amanda Sgarioni
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Viviane Bortoluzzi Frasson
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil.,Physique Centro de Fisioterapia, Porto Alegre, RS, Brazil
| | - Marco Aurélio Vaz
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Physique Centro de Fisioterapia, Porto Alegre, RS, Brazil
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Comparison between Russian and Aussie currents in the grip strength and thickness muscles of the non-dominant hand: A double-blind, prospective, randomized-controlled study. Turk J Phys Med Rehabil 2020; 66:423-428. [PMID: 33364562 PMCID: PMC7756837 DOI: 10.5606/tftrd.2020.4718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/10/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives
This study aims to compare the Russian and Aussie currents in the force gain and hypertrophy of the forearm muscles responsible for the grip.
Patients and methods
This double-blind, prospective, randomized-controlled study included a total of 30 healthy women (mean age: 20.2±1.7 years; range, 18 to 25 years) between May 2018 and July 2018. The participants were randomly divided into three groups: control group (CG, n=10), Aussie current group (ACG, n=10), and Russian current group (RCG, n=10). All three groups underwent a force test with a gripping dynamometer and the collection of images of the superficial and deep flexor muscles of the fingers with diagnostic ultrasound. The CG received a fictious current stimulus, while the other two groups received the designated stimuli from their currents. Further evaluations were performed after 24 h of the 12th application of the current.
Results
For grip, there were no significant differences in the moment of evaluation and interaction, while the effect size yielded certain points to advantages of force gain for the group using the RCG. The thickness of the superficial muscles showed a significant difference for the first evaluation between CG and RCG (p=0.014) and between RCG and ACG (p=0.010), indicating a larger effect size for RCG.
Conclusion
Our study results show that the Russian current is proven to be the mode which yields the most optimal results.
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New Guidelines for Electrical Stimulation Parameters in Adult Patients With Knee Osteoarthritis Based on a Systematic Review of the Current Literature. Am J Phys Med Rehabil 2020; 99:682-688. [PMID: 32167955 DOI: 10.1097/phm.0000000000001409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The goal of this systematic review was to provide guidelines for treatment parameters regarding electrical stimulation by investigating its efficacy in improving muscle strength and decreasing pain in patients with knee osteoarthritis. DESIGN Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard, three electronic databases (CINAHL, PubMed, and PEDro) and gray literature were used. Randomized control trials comparing electrical stimulation and conservative physical therapy were critically appraised using the 2005 University of Oxford standard. RESULTS Nine randomized control trials were included in our review. First, our review confirmed that neuromuscular electrical stimulation is the most effective electrical stimulation treatment in the management of knee OA, and its efficiency is higher when combined with a strengthening program. Second, frequency of at least 50 Hz and no more than 75 Hz with a pulse duration between 200 and 400 μs and a treatment duration of 20 mins is necessary for successful treatment. CONCLUSIONS For the first time, our review provides standardized clinical treatment parameters for neuromuscular electrical stimulation to be included in a strengthening program for the adult patient with knee OA. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Recall the impact of quadriceps femoris weakness on joint stability; (2) Summarize the mechanism of action of neuromuscular electrical stimulation (NMES) on reducing pain and increasing muscle strength; and (3) Plan the clinical treatment parameters of NMES to be included in a strengthening program for an adult patient with knee osteoarthritis. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Russian and Low-Frequency Currents Induced Similar Neuromuscular Adaptations in Soccer Players: A Randomized Controlled Trial. J Sport Rehabil 2020; 29:594-601. [PMID: 31141429 DOI: 10.1123/jsr.2018-0314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 03/22/2019] [Accepted: 05/12/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Neuromuscular electrical stimulation is widely used to induce muscular strength increase; however, no study has compared Russian current (RC) with pulsed current (PC) effects after a training program. OBJECTIVES We studied the effects of different neuromuscular electrical stimulation currents, RC, and PC on the neuromuscular system after a 6-week training period. DESIGN Blinded randomized controlled trial. SETTING Laboratory. PATIENTS A total of 27 male soccer players (age 22.2 [2.2] y, body mass 74.2 [10.0] kg, height 177 [0] cm, and body mass index 23.7 [2.9] kg/cm2 for the control group; 22.1 [3.1] y, 69.7 [5.7] kg, 174 [0] cm, and 23.0 [2.5] kg/cm for the PC group; and 23.0 [3.4] y, 72.1 [10.7] kg, 175 [0] cm, and 23.5 [3.4] kg/cm for the RC group) were randomized into 3 groups: (1) control group; (2) RC (2500 Hz, burst 100 Hz, and phase duration 200 μs); and (3) PC (100 Hz and 200 μs). INTERVENTION The experimental groups trained for 6 weeks, with 3 sessions per week with neuromuscular electrical stimulation. MAIN OUTCOME MEASURES Maximal voluntary isometric contraction and evoked torque, muscle architecture, sensory discomfort (visual analog scale), and electromyographic activity were evaluated before and after the 6-week period. RESULTS Evoked torque increased in the RC (169.5% [78.2%], P < .01) and PC (248.7% [81.1%], P < .01) groups. Muscle thickness and pennation angle increased in the RC (8.7% [3.8%] and 16.7% [9.0%], P < .01) and PC (16.1% [8.0%] and 27.4% [11.0%], P < .01) groups. The PC demonstrated lower values for visual analog scale (38.8% [17.1%], P < .01). There was no significant time difference for maximal voluntary isometric contraction and root mean square values (P > .05). For all these variables, there was no difference between the RC and PC (P > .05). CONCLUSION Despite the widespread use of RC in clinical practice, RC and PC training programs produced similar neuromuscular adaptations in soccer players. Nonetheless, as PC generated less perceived discomfort, it could be preferred after several training sessions.
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Batistella CE, Bidin F, Giacomelli I, Nunez MA, Gasoto E, Albuquerque CED, Flores LJF, Bertolini GRF. Effects of the Russian current in the treatment of low back pain in women: A randomized clinical trial. J Bodyw Mov Ther 2020; 24:118-122. [PMID: 32507136 DOI: 10.1016/j.jbmt.2019.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Low back pain (LBP) is a high impact condition that affects the working population, generating social and economic repercussions, the most relevant symptoms being pain and functional disability. Conservative treatment is often based on stabilizing spinal muscles with exercises: the Russian current (RC) is reported as an alternative, because it promotes muscle contraction, providing muscle strengthening and hypertrophy. OBJECTIVE To assess the effectiveness of the RC in aiding the treatment of low back pain. METHODS This randomized study included 23 women aged 18-30 years, divided into two groups: the control group (CG) and the Russian current group (RCG), for four weeks. Pain (visual analogue scale, VAS; pressure algometer, PA), function (Oswestry Low Back Disability Index), resistance (trunk resistance [TR] test) and thickness changes in the muscle (ultrasound image) were evaluated before and after the RC protocol and at one-month follow-up. RESULTS There were significant VAS reductions in both groups, but at follow-up these had only been maintained in the RCG, which presented lower values than the CG in the second evaluation. For PA, Oswestry and TR, there were differences only in the RCG. In a comparison of LBP between the groups, the initial difference disappeared in subsequent evaluations; TR presented higher values in evaluation 2 and 3 in the RCG group. In terms of thickness changes, differences between the groups were reduced after treatment. CONCLUSION The proposed treatment was effective in the reduction of LBP, with short-term improvement in resistance and thickness changes of the multifidus.
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Affiliation(s)
- Carla Elis Batistella
- Universidade Estadual Do Oeste Do Paraná - UNIOESTE, Universitaria St. 2069, Cascavel, Paraná, 85819-110, Brazil.
| | - Fernanda Bidin
- Universidade Estadual Do Oeste Do Paraná - UNIOESTE, Universitaria St. 2069, Cascavel, Paraná, 85819-110, Brazil.
| | - Isabela Giacomelli
- Universidade Estadual Do Oeste Do Paraná - UNIOESTE, Universitaria St. 2069, Cascavel, Paraná, 85819-110, Brazil.
| | - Milena Aparecida Nunez
- Universidade Estadual Do Oeste Do Paraná - UNIOESTE, Universitaria St. 2069, Cascavel, Paraná, 85819-110, Brazil.
| | - Eduardo Gasoto
- Universidade Estadual Do Oeste Do Paraná - UNIOESTE, Universitaria St. 2069, Cascavel, Paraná, 85819-110, Brazil.
| | | | - Lucinar Jupir Forner Flores
- Universidade Estadual Do Oeste Do Paraná - UNIOESTE, Universitaria St. 2069, Cascavel, Paraná, 85819-110, Brazil.
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Manson GA, Calvert JS, Ling J, Tychhon B, Ali A, Sayenko DG. The relationship between maximum tolerance and motor activation during transcutaneous spinal stimulation is unaffected by the carrier frequency or vibration. Physiol Rep 2020; 8:e14397. [PMID: 32170844 PMCID: PMC7070156 DOI: 10.14814/phy2.14397] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 12/24/2022] Open
Abstract
Transcutaneous spinal stimulation (TSS) is a useful tool to modulate spinal sensorimotor circuits and has emerged as a potential treatment for motor disorders in neurologically impaired populations. One major limitation of TSS is the discomfort associated with high levels of stimulation during the experimental procedure. The objective of this study was to examine if the discomfort caused by TSS can be alleviated using different stimulation paradigms in a neurologically intact population. Tolerance to TSS delivered using conventional biphasic balanced rectangular pulses was compared to two alternative stimulation paradigms: a 5 kHz carrier frequency and biphasic balanced rectangular pulses combined with vibrotactile stimulation. In ten healthy participants, tolerance to TSS was examined using both single-pulse (0.2 Hz) and continuous (30 Hz) stimulation protocols. In both the single-pulse and continuous stimulation protocols, participants tolerated significantly higher levels of stimulation with the carrier frequency paradigm compared to the other stimulation paradigms. However, when the maximum tolerable stimulation intensity of each stimulation paradigm was normalized to the intensity required to evoke a lower limb muscle response, there were no statistical differences between the stimulation paradigms. Our results suggest that, when considering the intensity of stimulation required to obtain spinally evoked motor potentials, neither alternative stimulation paradigm is more effective at reducing discomfort than the conventional, unmodulated pulse configuration.
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Affiliation(s)
- Gerome A Manson
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Jonathan S Calvert
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA.,Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jeremiah Ling
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Boranai Tychhon
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Amir Ali
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Dimitry G Sayenko
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
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Bellew JW, Cayot T, Brown K, Blair C, Dishion T, Ortman B, Reel A. Changes in microvascular oxygenation and total hemoglobin concentration of the vastus lateralis during neuromuscular electrical stimulation (NMES). Physiother Theory Pract 2019; 37:926-934. [PMID: 31402741 DOI: 10.1080/09593985.2019.1652945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background and Introduction: Neuromuscular electrical stimulation (NMES) is predicated on eliciting muscle contractions and increasing muscle demand to promote increase in strength. Previous studies have shown differences in the magnitude of elicited force among various NMES waveforms but less is known about metabolic demand of muscle during NMES.Objective/Purpose: The purpose of this study was to compare elicited force and muscle metabolic demand during electrically elicited contractions using different NMES waveforms.Methods: A single-session repeated measures design was used. Electrically elicited force (EEF), microvascular oxygenation (SmO2), total hemoglobin concentration ([THC]) of the vastus lateralis, and subject tolerance (VAS score) were measured using three NMES waveforms; burst modulated alternating current (Russian), biphasic pulsed current (VMS®), and burst modulated biphasic pulsed current (VMS-burst®).Results: A significant main effect for waveform was noted for EEF (F = 12.693, p < .001), SmO2 (F = 8.340, p = .001), and VAS (F = 4.213, p = .025), but not [THC]. Compared to Russian current, VMS-burst and VMS resulted in significantly greater EEF (p = .001; p = .009) and local metabolic demand (i.e. decreased SmO2) (p = .005; p = .003), but not [THC]. VAS was significantly greater (p = .023) for VMS (4.2) compared to Russian (3.07) but not different between VMS-burst and Russian and VMS-burst and VMS.Conclusion: Greater muscle force and local metabolic demand were observed with VMS-burst and VMS compared to Russian current. These data provide novel evidence to guide clinical decision making when selecting an NMES waveform.
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Affiliation(s)
- James W Bellew
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Trent Cayot
- Department of Exercise Science, University of Indianapolis, Indianapolis, IN, USA
| | - Karisa Brown
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Crystal Blair
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Tommy Dishion
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Brett Ortman
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Alex Reel
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
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Scott W, Adams C, Fisher J, Fisher S, Jones K, Mathieu B. Electrically elicited quadriceps muscle torque: Comparison at three knee angles. Physiother Theory Pract 2019; 37:729-735. [PMID: 31293196 DOI: 10.1080/09593985.2019.1639867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background and Purpose: The effect of knee angle on electrically elicited quadriceps muscle torque has not been established. The goal of this study was to determine which knee angle allowed for the production of the greatest knee extensor maximal voluntary isometric torque (KEMVIT), the greatest electrically elicited torque, and the highest percent of KEMVIT from the knee extensor muscles. Case Description: Eighteen participants were secured in a force dynamometer with the knee positioned at 30°, 60°, and 90° flexion. Participants performed KEMVITs followed by electrically elicited contractions to their maximum tolerance. Outcomes: The mean ± SD of the peak KEMVITs was 123.7 ± 35.7 Nm, 222.6 ± 67.1 Nm, and 248.2 ± 81.1 Nm at 30°, 60°, and 90°, respectively. Significantly greater KEMVITs were produced at 60° and 90° than at 30° (p < 0.001). The mean ± SD of the maximally tolerated electrically elicited torques was 71.8 ± 18.8 Nm, 170.9 ± 70.4 Nm, and 134.6 ± 72.6 Nm at 30°, 60°, and 90°, respectively. Significantly higher torques were tolerated at 60° than at 30° (p < 0.001) and 90° (p = 0.018). The mean ± SD of the percent KEMVITs was 59.7 ± 11.7%, 78.2 ± 23.8%, and 52.6 ± 18.7% at 30°, 60°, and 90°, respectively. Significantly greater percent KEMVITs were produced at 60° than at 30° (p = 0.001) and 90° (p < 0.001). Discussion: Electrically elicited quadriceps torque production is greater at 60° as compared to 30° and 90° knee flexion.
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Affiliation(s)
- Wayne Scott
- School of Physical Therapy, Husson University, Bangor, ME, USA
| | - Cheryl Adams
- School of Physical Therapy, Husson University, Bangor, ME, USA
| | - Jason Fisher
- School of Physical Therapy, Husson University, Bangor, ME, USA
| | | | - Kayla Jones
- School of Physical Therapy, Husson University, Bangor, ME, USA
| | - Brian Mathieu
- School of Physical Therapy, Husson University, Bangor, ME, USA
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Pelegrini ACA, Gasoto E, Bussolaro JM, Segatti G, de Albuquerque CE, Bertolini GRF. The analgesic action of Aussie current in women with non-specific chronic lumbar pain. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2018.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aimsDespite electrostimulation being a common adjuvant therapy for non-specific low back pain, the use of Aussie current for muscle contraction is still underreported in the literature. The present study aimed to assess the use of Aussie current in the treatment of chronic, non-specific lumbar pain.MethodsTwenty-four young women with chronic non-specific low back pain were randomly assigned to the Aussie current group or control group. Pain (visual analogue scale and McGill Pain Questionnaire), function (Oswestry Disability Index), trunk muscle resistance (the time the participant remained in a predefined static position) and multifidus muscle thickness (ultrasound images) were analysed bilaterally before, at the end of and 30 days after completing the treatment protocol. The treatment group received 12 sessions of Aussie current over a period of 4 weeks. The electrodes were arranged laterally and bilaterally to the spinous processes of the first and fifth lumbar vertebrae.ResultsThere was a reduction in the pain profile for the Aussie group, as measured by a visual analogue scale and the McGill Pain Questionnaire. There was an increase in trunk muscle resistance and in muscle thickness in the Aussie group when compared to the control group. There were no changes in the Oswestry Disability Index in either group.ConclusionsAussie current resulted in significant improvements in pain, endurance and muscle thickness in women with chronic, non-specific low back pain.
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Affiliation(s)
| | - Eduardo Gasoto
- Physiotherapy student, Western Paraná State University, Cascavel, Brazil
| | | | - Gabriel Segatti
- Physiotherapy student, Western Paraná State University, Cascavel, Brazil
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Montenegro EJN, Santos KVD, Alencar GGD, Siqueira GRD, Maia JN, Andrade MDA. USE OF RUSSIAN AND AUSSIE CURRENT IN ISOMETRIC TETANIZATION OF THE QUADRICEPS FEMORIS. REV BRAS MED ESPORTE 2019. [DOI: 10.1590/1517-869220192502157134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: To qualitatively and quantitatively analyze the interaction of Russian and Aussie currents in isometric contraction of the quadriceps femoris muscle in the sensory, motor and pain tolerance spectra in healthy young women. Methods: The subjects were studied at a single point in time. A lower limb was selected at random to receive each current, and the electrodes were placed simultaneously on both legs, respecting 10 minutes between individual stimulation. Sensory, motor and pain-tolerance thresholds were assessed in quantitative (current density in mA/cm²) and qualitative (VAS) terms. Results: Subjects were 19 volunteers, aged 22.31 (1.29), with a BMI of 21.79 (1.78). The Aussie current reached the sensory threshold with significantly lower current density when compared with the Russian current for the same threshold. The results were significant in the overall group (treatment) for the two currents studied in terms of current density needed to reach the three thresholds. However, in the blocks (individually), there was significance only for the sensory threshold (p = 0.0126). Analysis of the perception of discomfort, assessed by VAS, was significant at the three time points for both currents, but in the comparison between these there was no significant difference. Conclusion: The Russian and Aussie currents are adequate in terms of the current density required to reach each threshold studied, and present differences between one another during interaction with the biological system, with the Aussie current necessitating less energy. However, in terms of perception of discomfort there are no significant differences between the two currents. Level of evidence III; Therapeutic studies - Investigating the results of treatment.
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Effects of Multipath and Conventional NMES on Maximum Comfortable Stimulus and Torque Production. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2019. [DOI: 10.18276/cej.2019.1-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Zhao Y, Lai JJ, Wu XY, Qu W, Wang MQ, Chen L, Hu N, Wang X, Hou WS. Neuromuscular Electrical Stimulation with Kilohertz Frequency Alternating Current to Enhance Sensorimotor Cortical Excitability. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:2240-2243. [PMID: 30440851 DOI: 10.1109/embc.2018.8512855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Enhancement of cortical excitability has been demonstrated to be beneficial for neural recovery of motor dysfunction, such as stroke and spinal cord injury. Neuromuscular electrical stimulation (NMES) has been widely used to evoke limb movements, resulting in the increasing cortical excitability. Due to the advantages of low skin impedance and less discomfort, an alternative NMES of kilohertz frequency alternating current (KFAC) has been proposed, and the effects of current parameters on evoked torque has been studied. However, few studies concerned cortical excitability effects during KFAC-evoked limb movement. In this paper, we utilized the event-related spectral estimation (ERSP) to calculate the beta ERD values to investigate the effects of KFAC-evoked elbow flexion movement on cortical excitability and compared them with that of passive movement. Firstly, averaged ERSP values were extracted in beta band during elbow flexion movements by sliding a 2Hz wide window for all trails of each subject. And then the minimal value was chosen as the representative value of beta ERD. Finally, the absolute ERD values and the descending slopes of all subjects were both calculated for statistical analysis by one-way repeated measures ANOVA. The results showed KFAC can increase cortical excitability, especially with long pulse duration. Moreover, beta cortical activities during KFAC500-evoked movement are significantly activated than those during passive movement. Therefore, our study may provide a new NMES rehabilitation method to enhance cortical excitability for motor dysfunction patients.
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Canela VC, Crivelaro CN, Ferla LZ, Pelozo GM, Azevedo J, Liebano RE, Nogueira C, Guidi RM, Grecco C, Sant’Ana E. Synergistic effects of Combined Therapy: nonfocused ultrasound plus Aussie current for noninvasive body contouring. Clin Cosmet Investig Dermatol 2018; 11:203-212. [PMID: 29731654 PMCID: PMC5927144 DOI: 10.2147/ccid.s157782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Nowadays, there are several noninvasive technologies being used for improving of body contouring. The objectives of this pilot study were to verify the effectiveness of the Heccus® device, emphasizing the synergism between nonfocused ultrasound plus Aussie current in the improvement of body contour, and to determine if the association of this therapy with whole-body vibration exercises can have additional positive effects in the results of the treatments. SUBJECTS AND METHODS Twenty healthy women aged 20-40 years participated in the study. Ten patients received Combined Therapy treatment (G1) and the other 10 participants received Combined Therapy with additional vibratory platform treatment (G2). Anthropometric and standardized photography analysis, ultrasonography, cutometry and self-adminestered questionnaires of tolerance and satisfaction levels with the treatment were used. RESULTS Compared with baseline values, reduction of fat thickness was observed by ultrasonography in the posterior thigh area in the G1 group (P<0.05) and in the buttocks (P<0.05) and the posterior thigh areas (P<0.05) in the G2. All the treated areas in both groups showed reduction in cellulite degree in the buttocks, G1 (P<0.05) and G2 (P<0.05), and in posterior thigh areas, G1 (P<0.05) and G2 (P<0.05). Optimal improvement of skin firmness (G1, P<0.0001; G2, P=0.0034) in the treated areas was observed in both groups. CONCLUSION We conclude that the synergistic effects of the Combined Therapy (nonfocused ultrasound plus Aussie current) might be a good option with noninvasive body contouring treatment for improving the aspect of the cellulite, skin firmness and localized fat. If used in association with the whole-body vibratory platform, the results can be better, especially in the treatment of localized fat. Further studies with larger sample size should be performed to confirm these results.
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Affiliation(s)
| | | | | | | | - Juliana Azevedo
- CDE Medical Imaging Department, Brazilian College of Radiology (CBR), Amparo, SP, Brazil
| | - Richard Eloin Liebano
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Caroline Nogueira
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
- Biomedical Engineering Department, Faculty of Electrical Engineering and Computing, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Renata Michelini Guidi
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
- Biomedical Engineering Department, Faculty of Electrical Engineering and Computing, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Clóvis Grecco
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
| | - Estela Sant’Ana
- Research, Development and Innovation Department, Ibramed Research Group (IRG), IBRAMED, Amparo, SP, Brazil
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De Oliveira PFA, Durigan JLQ, Modesto KAG, Bottaro M, Babault N. Neuromuscular fatigue after low- and medium-frequency electrical stimulation in healthy adults. Muscle Nerve 2018; 58:293-299. [PMID: 29687898 DOI: 10.1002/mus.26143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2018] [Indexed: 11/10/2022]
Abstract
INTRODUCTION In this study we investigated fatigue origins induced by low-frequency pulsed current (PC) and medium-frequency current (MF) neuromuscular electrical stimulation (NMES) after a clinical-like session. METHODS Eleven healthy men randomly underwent 2 NMES sessions, PC and MF, on quadriceps muscle (15-minute duration, 6 seconds on and 18 seconds off). Maximal voluntary contraction (MVC), central activation ratio (CAR), vastus lateralis electromyographic activity (EMG), and evoked contractile properties were determined before and after the sessions. Evoked torque and discomfort during the sessions were also measured. RESULTS Both currents produced decreases in MVC, EMG, and evoked contractile properties after the sessions. No difference was found between currents for all variables (P > 0.05). Evoked torque during sessions decreased (P < 0.05). No difference was observed in mean evoked torque and discomfort (P > 0.05). DISCUSSION Both currents induced similar neuromuscular fatigue. Clinicians can choose either PC or MF and expect similar treatment effects when the goal is to generate gains in muscle strength. Muscle Nerve 58: 293-299, 2018.
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Affiliation(s)
- Pedro Ferreira Alves De Oliveira
- Federal Institute of Brasília, Brasília, Federal District, 72015-606, Brazil.,College of Physical Education, University of Brasília, Brasília, Federal District, Brazil
| | - João Luiz Quagliotti Durigan
- College of Physiotherapy, University of Brasília, Brasília, Federal District, Brazil.,College of Physical Education, University of Brasília, Brasília, Federal District, Brazil
| | | | - Martim Bottaro
- College of Physical Education, University of Brasília, Brasília, Federal District, Brazil
| | - Nicolas Babault
- Centre d'Expertise de la Performance, CAPS, U1093 INSERM, Université de Bourgogne, Faculté des Sciences du Sport, Dijon, Bourgogne, France
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Iijima H, Takahashi M, Tashiro Y, Aoyama T. Comparison of the effects of kilohertz- and low-frequency electric stimulations: A systematic review with meta-analysis. PLoS One 2018; 13:e0195236. [PMID: 29689079 PMCID: PMC5915276 DOI: 10.1371/journal.pone.0195236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 02/26/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study aimed to determine whether kilohertz-frequency alternating current (KFAC) is superior to low-frequency pulsed current (PC) in increasing muscle-evoked torque and lessening discomfort. DATA SOURCES The electronic databases PubMed, PEDro, CINAHL, and CENTRAL were searched for related articles, published before August 2017. Furthermore, citation search was performed on the original record using Web of Science. REVIEW METHODS Randomized controlled trials, quasi-experimental studies, and within-subject repeated studies evaluating and comparing KFAC and PC treatments were included. The pooled standardized mean differences (SMDs) of KFAC and PC treatments, with 95% confidence intervals (CIs), were calculated using the random effects model. RESULTS In total, 1148 potentially relevant articles were selected, of which 14 articles with within-subject repeated designs (271 participants, mean age: 26.4 years) met the inclusion criteria. KFAC did not significantly increase muscle-evoked torque, compared to PC (pooled SMD: -0.25; 95% CI: -0.53, 0.06; P = 0.120). KFAC had comparable discomfort compared to that experienced using PC (pooled SMD: -0.06; 95% CI: -0.50, 0.38; P = 0.800). These estimates of the effects had a high risk of bias, as assessed using the Downs and Black scale, and were highly heterogeneous studies. CONCLUSIONS This meta-analysis does not establish that KFAC is superior to PC in increasing muscle-evoked torque and lessening discomfort level. However, no strong conclusion could be drawn because of a high risk of bias and a large amount of heterogeneity. High quality studies comparing the efficacy between PC and KFAC treatments with consideration of potential confounders is warranted to facilitate the development of effective treatment.
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Affiliation(s)
- Hirotaka Iijima
- Department of System Design Engineering, Keio University, Yokohama, Japan
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masaki Takahashi
- Department of System Design Engineering, Keio University, Yokohama, Japan
| | - Yuto Tashiro
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Vaz MA, Frasson VB. Low-Frequency Pulsed Current Versus Kilohertz-Frequency Alternating Current: A Scoping Literature Review. Arch Phys Med Rehabil 2018; 99:792-805. [DOI: 10.1016/j.apmr.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
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Abstract
Study Design A controlled laboratory study, with a single-blind, block-randomization crossover design. Objectives To compare the electrically elicited knee extensor torque produced by 3 clinically available waveforms: 2500-Hz burst-modulated alternating current (BMAC), 1000-Hz BMAC, and 1000-Hz burst-modulated biphasic square-wave pulsed current (BMBPC). Background Neuromuscular electrical stimulation (NMES) is the therapeutic use of electrical current to strengthen muscle. Muscle torque produced by NMES is limited by discomfort. Methods The knee extensor maximal volitional isometric torque (KEMVIT) of 33 able-bodied participants (18 female) was measured and used to normalize the electrically elicited knee extensor torque to produce a percent of KEMVIT (%KEMVIT). Electrically elicited isometric knee extensor torque was measured in response to each of the waveforms at the participants' maximum tolerance. Results The average maximum tolerated stimulation produced 32.0 ± 16.7 %KEMVIT with 2500-Hz BMAC, 38.2 ± 18.4 %KEMVIT with 1000-Hz BMAC, and 42.2 ± 17.1 %KEMVIT with 1000-Hz BMBPC. Tukey honest significant difference (HSD) post hoc testing revealed a statistically significant difference between 2500-Hz BMAC and 1000-Hz BMAC (P = .046), and between 2500-Hz BMAC and 1000-Hz BMBPC (P<.001). No statistically significant difference was found between 1000-Hz BMAC and 1000-Hz BMBPC (P = .267). Conclusion For eliciting maximum knee extensor muscle torque, 1000-Hz BMBPC and 1000-Hz BMAC were similarly effective, and 2500-Hz BMAC was less effective. J Orthop Sports Phys Ther 2018;48(3):217-224. Epub 19 Dec 2017. doi:10.2519/jospt.2018.7601.
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Bellew JW, Allen M, Biefnes A, Grantham S, Miglin J, Swartzell D. Efficiency of neuromuscular electrical stimulation: A comparison of elicited force and subject tolerance using three electrical waveforms. Physiother Theory Pract 2018; 34:551-558. [DOI: 10.1080/09593985.2017.1422820] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- James W. Bellew
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Molly Allen
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Austin Biefnes
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Sara Grantham
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - James Miglin
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Dylan Swartzell
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
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Kilohertz and Low-Frequency Electrical Stimulation With the Same Pulse Duration Have Similar Efficiency for Inducing Isometric Knee Extension Torque and Discomfort. Am J Phys Med Rehabil 2017; 96:388-394. [PMID: 27680427 DOI: 10.1097/phm.0000000000000631] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the hypotheses that, as compared with pulsed current with the same pulse duration, kilohertz frequency alternating current would not differ in terms of evoked-torque production and perceived discomfort, and as a result, it would show the same current efficiency. DESIGN A repeated-measures design with 4 stimuli presented in random order was used to test 25 women: (1) 500-microsecond pulse duration, (2) 250-microsecond pulse duration, (3) 500-microsecond pulse duration and low carrier frequency (1 kHz), (4) 250-microsecond pulse duration and high carrier frequency (4 kHz). Isometric peak torque of quadriceps muscle was measured using an isokinetic dynamometer. Discomfort was measured using a visual analog scale. RESULTS Currents with long pulse durations induced approximately 21% higher evoked torque than short pulse durations. In addition, currents with 500 microseconds delivered greater amounts of charge than stimulation patterns using 250-microsecond pulse durations (P < 0.05). All currents presented similar discomfort. There was no difference on stimulation efficiency with the same pulse duration. CONCLUSIONS Both kilohertz frequency alternating current and pulsed current, with the same pulse duration, have similar efficiency for inducing isometric knee extension torque and discomfort. However, neuromuscular electrical stimulation (NMES) with longer pulse duration induces higher NMES-evoked torque, regardless of the carrier frequency. Pulse duration is an important variable that should receive more attention for an optimal application of NMES in clinical settings.
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Wiest MJ, Bergquist AJ, Collins DF. Torque, Current, and Discomfort During 3 Types of Neuromuscular Electrical Stimulation of Tibialis Anterior. Phys Ther 2017; 97:790-789. [PMID: 28789468 DOI: 10.1093/ptj/pzx053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 05/03/2017] [Indexed: 11/14/2022]
Abstract
BACKGROUND The benefits of neuromuscular electrical stimulation (NMES) for rehabilitation depend on the capacity to generate functionally relevant torque with minimal fatigability and discomfort. Traditionally, NMES is delivered either over a muscle belly (mNMES) or a nerve trunk (nNMES). Recently, a technique that minimizes contraction fatigability by alternating pulses between the mNMES and nNMES sites, termed "interleaved" NMES (iNMES), was developed. However, discomfort and the ability to generate large torque during iNMES have not been explored adequately. OBJECTIVE The study objective was to compare discomfort and maximal torque between mNMES, nNMES, and iNMES. METHODS Stimulation trains (12 pulses at 40 Hz) were delivered to produce dorsiflexion torque using mNMES, nNMES, and iNMES. Discomfort was assessed using a visual analogue scale for contractions that generated 5-30% of a maximal voluntary isometric contraction (MVIC), and for the maximal tolerable torque. RESULTS Discomfort scores were not different between NMES types when torque was ≤20% MVIC. At 30% MVIC, mNMES produced more discomfort than nNMES and iNMES. nNMES produced the most torque (65% MVIC), followed by iNMES (49% MVIC) and mNMES (33% MVIC); in these trials, mNMES produced more discomfort than nNMES, but not iNMES. LIMITATIONS The present results may be limited to individuals with no history of neuromusculoskeletal impairment. CONCLUSIONS In terms of discomfort, there were no differences between mNMES, nNMES, or iNMES for contractions between 5-20% MVIC. However, mNMES produced more discomfort than nNMES and iNMES for contractions of 30% MVIC, while for larger contractions, mNMES only produced more discomfort than nNMES. The advantages and disadvantages of each NMES type should be considered prior to implementation in rehabilitation programs.
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Affiliation(s)
- Matheus J Wiest
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta and Biomechanics Laboratory, Department of Physical Education, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Austin J Bergquist
- Rehabilitation Engineering Laboratory, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - David F Collins
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, 4-218 Van Vliet Complex, Edmonton, Alberta, Canada T6G 2H9
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Lima RADO, Freire APCF, Guimarães A, Santos CP, Pacagnelli FL. Effectiveness of Russian current in bone regeneration process in rats. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.002.ao13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Russian current is an electric current of average frequency that is able to restore the properties of skeletal muscle at a low treatment cost. It is essential to know the effects of Russian current in bone tissue, since electromagnetic energy could be an efficient and low cost method to treat bone disorders. Objective: The aim of the study was to evaluate the effectiveness of Russian current in the consolidation of tibia fracture in adult rats. Methods: 24 adult male Albinus Wistar rats wereused. The animals were divided randomly into two groups: control group (CG), composed of 12 animals, and Intervention Group (IG) consisting of 12 animals, both groups were submitted to osteotomy (proximal medial surface of the tibia). The IG underwent an electrical stimulation protocol with Russian current, while the CG did not undergo any kind of intervention. Euthanasia was performed in three animals of each group on the following days: 5, 10, 20, and 30 days of treatment. Results: The results suggested higher primary ossification, intense osteogenic activity, and increased thickness of the periosteum, characterizing more advanced ossification and a greater presence of trabecular bone marrow in rats in the group subjected to the treatment. In this way, we can assign one more beneficial effect to interventions with Russian current, for the treatment of postfracture rehabilitation. Conclusion: In both groups the bone tissue repair process occurred, but in the electrically stimulated group the osteogenesis process was more advanced.
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Affiliation(s)
| | | | - Alcides Guimarães
- Universidade do Oeste Paulista, Brazil; Universidade Estadual de Campinas, Brazil
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da Silva VZM, Durigan JLQ, Arena R, de Noronha M, Gurney B, Cipriano G. Current evidence demonstrates similar effects of kilohertz-frequency and low-frequency current on quadriceps evoked torque and discomfort in healthy individuals: a systematic review with meta-analysis. Physiother Theory Pract 2015; 31:533-9. [DOI: 10.3109/09593985.2015.1064191] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Medeiros FVA, Vieira A, Carregaro RL, Bottaro M, Maffiuletti NA, Durigan JLQ. Skinfold thickness affects the isometric knee extension torque evoked by Neuromuscular Electrical Stimulation. Braz J Phys Ther 2015; 19:466-72. [PMID: 26647748 PMCID: PMC4668340 DOI: 10.1590/bjpt-rbf.2014.0114] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 05/28/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: Subcutaneous adipose tissue may influence the transmission of electrical stimuli
through to the skin, thus affecting both evoked torque and comfort perception
associated with neuromuscular electrical stimulation (NMES). This could seriously
affect the effectiveness of NMES for either rehabilitation or sports purposes.
OBJECTIVE: To investigate the effects of skinfold thickness (SFT) on maximal NMES current
intensity, NMES-evoked torque, and NMES-induced discomfort. METHOD: First, we compared NMES current intensity, NMES-induced discomfort, and
NMES-evoked torque between two subgroups of subjects with thicker (n=10; 20.7 mm)
vs. thinner (n=10; 29.4 mm) SFT. Second, we correlated SFT to NMES current
intensity, NMES-induced discomfort, and NMES-evoked knee extension torque in 20
healthy women. The NMES-evoked torque was normalized to the maximal voluntary
contraction (MVC) torque. The discomfort induced by NMES was assessed with a
visual analog scale (VAS). RESULTS: NMES-evoked torque was 27.5% lower in subjects with thicker SFT
(p=0.01) while maximal current intensity was 24.2% lower in
subjects with thinner SFT (p=0.01). A positive correlation was
found between current intensity and SFT (r=0.540,
p=0.017). A negative correlation was found between NMES-evoked
torque and SFT (r=-0.563, p=0.012). No
significant correlation was observed between discomfort scores and SFT
(rs=0.15, p=0.53). CONCLUSION: These results suggest that the amount of subcutaneous adipose tissue (as
reflected by skinfold thickness) affected NMES current intensity and NMES-evoked
torque, but had no effect on discomfort perception. Our findings may help physical
therapists to better understand the impact of SFT on NMES and to design more
rational stimulation strategies.
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Affiliation(s)
- Flávia V A Medeiros
- Faculdade de Educação Física, Universidade de Brasília, Brasília, DF, Brazil
| | - Amilton Vieira
- Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, DF, Brazil
| | - Rodrigo L Carregaro
- Departamento de Fisioterapia, Universidade de Brasília, Brasília, DF, Brazil
| | - Martim Bottaro
- Faculdade de Educação Física, Universidade de Brasília, Brasília, DF, Brazil
| | | | - João L Q Durigan
- Departamento de Fisioterapia, Universidade de Brasília, Brasília, DF, Brazil
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Herzig D, Maffiuletti NA, Eser P. The Application of Neuromuscular Electrical Stimulation Training in Various Non-neurologic Patient Populations: A Narrative Review. PM R 2015; 7:1167-1178. [DOI: 10.1016/j.pmrj.2015.03.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 03/24/2015] [Accepted: 03/27/2015] [Indexed: 12/16/2022]
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