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Sudo M, Kitajima D, Takagi Y, Mochizuki K, Fujibayashi M, Costello JT, Ando S. Effects of voluntary exercise and electrical muscle stimulation on reaction time in the Go/No-Go task. Eur J Appl Physiol 2024:10.1007/s00421-024-05562-8. [PMID: 39044028 DOI: 10.1007/s00421-024-05562-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Acute exercise improves cognitive performance. However, it remains unclear what triggers cognitive improvement. Electrical muscle stimulation (EMS) facilitates the examination of physiological changes derived from peripheral muscle contraction during exercise. Thus, we compared the effects of EMS and voluntary exercise at low- or moderate-intensity on reaction time (RT) in a cognitive task to understand the contribution of central and peripheral physiological factors to RT improvement. METHODS Twenty-four young, healthy male participants performed a Go/No-Go task before and after EMS/exercise. In the EMS condition, EMS was applied to the lower limb muscles. In the low-intensity exercise condition, the participants cycled an ergometer while maintaining their heart rate (HR) at the similar level during EMS. In the moderate-intensity exercise condition, exercise intensity corresponded to ratings of perceived exertion of 13/20. The natural log-transformed root mean square of successive differences between adjacent inter-beat (R-R) intervals (LnRMSSD), which predominantly reflects parasympathetic HR modulation, was calculated before and during EMS/exercise. RESULTS RT improved following moderate-intensity exercise (p = 0.002, Cohen' d = 0.694), but not following EMS (p = 0.107, Cohen' d = 0.342) and low-intensity exercise (p = 0.076, Cohen' d = 0.380). Repeated measures correlation analysis revealed that RT was correlated with LnRMSSD (Rrm(23) = 0.599, p = 0.002) in the moderate-intensity exercise condition. CONCLUSION These findings suggest that the amount of central neural activity and exercise pressor reflex may be crucial for RT improvement. RT improvement following moderate-intensity exercise may, at least partly, be associated with enhanced sympathetic nervous system activity.
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Affiliation(s)
- Mizuki Sudo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachioji, Tokyo, 192-0001, Japan
| | - Daisuke Kitajima
- Faculty of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Yoko Takagi
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Kodai Mochizuki
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Mami Fujibayashi
- Faculty of Agriculture, Setsunan University, 45-1 Nagaotoge-Cho, Hirakata, Osaka, 573-0101, Japan
| | - Joseph T Costello
- School of Psychology, Sport and Health Sciences, University of Portsmouth, Portsmouth, UK
| | - Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan.
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Nishikawa Y, Sakaguchi H, Takada T, Maeda N, Hyngstrom A. Influence of stimulation frequency on brain-derived neurotrophic factor and cathepsin-B production in healthy young adults. J Comp Physiol B 2024:10.1007/s00360-024-01566-0. [PMID: 38819461 DOI: 10.1007/s00360-024-01566-0] [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: 09/24/2023] [Revised: 04/21/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Abstract
Electrical muscle stimulation (EMS) has been shown to stimulate the production of myokines (i.e., brain-derived neurotrophic factor (BDNF)), but the most effective EMS parameters for myokine production have not been fully elucidated. The purpose of this study was to quantify the optimal EMS frequency for stimulating myokine production. This study included sixteen young adults (male, n = 13, age = 27.3 ± 5.5 years). Participants underwent four EMS interventions (20 min each) with the following conditions: (1) 4 Hz, (2) 20 Hz, (3) 80 Hz, and (4) control (no intervention). Blood samples were obtained before and immediately after EMS. For the control condition, blood samples were taken before and after 20 min of quiet sitting. BDNF and cathepsin-B levels were analyzed in serum. Compared to preintervention levels, stimulation at 20 Hz resulted in significantly greater postintervention cathepsin-B and BDNF levels (p < 0.01). On the other hand, the control condition did not result in a significant change between pre- and posttreatment. Furthermore, stimulation at 20 Hz caused significantly larger increases in cathepsin-B and BDNF levels than stimulation at 4-80 Hz or the control condition (p < 0.05). In conclusion, stimulation at 20 Hz effectively causes a robust cathepsin-B and BDNF response. Based on these results, we suggest a new strategy for rehabilitation of people with neurological disorders.
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Affiliation(s)
- Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kakuma-machi, Kanazawa, Kanazawa, 920-1192, Japan.
| | - Hiroyuki Sakaguchi
- Graduate School of Frontier Engineering, Kanazawa University, Kanazawa, Japan
| | | | - Noriaki Maeda
- Department of Sport Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Allison Hyngstrom
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
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Ando S, Ishioka Y, Kambayashi S, Kano K, Fujibayashi M, Costello JT, Sudo M. Combined effects of electrical muscle stimulation and cycling exercise on cognitive performance. Front Physiol 2024; 15:1408963. [PMID: 38827991 PMCID: PMC11140777 DOI: 10.3389/fphys.2024.1408963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
The purpose of this study was to investigate whether a combination of electrical muscle stimulation (EMS) and cycling exercise is beneficial for improving cognitive performance. Eighteen participants (7 females and 11 males) performed a Go/No-Go task before and 2 min after i) cycling exercise (EX), ii) a combination of EMS and cycling (EMS + EX) and iii) a control (rest) intervention in a randomized controlled crossover design. In the EX intervention, the participants cycled an ergometer for 20 min with their heart rate maintained at ∼120 beats·min-1. In the EMS + EX intervention, the participants cycled an ergometer simultaneously with EMS for 20 min, with heart rate maintained at ∼120 beats·min-1. In the Control intervention, the participants remained at rest while seated on the ergometer. Cognitive performance was assessed by reaction time (RT) and accuracy. There was a significant interaction between intervention and time (p = 0.007). RT was reduced in the EX intervention (p = 0.054, matched rank biserial correlation coefficient = 0.520). In the EMS + EX intervention, RT was not altered (p = 0.243, Cohen's d = 0.285) despite no differences in heart rate between the EX and EMS + EX interventions (p = 0.551). RT was increased in the Control intervention (p = 0.038, Cohen's d = -0.529). These results indicate that combining EMS and cycling does not alter cognitive performance despite elevated heart rate, equivalent to a moderate intensity. The present findings suggest that brain activity during EMS with cycling exercise may be insufficient to improve cognitive performance when compared to exercise alone.
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Affiliation(s)
- Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | - Yuka Ishioka
- Faculty of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | - Sari Kambayashi
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | - Kosuke Kano
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | | | - Joseph T. Costello
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Mizuki Sudo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Shinjuku, Tokyo, Japan
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Ando S, Fujimoto T, Sudo M, Watanuki S, Hiraoka K, Takeda K, Takagi Y, Kitajima D, Mochizuki K, Matsuura K, Katagiri Y, Nasir FM, Lin Y, Fujibayashi M, Costello JT, McMorris T, Ishikawa Y, Funaki Y, Furumoto S, Watabe H, Tashiro M. The neuromodulatory role of dopamine in improved reaction time by acute cardiovascular exercise. J Physiol 2024; 602:461-484. [PMID: 38165254 DOI: 10.1113/jp285173] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024] Open
Abstract
Acute cardiovascular physical exercise improves cognitive performance, as evidenced by a reduction in reaction time (RT). However, the mechanistic understanding of how this occurs is elusive and has not been rigorously investigated in humans. Here, using positron emission tomography (PET) with [11 C]raclopride, in a multi-experiment study we investigated whether acute exercise releases endogenous dopamine (DA) in the brain. We hypothesized that acute exercise augments the brain DA system, and that RT improvement is correlated with this endogenous DA release. The PET study (Experiment 1: n = 16) demonstrated that acute physical exercise released endogenous DA, and that endogenous DA release was correlated with improvements in RT of the Go/No-Go task. Thereafter, using two electrical muscle stimulation (EMS) studies (Experiments 2 and 3: n = 18 and 22 respectively), we investigated what triggers RT improvement. The EMS studies indicated that EMS with moderate arm cranking improved RT, but RT was not improved following EMS alone or EMS combined with no load arm cranking. The novel mechanistic findings from these experiments are: (1) endogenous DA appears to be an important neuromodulator for RT improvement and (2) RT is only altered when exercise is associated with central signals from higher brain centres. Our findings explain how humans rapidly alter their behaviour using neuromodulatory systems and have significant implications for promotion of cognitive health. KEY POINTS: Acute cardiovascular exercise improves cognitive performance, as evidenced by a reduction in reaction time (RT). However, the mechanistic understanding of how this occurs is elusive and has not been rigorously investigated in humans. Using the neurochemical specificity of [11 C]raclopride positron emission tomography, we demonstrated that acute supine cycling released endogenous dopamine (DA), and that this release was correlated with improved RT. Additional electrical muscle stimulation studies demonstrated that peripherally driven muscle contractions (i.e. exercise) were insufficient to improve RT. The current study suggests that endogenous DA is an important neuromodulator for RT improvement, and that RT is only altered when exercise is associated with central signals from higher brain centres.
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Affiliation(s)
- Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Toshihiko Fujimoto
- Institute of Excellence in Higher Education, Tohoku University, Miyagi, Japan
| | - Mizuki Sudo
- Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Shoichi Watanuki
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Kotaro Hiraoka
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Kazuko Takeda
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Yoko Takagi
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Daisuke Kitajima
- Faculty of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Kodai Mochizuki
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Koki Matsuura
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Yuki Katagiri
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Fairuz Mohd Nasir
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
- Faculty of Health Sciences, University Sultan Zainal Abidin, Malaysia
| | - Yuchen Lin
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
- Department of Occupational Therapy, Da-Yeh University, Changhua, Taiwan
| | | | - Joseph T Costello
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Terry McMorris
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
- Institue of Sport, Nursing and Allied Health, University of Chichester, Chichester, UK
| | - Yoichi Ishikawa
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Yoshihito Funaki
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Shozo Furumoto
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Hiroshi Watabe
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Manabu Tashiro
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
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Moroder P, Karpinski K, Akgün D, Danzinger V, Gerhardt C, Patzer T, Tauber M, Wellmann M, Scheibel M, Boileau P, Lambert S, Porcellini G, Audige L. Neuromuscular Electrical Stimulation-Enhanced Physical Therapist Intervention for Functional Posterior Shoulder Instability (Type B1): A Multicenter Randomized Controlled Trial. Phys Ther 2024; 104:pzad145. [PMID: 37870503 PMCID: PMC10824628 DOI: 10.1093/ptj/pzad145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/26/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE Functional posterior shoulder instability (FPSI) (type B1) is a severe type of instability, mainly in teenagers and young adults, that leads to loss of function, pain, and stigmatization among peers. An experimental nonsurgical treatment protocol based on neuromuscular electrical stimulation (NMES) showed very promising early results in the treatment of FPSI. The hypothesis of this study was that NMES-enhanced physical therapy leads to better outcomes than physical therapy alone as the current gold standard of treatment in patients with FPSI. METHODS In this multicenter randomized controlled trial, patients with FPSI were randomly allocated in a 1:1 ratio to either 6 weeks of physical therapy or 6 weeks of physical therapy with simultaneous motion-triggered NMES. Baseline scores as well as outcome scores at 6 weeks, 3 months, 6 months, and 12 months after the intervention were obtained. The predefined primary outcome of this trial was the Western Ontario Shoulder Instability Index (WOSI) at the 3-month time point. RESULTS Forty-nine patients were randomized and eligible for the trial. The group that received physical therapy with simultaneous motion-triggered NMES showed a significantly better main outcome measurement in terms of the 3-month WOSI score (64% [SD = 16%] vs 51% [SD = 24%]). Two-thirds of the patients from the physical therapist group crossed over to the group that received physical therapy with simultaneous motion-triggered NMES due to dissatisfaction after the 3-month follow-up and showed a significant increase in their WOSI score from 49% [SD = 8%] to 67% [SD = 24%]. The frequency of instability episodes showed a significant improvement in the group that received physical therapy with simultaneous motion-triggered NMES at the 3-month follow-up and beyond, while in the physical therapist group, no significant difference was observed. CONCLUSION The current study shows that NMES-enhanced physical therapy led to statistically significant and clinically relevant improvement in outcomes in the treatment of FPSI compared to conventional physical therapy alone-from which even patients with prior unsatisfactory results after conventional physical therapy can benefit. IMPACT Based on the results of this study, NMES-enhanced physical therapy is an effective new treatment option for FPSI, a severe type of shoulder instability. NMES-enhanced physical therapy should be preferred over conventional physical therapy for the treatment of patients with FPSI.
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Affiliation(s)
- Philipp Moroder
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
| | - Katrin Karpinski
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Doruk Akgün
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Victor Danzinger
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Christian Gerhardt
- Department of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics Karlsruhe, Karlsruhe, Germany
| | - Thilo Patzer
- Department of Orthopaedics and Trauma Surgery, Schoenklinik Düsseldorf, Düsseldorf, Germany
| | - Mark Tauber
- Deutsches Schulterzentrum, ATOS Klinik, Munich, Germany
| | | | - Markus Scheibel
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Pascal Boileau
- Institute for Sports & Reconstructive Surgery, Groupe Kantys, Nice, France
| | - Simon Lambert
- Department of Trauma and Orthopedics, University College London Hospital NHS Foundation Trust, London, UK
| | - Giuseppe Porcellini
- Department of Orthopedics and Traumatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Laurent Audige
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
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Lo Re V, Russelli G, Lo Gerfo E, Alduino R, Bulati M, Iannolo G, Terzo D, Martucci G, Anzani S, Panarello G, Sparacia G, Parla G, Avorio F, Raffa G, Pilato M, Speciale A, Agnese V, Mamone G, Tuzzolino F, Vizzini GB, Conaldi PG, Ambrosio F. Cognitive outcomes in patients treated with neuromuscular electrical stimulation after coronary artery bypass grafting. Front Neurol 2023; 14:1209905. [PMID: 37693766 PMCID: PMC10486105 DOI: 10.3389/fneur.2023.1209905] [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: 04/24/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Objective Mechanisms of neurocognitive injury as post-operative sequelae of coronary artery bypass grafting (CABG) are not understood. The systemic inflammatory response to surgical stress causes skeletal muscle impairment, and this is also worsened by immobility. Since evidence supports a link between muscle vitality and neuroprotection, there is a need to understand the mechanisms by which promotion of muscle activity counteracts the deleterious effects of surgery on long-term cognition. Methods We performed a clinical trial to test the hypothesis that adding neuromuscular electrical stimulation (NMES) to standard rehabilitation care in post-CABG patients promotes the maintenance of skeletal muscle strength and the expression of circulating neuroprotective myokines. Results We did not find higher serum levels of neuroprotective myokines, except for interleukin-6, nor better long-term cognitive performance in our intervention group. However, a greater increase in functional connectivity at brain magnetic resonance was seen between seed regions within the default mode, frontoparietal, salience, and sensorimotor networks in the NMES group. Regardless of the treatment protocol, patients with a Klotho increase 3 months after hospital discharge compared to baseline Klotho values showed better scores in delayed memory tests. Significance We confirm the potential neuroprotective effect of Klotho in a clinical setting and for the first time post-CABG.
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Affiliation(s)
- Vincenzina Lo Re
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center (UPMC), Palermo, Italy
| | | | - Emanuele Lo Gerfo
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center (UPMC), Palermo, Italy
- Department of Research, IRCCS ISMETT, UPMC, Palermo, Italy
| | | | - Matteo Bulati
- Department of Research, IRCCS ISMETT, UPMC, Palermo, Italy
| | | | - Danilo Terzo
- Rehabilitation Service, IRCCS ISMETT, Palermo, Italy
| | - Gennaro Martucci
- Department of Anesthesiology and Intensive Care, IRCCS ISMETT, UPMC, Palermo, Italy
| | - Stefano Anzani
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center (UPMC), Palermo, Italy
- Department of Research, IRCCS ISMETT, UPMC, Palermo, Italy
| | - Giovanna Panarello
- Department of Anesthesiology and Intensive Care, IRCCS ISMETT, UPMC, Palermo, Italy
| | - Gianvincenzo Sparacia
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT, Palermo, Italy
| | - Giuseppe Parla
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT, Palermo, Italy
| | - Federica Avorio
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center (UPMC), Palermo, Italy
| | - Giuseppe Raffa
- Cardiac Surgery Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT, Palermo, Italy
| | - Michele Pilato
- Cardiac Surgery Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT, Palermo, Italy
| | | | | | - Giuseppe Mamone
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT, Palermo, Italy
| | | | | | | | - Fabrisia Ambrosio
- Discovery Center for Musculoskeletal Recovery, Schoen Adams Research Institute at Spaulding, Boston, MA, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
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Reganova E, Solovyeva K, Buyanov D, Gerasimenko AY, Repin D. Effects of Intermittent Hypoxia and Electrical Muscle Stimulation on Cognitive and Physiological Metrics. Bioengineering (Basel) 2023; 10:bioengineering10050536. [PMID: 37237606 DOI: 10.3390/bioengineering10050536] [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: 03/16/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES This study describes the effects of interval hypoxic training and electrical muscle stimulation (EMS) technology on human productivity with the following metrics: biochemical indices, cognitive abilities, changes in oxygenated (HbO) and deoxygenated (Hb) hemoglobin concentrations over the prefrontal cortex, and functional connectivity via electroencephalography (EEG). METHODS All measurements according to the described technology were made before the start of training and one month later, right after it ended. The study involved middle-aged Indo-European men. Specifically, there were 14, 15, and 18 participants in the control, hypoxic, and EMS groups, respectively. RESULTS EMS training improved reactions and nonverbal memory but decreased attention scores. Functional connectivity decreased in the EMS group while it increased in the hypoxic group. A result of the interval normobaric hypoxic training (IHT) was significantly improved contextual memory, with a p-value = 0.08. CONCLUSIONS It was found that EMS training is more likely to cause stress on the body than positively affect cognitive functions. At the same time, interval hypoxic training can be considered a promising direction for increasing human productivity. The data obtained during the study can also help in the timely diagnosis of insufficient or overestimated indicators of biochemistry.
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Affiliation(s)
- Elizaveta Reganova
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS)б, University of Genoa, 16146 Genoa, Italy
- Functional Neurophysiology Laboratory, Autonomous Noncommercial Organization National Technology Initiative University 2035", 121205 Moscow, Russia
| | - Ksenia Solovyeva
- Functional Neurophysiology Laboratory, Autonomous Noncommercial Organization National Technology Initiative University 2035", 121205 Moscow, Russia
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, The Georgia State University, Atlanta, GA 30303, USA
| | - Dmitriy Buyanov
- Institute of Biomedical Systems, National Research University of Electronic Technology (MIET), Zelenograd, 124498 Moscow, Russia
- Medical Computer Systems Ltd., Zelenograd, 124460 Moscow, Russia
| | - Alexander Yu Gerasimenko
- Institute of Biomedical Systems, National Research University of Electronic Technology (MIET), Zelenograd, 124498 Moscow, Russia
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Dmitry Repin
- Improbability Foundation, Rue De-Candolle 19, CH-1205 Geneva, Switzerland
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Nishikawa Y, Sakaguchi H, Kawade S, Maeda N, Tanaka S, Hyngstrom A. Electrical muscle stimulation in young adults: effect of muscle volume on brain-derived neurotrophic factor levels. Eur J Appl Physiol 2023; 123:361-366. [PMID: 36301337 DOI: 10.1007/s00421-022-05078-z] [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: 09/09/2022] [Accepted: 10/18/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Electrical muscle stimulation (EMS) is known to be effective at stimulating brain-derived neurotrophic factor (BDNF) levels, but the relationship between the volume of muscle stimulated and BDNF levels is not clear. The purpose of this study was to quantify BDNF as a function of muscle volume stimulated in young adults. METHODS Twelve young adults (male, n = 9, age = 27.3 ± 5.5 years) were enrolled in this study. Participants completed three testing conditions in randomized order: 23 min of maximum tolerated bilateral stimulation of (1) the quadriceps muscle or (2) the musculature of the entire lower limbs and (3) control testing and retesting after 23 min without an intervention. Blood samples were collected before, immediately after, 20 min after, and 40 min after the intervention when EMS was applied to the thighs or the entire lower limb conditions. Serum obtained from blood collection was used for BDNF analysis. RESULTS The delta value of BDNF for the test and retest in the control condition was - 42.1 ± 73.8 pg/mL, and there was no significant difference between the test and retest BDNF. Compared to stimulation of the quadriceps muscle, stimulation of the entire lower limbs produced significantly higher BDNF at 20 min post-treatment than those at pre-treatment or 40 min post-treatment, and BDNF was also significantly higher immediately post-treatment than those at pre-treatment. Only stimulation of the quadriceps muscle did not induce a significant change between pre- and post-treatment. CONCLUSION Our findings suggest that the volume of muscle stimulation is important for increased BDNF.
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Affiliation(s)
- Yuichi Nishikawa
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kakuma-Machi, Kanazawa, 920-1192, Japan.
| | - Hiroyuki Sakaguchi
- Graduate School of Frontier Engineering, Kanazawa University, Kanazawa, Japan
| | | | - Noriaki Maeda
- Division of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinobu Tanaka
- Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kakuma-Machi, Kanazawa, 920-1192, Japan
| | - Allison Hyngstrom
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
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9
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F-waves induced by motor point stimulation are facilitated during handgrip and motor imagery tasks. Exp Brain Res 2023; 241:527-537. [PMID: 36622384 DOI: 10.1007/s00221-022-06537-x] [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: 07/27/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Abstract
The F-wave is a motor response elicited via the antidromic firings of motor nerves by the electrical stimulation of peripheral nerves, which reflects the motoneuron pool excitability. However, the F-wave generally has low robustness i.e., low persistence and small amplitude. We recently found that motor point stimulation (MPS), which provides the muscle belly with electrical stimulation, shows different neural responses compared to nerve stimulation, e.g., MPS elicits F-waves more robustly than nerve stimulation. Here, we investigated whether F-waves induced by MPS can identify changes in motoneuron pool excitability during handgrip and motor imagery. Twelve participants participated in the present study. We applied MPS on their soleus muscle and recorded F-waves during eyes-open (EO), eyes-closed (EC), handgrip (HG), and motor imagery (MI) conditions. In the EO and EC conditions, participants relaxed with their eyes open and closed, respectively. In the HG, participants matched the handgrip force level to 30% of the maximum voluntary force with visual feedback. In the MI, they performed kinesthetic MI of plantarflexion at the maximal strength with closed eyes. In the HG and MI, the amplitudes of the F-waves induced by MPS were increased compared with those in the EO and EC, respectively. These results indicate that the motoneuron pool excitability was facilitated during the HG and MI conditions, consistent with findings in previous studies. Our findings suggest that F-waves elicited by MPS can be a good tool in human neurophysiology to assess the motoneuron pool excitability during cognitive and motor tasks.
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Thapa N, Yang JG, Bae S, Kim GM, Park HJ, Park H. Effect of Electrical Muscle Stimulation and Resistance Exercise Intervention on Physical and Brain Function in Middle-Aged and Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:101. [PMID: 36612423 PMCID: PMC9819342 DOI: 10.3390/ijerph20010101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
This study investigated the effectiveness of electrical muscle stimulation (EMS) with resistance exercise training (ERT) and resistance exercise training (RT) on physical and brain function in middle-aged and older women. Method: Forty-eight participants were randomly allocated into three groups: (i) ERT (n = 16), (ii) RT (n = 16), and (iii) control group (n = 16). The intervention session was 50 min long and performed three times/week for four weeks. The ERT group performed quadriceps setting, straight leg raises, and ankle pump exercises while constantly receiving EMS on their quadriceps muscle on both legs. The RT group performed the same exercise without EMS. Physical function was measured using skeletal muscle mass index (SMI), handgrip strength, gait speed, five times sit-to-stand test (FTSS) and timed up-and-go test (TUG). Brain function was assessed with electroencephalogram measurement of whole brain activity. Results: After four-week intervention, significant improvements were observed in SMI (p < 0.01), phase angle (p < 0.05), and gait speed (p < 0.05) in the ERT group compared to the control group. ERT also increased muscle strength (p < 0.05) and mobility in lower limbs as observed in FTSS and TUG tests (p < 0.05) at post-intervention compared to the baseline. In the ERT group, significant positive changes were observed in Beta1 band power, Theta band power, and Alpha1 band whole brain connectivity (p < 0.005) compared to the control group. Conclusions: Our findings showed that ERT can improve muscle and brain function in middle-aged and older adults during a four-week intervention program whereas significant improvements were not observed with RT. Therefore might be one of the feasible alternative intervention to RT for the prevention of muscle loss whilst improving brain function for middle-aged and older population.
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Affiliation(s)
- Ngeemasara Thapa
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Republic of Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Republic of Korea
| | - Ja-Gyeong Yang
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Republic of Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Republic of Korea
| | - Seongryu Bae
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Republic of Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Republic of Korea
| | - Gwon-Min Kim
- Medical Research Institute, Pusan National University, Busan 49241, Republic of Korea
| | - Hye-Jin Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Republic of Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Republic of Korea
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan 49315, Republic of Korea
- Laboratory of Smart Healthcare, Dong-A University, Busan 49315, Republic of Korea
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11
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Manuskiatti W, Nanchaipruek Y, Gervasio MK, Lektrakul N, Apinuntham C. Combination of monopolar 2 MHz radiofrequency and electrical multidirectional stimulation for reducing abdominal circumference and enhancing the muscle definition in subjects with overweight range body mass index. Lasers Surg Med 2022; 54:1198-1206. [PMID: 36183371 PMCID: PMC9828667 DOI: 10.1002/lsm.23606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/17/2022] [Accepted: 09/22/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND The popularity of noninvasive body contouring procedures has been steadily increasing in recent years, however, studies evaluating its effectiveness in individuals with overweight range body mass index (BMI) are limited. OBJECTIVE To evaluate the efficacy and safety of combined 2 MHz radiofrequency (RF) and electrical multidirectional stimulation (EMDS) for the improvement of the abdominal contour in subjects with overweight range BMI. METHODS Twelve participants with overweight range BMI (23.6-24.9 kg/m2 ) underwent a single RF treatment, followed by a series of six EMDS treatments. Follow-up assessments (abdominal circumference [AC] and skinfold thickness measurements) were scheduled 1, 2, and 3 months after the final session. RESULTS At 1 month after the final treatment, a 3.1% (2.6 ± 0.47 cm, mean ± SD) significant reduction in mean AC was observed (p ˂ 0.001) and a maximal skinfold thickness reduction of 14% (4.6 ± 1.1 mm) was also noted (p = 0.032). Transient dysesthesia lasting 2-3 hours after EMDS treatment was the most common adverse effect reported by 5 of 12 subjects (41.7%), with no other serious side effects. CONCLUSIONS Combined RF and EMDS treatments are safe and effective, yielding significant reductions in both AC and skinfold thickness in patients with overweight range BMI, causing only minimal and transient adverse effects.
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Affiliation(s)
- Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Yanisorn Nanchaipruek
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Mia Katrina Gervasio
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Nittaya Lektrakul
- Department of Radiology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Chalermkwan Apinuntham
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
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12
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Fernandes JA, Silva MLD, Trancho AC, Macedo JRDD, Martins HR, Silva PE. Assessment of neuromuscular electrical stimulation in critically ill patients: physical therapists’ knowledge and barriers to its use. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21003529032022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
ABSTRACT Transcutaneous neuromuscular electrical stimulation (NMES) is considered an important tool to prevent muscle mass and strength loss in patients admitted to intensive care units (ICU). This study aimed to evaluate physical therapists’ profile and knowledge of NMES and identify the main barriers to its use in ICUs. This observational cross-sectional study was conducted via a structured questionnaire created by the authors. It consisted of 12 objective questions to analyze physical therapists’ knowledge of NMES use in critically ill patients. Physical therapists were invited to participate in this study during an international symposium on NMES. In total, 56 physical therapists, with a mean age of 33.5±7.2 years and working an average of 9.7±7 years after graduation, completed the survey. Overall, 34 respondents worked in ICUs, of which only four (12%) reported regular NMES use in their ICUs. We found a low average of correct answers to our questionnaire (25%; 3/12). The main barriers reported to using NMES in ICUs were lack of knowledge (28; 50%) and equipment (24; 43%). The number of correct answers expert and non-expert physical therapists was not statistically significant (p=0.68). Thus, we observed participants’ poor knowledge of NMES use in critically ill patients. Respondents showed that NMES has been underused in their ICUs. Lack of knowledge and equipment seems to be the main barriers for the use of NMES in ICUs.
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Majdi JA, Acuña SA, Chitnis PV, Sikdar S. Toward a wearable monitor of local muscle fatigue during electrical muscle stimulation using tissue Doppler imaging. WEARABLE TECHNOLOGIES 2022; 3:e16. [PMID: 38486895 PMCID: PMC10936279 DOI: 10.1017/wtc.2022.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/26/2022] [Accepted: 06/12/2022] [Indexed: 03/17/2024]
Abstract
Electrical muscle stimulation (EMS) is widely used in rehabilitation and athletic training to generate involuntary muscle contractions. However, EMS leads to rapid muscle fatigue, limiting the force a muscle can produce during prolonged use. Currently available methods to monitor localized muscle fatigue and recovery are generally not compatible with EMS. The purpose of this study was to examine whether Doppler ultrasound imaging can assess changes in stimulated muscle twitches that are related to muscle fatigue from electrical stimulation. We stimulated five isometric muscle twitches in the medial and lateral gastrocnemius of 13 healthy subjects before and after a fatiguing EMS protocol. Tissue Doppler imaging of the medial gastrocnemius recorded muscle tissue velocities during each twitch. Features of the average muscle tissue velocity waveforms changed immediately after the fatiguing stimulation protocol (peak velocity: -38%, p = .022; time-to-zero velocity: +8%, p = .050). As the fatigued muscle recovered, the features of the average tissue velocity waveforms showed a return towards their baseline values similar to that of the normalized ankle torque. We also found that features of the average tissue velocity waveform could significantly predict the ankle twitch torque for each participant (R2 = 0.255-0.849, p < .001). Our results provide evidence that Doppler ultrasound imaging can detect changes in muscle tissue during isometric muscle twitch that are related to muscle fatigue, fatigue recovery, and the generated joint torque. Tissue Doppler imaging may be a feasible method to monitor localized muscle fatigue during EMS in a wearable device.
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Affiliation(s)
- Joseph A. Majdi
- Department of Bioengineering, George Mason University, Fairfax, Virginia, USA
- Center for Adaptive Systems of Brain–Body Interactions, George Mason University, Fairfax, Virginia, USA
| | - Samuel A. Acuña
- Department of Bioengineering, George Mason University, Fairfax, Virginia, USA
- Center for Adaptive Systems of Brain–Body Interactions, George Mason University, Fairfax, Virginia, USA
| | - Parag V. Chitnis
- Department of Bioengineering, George Mason University, Fairfax, Virginia, USA
- Center for Adaptive Systems of Brain–Body Interactions, George Mason University, Fairfax, Virginia, USA
| | - Siddhartha Sikdar
- Department of Bioengineering, George Mason University, Fairfax, Virginia, USA
- Center for Adaptive Systems of Brain–Body Interactions, George Mason University, Fairfax, Virginia, USA
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Design and fast-fabrication of a system for functional electrical stimulation in upper limb of people with tetraplegia. Spinal Cord Ser Cases 2022; 8:54. [PMID: 35568701 PMCID: PMC9107485 DOI: 10.1038/s41394-022-00519-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Proof of concept. OBJECTIVES Standard Functional Electrical Stimulation (FES) systems can enhance motor learning in people with tetraplegia and are widely delivered by self-adhesive electrodes. Their limitations are dexterity, specific knowledge to place the electrodes on muscles, need to fix electrodes when they lose the gel layer, and time. We designed a new FES system, using an existing protocol of drinking-like movements, to the upper limb of a person with tetraplegia C5 that fits in any anthropometry and can be easily produced. Furthermore, we tested the system to assess its effectiveness and users' perception during FES rehabilitation. SETTING São Carlos, SP, Brazil. METHODS A shell was designed with parametric design and fast-fabrication methods, and a stimulation unit and a smartphone application were developed. Questionnaires assessed the perceptions of a patient and a physiotherapist, about the usability of the new system in relation to standard FES. Kinematic data of drinking-like movements were collected from the patient wearing both systems and compared with data from an aged-matched control subject. RESULTS The results are a personalized shell and an intuitive FES system, overcoming the limitations of standard FES. The new system suggested better wrist-flexion control shown by the mean angles (-18.93°), then the other system (-59.35°), and compared with the control (-10.97°). CONCLUSIONS Fast-fabrication with parametric design offers a promising alternative for personalizing FES systems, with potential for home use. Further studies are required including randomized clinical trials.
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15
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Kaneko N, Fok KL, Nakazawa K, Masani K. Motor point stimulation induces more robust F-waves than peripheral nerve stimulation. Eur J Neurosci 2022; 55:1614-1628. [PMID: 35178805 DOI: 10.1111/ejn.15625] [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: 08/20/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 11/27/2022]
Abstract
The F-wave is a motor response induced by electrical stimulation of peripheral nerves via the antidromic firing of motor nerves, which reflects the motoneuron excitability. To induce F-waves, transcutaneous peripheral nerve stimulation (PNS) is used, which activates nerve branches via transcutaneous electrodes over the nerve branches. An alternative method to activate peripheral nerves, i.e., motor point stimulation (MPS) which delivers electrical stimulation over the muscle belly, has not been used to induce F-waves. In our previous studies, we observed that MPS induced F-wave like responses, i.e., motor responses at the latency of F-waves at a supramaximal stimulation. Here we further investigated the F-wave like responses induced by MPS in comparison to PNS in the soleus muscle. Thirteen individuals participated in this study. We applied MPS and PNS on the participant's left soleus muscle. Using a monopolar double-pulse stimulation, the amplitude of the second H-reflex induced by PNS decreased, while the amplitude of the motor response at the F-wave latency induced by MPS did not decrease. These results suggest that the motor response at the F-wave latency induced by MPS was not an H-reflex but an F-wave. We also found that the F-wave induced by MPS had a greater amplitude, higher persistence, and caused less pain when compared to the F-waves induced using PNS. We conclude that MPS evokes antidromic firing inducing F-waves more consistently compared to PNS.
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Affiliation(s)
- Naotsugu Kaneko
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kai Lon Fok
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Kimitaka Nakazawa
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kei Masani
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Rahimian Bougar M, Veiskarami HA, Khodarahimi S, Izadpanah A, Sadeghi M, Nazari N. Effectiveness of Three Physical Treatments on Pain Perception and Emotional State in Males with Chronic Joint Pain. J Clin Psychol Med Settings 2022; 29:785-797. [DOI: 10.1007/s10880-021-09835-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 10/19/2022]
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17
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Klika AK, Yakubek G, Piuzzi N, Calabrese G, Barsoum WK, Higuera CA. Neuromuscular Electrical Stimulation Use after Total Knee Arthroplasty Improves Early Return to Function: A Randomized Trial. J Knee Surg 2022; 35:104-111. [PMID: 32610358 DOI: 10.1055/s-0040-1713420] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Neuromuscular electrical stimulation (NMES) has been reported as an effective method for quadriceps strengthening which could attenuate muscle loss in the early total knee arthroplasty (TKA) postoperative recovery period. The purpose of this randomized controlled trial was to test whether postoperative use of NMES on TKA patients results in increased quadriceps strength and ultimately improved functional outcomes. This randomized controlled clinical trial of 66 primary TKA patients was conducted at a large academic medical center. Patients were randomized 2:1 into treatment (NMES use, n = 44) or control arm (no NMES, n = 22). Patients who used the device for an average of 200 minutes/week or more (starting 1 week postoperative and continuing through week 12) were considered compliant. Baseline measurements and outcomes were recorded at 3, 6, and 12 weeks postoperatively, and included quadriceps strength, range of motion (ROM), resting pain, functional timed up and go (TUG), stair climb test, and knee injury and osteoarthritis outcome score (KOOS) and veterans rand 12-item health survey (VR-12) scores. Patients in the treatment arm (NMES use) experienced quadriceps strength gains over baseline at 3, 6, and 12 weeks following surgery, which were statistically significant compared with controls with quadriceps strength losses at 3 (p = 0.050) and 6 weeks (p = 0.015). The TUG improvements for patients treated with NMES showed significant improvements at 6 (p = 0.018) and 12 weeks (p = 0.003) postoperatively. Use of a home-based application-controlled NMES therapy system added to standard of care treatment showed statistically significant improvements in quadriceps strength and TUG following TKA, supporting a quicker return to function.
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Affiliation(s)
- Alison K Klika
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - George Yakubek
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Nicholas Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Gary Calabrese
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
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Korres G, Park W, Eid M. A Comparison of Vibrotactile Feedback and Electrical Muscle Stimulation (EMS) for Motor Response During Active Hand Movement. IEEE TRANSACTIONS ON HAPTICS 2022; 15:74-78. [PMID: 35077368 DOI: 10.1109/toh.2022.3142442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Wearable haptic technologies have garnered recent widespread attention due to increased accessibility, functionality, and affordability. These systems typically provide haptic feedback to augment the human ability to interact with their environment. This study compares two haptic feedback modalities, vibrotactile and EMS, against visual feedback to elicit a motor response during active hand movement. Forty-five participants, divided into three groups, performed a task to touch their face and received one of three possible sensory feedback cues, namely visual, vibrotactile, and electrical muscle stimulation (EMS), to interrupt their movement and avoid touching their face. Two quantitative performance measures are used in the comparison, the response time (time elapsed from stimulation to motor response) and the error rate (percentage that the user fails to avoid touching their face). Results showed that vibrotactile and EMS feedback yielded significantly faster response time than visual feedback, while no significant differences between vibrotactile and EMS were observed. Furthermore, the error rate was significantly lower for EMS compared to visual feedback, whereas no significant differences were observed between vibrotactile and visual feedback. In conclusion, it seems that EMS feedback is preferable for applications where errors are not tolerable (critical medical applications), whereas vibrotactile is superior for non-critical applications due to its low cost and higher usability (more pleasant compared to EMS).
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Sakugawa RL, Orssatto LBR, Sampaio LT, de Brito Fontana H, Diefenthaeler F. Pressure on the electrode to reduce discomfort during neuromuscular electrical stimulation in individuals with different subcutaneous-fat thickness: is the procedure effective and reliable? IEEE Trans Neural Syst Rehabil Eng 2021; 30:1-7. [PMID: 34941513 DOI: 10.1109/tnsre.2021.3138202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The addition of manual pressure on the electrode during neuromuscular electrical stimulation (NMES) has been used to reduce current intensity and perceived discomfort. In this study we aimed to test i) whether this approach affect the reliability of commonly made torque output measurements and ii) whether subcutaneous-fat thickness influence the efficacy of this approach in reducing current intensity and perceived discomfort. Twenty-one men (24±3.1 years) performed knee extension maximal voluntary isometric contractions with and without manual pressure on the NMES femoral nerve electrode (superimposed and resting doublets, 2 pulses at 100 Hz) during two separate sessions. Torque output was measured in an isokinetic dynamometer and thigh subcutaneous-fat thickness assessed with ultrasonography. A scale of perceived discomfort was presented after contractions. Reductions in current intensity (p<0.001) and discomfort during superimposed doublet (p=0.002) and resting doublet (p=0.002) were confirmed for the condition in which pressure was applied to the electrode. Fat thickness was correlated to changes in current intensity (r=0.63; p=0.002) and changes in discomfort (r=0.45; p=0.04) and no differences between pressure conditions and testing sessions were observed for torque output (p>0.05; ICC 0.95). Adding manual pressure during NMES on femoral nerve reduces discomfort and the maximal NMES intensity required to reach maximum torque without affecting torque output magnitude and reliability. Greater reduction in intensity and discomfort were observed in participants with higher subcutaneous-fat thickness levels after adding pressure on the electrode.
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20
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Vaz MA, Fröhlich M, Júnior DPDS, Schildt A, Thomé PRO, Muller AF, Tondin BR, Sbruzzi G, Maffiuletti NA, Sanches PRS. Development and reliability of a new system for bedside evaluation of non-volitional knee extension force. Med Eng Phys 2021; 98:28-35. [PMID: 34848035 DOI: 10.1016/j.medengphy.2021.10.007] [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: 11/05/2020] [Revised: 08/31/2021] [Accepted: 10/11/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Neuromuscular electrical stimulation (NMES) is a widely-used technique for diagnostic and therapeutic purposes. Here we developed and tested the reliability of a new NMES-dynamometer system for bedside evaluation of knee extensor muscle function. MATERIALS AND METHODS Thirty-two healthy participants (16 men, 16 women; 27±5 years) completed two testing sessions, 7 days apart. On day 1, a single experienced rater, who repeated the evaluation on day 2 with two other raters, completed a standardized testing procedure. Participants were placed supine, with knees flexed and legs connected to the dynamometer. Maximal voluntary knee extensor isometric force (MVF) and supramaximal twitch force (TwF) were obtained. RESULTS High intra-rater intraclass correlation coefficients were observed for both MVF (0.91) and TwF (0.94). MVF and TwF standard error of measurements (8.2%, 5.9%) and minimal detectable changes (16%, 11.6%) were low compared to mean values. High intraclass correlation coefficients were also observed for inter-rater comparisons of MVF (0.89) and TwF (0.86). Standard errors of measurements (MVF: 8.7%, TwF: 5.5%) and minimal detectable changes (MVF: 17.2%, TwF: 10.8%) were similar to intra-rater comparisons. CONCLUSION The good reliability of the novel NMES-dynamometer system suggests it as an appropriate tool for the bedside evaluation of knee extensor muscle function.
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Affiliation(s)
- Marco Aurélio Vaz
- School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Matias Fröhlich
- School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Danton Pereira da Silva Júnior
- Biomedical Engineering Research and Development Service of the Porto Alegre's Clinical Hospital, Porto Alegre, RS, Brazil
| | - Alessandro Schildt
- Biomedical Engineering Research and Development Service of the Porto Alegre's Clinical Hospital, Porto Alegre, RS, Brazil
| | - Paulo Ricardo Oppermann Thomé
- Biomedical Engineering Research and Development Service of the Porto Alegre's Clinical Hospital, Porto Alegre, RS, Brazil
| | - André Frotta Muller
- Biomedical Engineering Research and Development Service of the Porto Alegre's Clinical Hospital, Porto Alegre, RS, Brazil
| | - Bruno Rodriguez Tondin
- Biomedical Engineering Research and Development Service of the Porto Alegre's Clinical Hospital, Porto Alegre, RS, Brazil
| | - Graciele Sbruzzi
- School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Paulo Roberto Stefani Sanches
- Biomedical Engineering Research and Development Service of the Porto Alegre's Clinical Hospital, Porto Alegre, RS, Brazil
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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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Fagoni N, Ferretti G, Piva S, Barbieri S, Rasulo F, Latronico N, Gobbo M. A reappraisal of the strength-duration test to assess neuromuscular impairment of critically ill patients. J Electromyogr Kinesiol 2021; 59:102555. [PMID: 34000696 DOI: 10.1016/j.jelekin.2021.102555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Neuromuscular impairment (NMI) affects almost half of critically ill patients. The purpose was to investigate the role of neuromuscular electrical stimulation (NMES) to gain more insight into the nature of the NMI associated with ICU admission. To this aim, we analyzed the strength-duration (S-D) curves of the rectus femoris muscles of ICU patients compared to healthy volunteers. METHODS S-D curves were recorded from 44 healthy volunteers and 29 ICU patients. Three electrophysiological parameters were used to classify the neuromuscular function, from grade 0 (normal function), to grade 3 (no evocable muscle contraction). ICU patients underwent electroneurographic peroneal nerve testing (PENT) to analyze NMI by electroneurography (ENG). RESULTS Three patients were classified as Grade 0; nine as mild NMI (Grade 1), 13 as Grade 2, and four showed unexcitable muscles (Grade 3). Mean CMAP amplitudes were 6.1, 3.4, 2.9 and 0.81 mV from Grade 0 to Grade 3, respectively. CMAP was inversely correlated to NMI grade (-1.7 mV, R2 = 0.946, p < 0.05). CONCLUSIONS The normative parameters of the S-D curves obtained by NMES in healthy volunteers allowed identification of NMI in ICU patients. NMES was an affordable tool to evaluate NMI in ICU patients, providing additional information to that obtained by ENG.
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Affiliation(s)
- Nazzareno Fagoni
- Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva, Switzerland; AAT Brescia, Azienda Regionale Emergenza Urgenza (AREU), ASST Spedali Civili di Brescia, Italy.
| | - Guido Ferretti
- Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva, Switzerland; Department of Molecular and Translational Medicine, University of Brescia, Italy; Laboratory of Integrative and Clinical Physiology (FCI lab), University of Brescia, Italy
| | - Simone Piva
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy; Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili of Brescia, Italy
| | - Silvia Barbieri
- Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili of Brescia, Italy
| | - Frank Rasulo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy; Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili of Brescia, Italy
| | - Nicola Latronico
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy; Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili of Brescia, Italy
| | - Massimiliano Gobbo
- Laboratory of Integrative and Clinical Physiology (FCI lab), University of Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Italy
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The Effect of Electrical Muscle Stimulation on Muscle Mass and Balance in Older Adults with Dementia. Brain Sci 2021; 11:brainsci11030339. [PMID: 33800054 PMCID: PMC8001595 DOI: 10.3390/brainsci11030339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/27/2021] [Accepted: 03/03/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Electrical muscle stimulation (EMS) is effective for increasing physical function. However, there is no evidence regarding the effects of EMS on muscle mass and physical function in older adults with dementia. The aim of the present study was to quantify the effects of EMS on muscle mass and balance in older adults with dementia. Methods: A total of 32 participants were randomly assigned to an intervention group (n = 16, age = 89.4 ± 4.8 years) and a control group (n = 16, age = 88.1 ± 5.2 years). Participants in the intervention group underwent a general rehabilitation program (20 min for three days/week) and an EMS intervention (23 min for three days/week) for 23 weeks. Participants in the control group underwent general rehabilitation only. The efficacy of EMS was evaluated by lower limb muscle mass, the Berg Balance Scale (BBS), and the functional independence measure (FIM). Results: Muscle mass was significantly increased in the intervention group after 12 weeks (p = 0.008), but average muscle mass in the control group did not change (p = 0.18). Participants in the control group showed a significant decrease in BBS after 12 weeks (p = 0.007), unlike those in the intervention group. Furthermore, there was a strong correlation between the mini-mental state examination (MMSE) results and the change in muscle mass, the BBS, and the FIM in the control group (p < 0.05). Conclusions: These findings suggest that EMS is a useful intervention for increasing muscle mass and maintaining balance function in older adults with dementia.
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25
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Kim K, Eun D, Jee YS. Higher Impulse Electromyostimulation Contributes to Psychological Satisfaction and Physical Development in Healthy Men. ACTA ACUST UNITED AC 2021; 57:medicina57030191. [PMID: 33668740 PMCID: PMC7996253 DOI: 10.3390/medicina57030191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/02/2022]
Abstract
Background and Objectives: This study investigated the various impulse effects of whole-body electromyostimulation (WB-EMS) on psychophysiological responses and adaptations. Materials and Methods: The participants included fifty-four men between 20 and 27 years of age who practiced isometric exercises for 20 min, three days a week, for 12 weeks while wearing WB-EMS suits, which enabled the simultaneous activation of eight muscle groups with three types of impulse intensities. Participants were allocated to one of four groups: control group (CON), low-impulse-intensity group (LIG), mid-impulse-intensity group (MIG), and high-impulse-intensity group (HIG). Psychophysiological conditions were measured at week 0, week 4, week 8, and week 12. Results: Compared with the CON, (1) three psychological conditions in LIG, MIG, and HIG showed positive tendencies every four weeks, and the analysis of covariance (ANCOVA) test revealed that body image (p = 0.004), body shape (p = 0.007), and self-esteem (p = 0.001) were significantly different among the groups. (2) Body weight, fat mass, body mass index, and percent fat in the CON showed decreasing tendencies, whereas those in LIG, MIG, and HIG showed a noticeable decrease, which revealed that there were significant differences among the groups. Specifically, a higher impulse intensity resulted in a greater increase in muscle mass. (3) Although there was no interaction effect in the abdominal visceral fat area, there were significant interactions in the abdominal subcutaneous fat (ASF) and total fat (ATF) areas. Both the ASF and ATF in the CON showed decreasing tendencies, whereas those in other groups showed a noticeable decrease. The ANCOVA revealed that the ASF (p = 0.002) and ATF (p = 0.001) were significantly different among the groups. In particular, the higher the impulse intensity, the greater the decrease in abdominal fat. Conclusions: This study confirmed that high-impulse-intensity EMS can improve psychophysiological conditions. In other words, healthy young adults felt that the extent to which their body image, body shape, and self-esteem improved depended on how intense their EMS impulse intensities were. The results also showed that higher levels of impulse intensity led to improved physical conditions.
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26
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Watanabe K, Takada T, Kawade S, Moritani T. Effect of exercise intensity on metabolic responses on combined application of electrical stimulation and voluntary exercise. Physiol Rep 2021; 9:e14758. [PMID: 33587340 PMCID: PMC7883830 DOI: 10.14814/phy2.14758] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/18/2021] [Accepted: 01/23/2021] [Indexed: 11/26/2022] Open
Abstract
The combined application of voluntary exercises and neuromuscular electrical stimulation (NMES) has been developed as a new type of exercise that can recruit motor units contributing to both aerobic and anaerobic energy metabolisms. We aimed to investigate the effect of voluntary exercise intensity on metabolic responses on the combination of voluntary exercise and NMES. In 13 volunteers, oxygen consumption and the blood lactate concentration were measured during (1) voluntary pedaling exercise at four different intensities: 50%, 75%, 100%, and 125% of the ventilatory threshold (VT) (VOL), (2) these voluntary exercises with superimposed NMES applied to the gluteus and thigh muscles (VOL+NMES), and (3) NMES only (NMES). Oxygen consumption and the blood lactate concentration in VOL+NMES were significantly greater than VOL at each exercise intensity (p < 0.05). Differences in oxygen consumption between VOL+NMES and VOL decreased with exercise intensity, and that at 125% VT was significantly lower than the net gain in oxygen consumption following NMES (p < 0.05). Differences in the blood lactate concentration between VOL+NMES and VOL increased with exercise intensity, and that at 50% VT was significantly lower than the net gain in the blood lactate concentration following NMES (p < 0.05). Our results suggest that voluntary exercise intensity has a critical impact on metabolic responses during the combined application of voluntary exercises and NMES. Superimposing NMES onto voluntary exercises at high exercise intensities may induce overlapping recruitment of motor units, leading to a markedly reduced benefit of additional metabolic responses on its superimposition.
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Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, Faculty of Liberal Arts and Sciences and School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | | | | | - Toshio Moritani
- School of Health and Sport Sciences, Chukyo University, Toyota, Japan.,Faculty of Sociology, Kyoto Sangyo University, Kyoto, Japan
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27
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Park HK, Na SM, Choi SL, Seon JK, Do WH. Physiological Effect of Exercise Training with Whole Body Electric Muscle Stimulation Suit on Strength and Balance in Young Women: A Randomized Controlled Trial. Chonnam Med J 2021; 57:76-86. [PMID: 33537223 PMCID: PMC7840343 DOI: 10.4068/cmj.2021.57.1.76] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022] Open
Abstract
Many studies about Electrical muscle stimulation (EMS) have been performed to determine the effectiveness of EMS. However, most studies enrolled only elderly patients. Moreover, only a few studies have verified the effect of a whole body (WB)-EMS suit on young healthy women. Thus, the main purpose of this study was to verify the physiological effects of exercise training with a WB-EMS suit in young women. During the study periods, 24 young women were randomly assigned into two groups: 1) the WB-EMS training group, and 2) the control. All participants in the two groups performed the same low-intensity resistance exercise three times a week for 6 weeks at a training center. Group 1 used an electric current for WB-EMS suit which was switched on during the exercise period. Outcome measures were body composition, body circumference of hips and abdomen, isokinetic muscle function of knees, balance functions, Magnetic resonance imaging (MRI)s, cardiopulmonary functions, and lipid profiles. All outcomes were measured before and after the exercise protocol over 6 weeks. A total of 23 young women (group 1, n=11; group 2, n=12) completed a 6-week exercise regimen. After exercise, we compared the differences before and after the exercise program in each group. There were significant differences (p≤0.05) in body circumference, cardiopulmonary function in group 1 and 2. In particular, group 1 that activated WB-EMS showed significant differences in the isokinetic muscle function on knee flexors and balance functions. The results of this study show that exercise with a WB-EMS suit can be considered as an effective exercise addition for young women.
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Affiliation(s)
- Hyeng-Kyu Park
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Seung Min Na
- Center for Joint Diseases, Chonnam National Univerity Bitgoeul Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Se-Lin Choi
- Department of Clothing and Textiles, Healthcare Ware Research and Business Development Center, Chonnam National University, Gwangju, Korea
| | - Jong-Keun Seon
- Center for Joint Diseases, Chonnam National Univerity Bitgoeul Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Wol-Hee Do
- Department of Clothing and Textiles, Healthcare Ware Research and Business Development Center, Chonnam National University, Gwangju, Korea
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28
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Létocart A, Grosset JF. Achilles Tendon Adaptation to Neuromuscular Electrical Stimulation: Morphological and Mechanical Changes. Int J Sports Med 2020; 42:651-661. [PMID: 33285575 DOI: 10.1055/a-1270-7568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
It remains unclear whether neuromuscular electrical stimulation can induce sufficient tendon stress to lead to tendon adaptations. Thus, we investigated the effect of such a training program on the triceps surae muscle following the morphological and mechanical properties of the Achilles tendon. Eight men participated in a 12-week high-frequency neuromuscular electrical stimulation training program of the triceps surae muscle under isometric conditions. Ultrasonography was used pre- and post-intervention to quantify cross-sectional area, free length, and total length of the Achilles tendon, as well as the myotendinous junction elongation during a maximal isometric ramp contraction under plantar flexion. Neuromuscular electrical stimulation training does not lead to changes in Achilles tendon free and total length, cross-sectional area, or maximal elongation capacity. However, a significant increase was evidenced in maximal tendon force post-training (+25.2%). Hence, Young's Modulus and maximal stress were significantly greater after training (+12.4% and +23.4%, respectively). High-frequency neuromuscular electrical stimulation training induces repeated stress sufficient to lead to adaptations of mechanical properties of the Achilles tendon. Thus, this training technique may be of particular interest as a new rehabilitation method in tendinopathy management or to counteract the effect of hypo-activity.
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29
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Nishikawa Y, Watanabe K, Takahashi T, Maeda N, Maruyama H, Kimura H. The effect of electrical muscle stimulation on quadriceps muscle strength and activation patterns in healthy young adults. Eur J Sport Sci 2020; 21:1414-1422. [PMID: 33059519 DOI: 10.1080/17461391.2020.1838617] [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] [Indexed: 10/23/2022]
Abstract
AbstractThe aim of the present study was to clarify the effect of electrical muscle stimulation (EMS) on the spatial distribution pattern of electromyographic activity in healthy young adults using multi-channel surface electromyography (SEMG). A total of 32 men (age = 21-26 years) were randomly assigned to the intervention group (n = 18) and control group (n = 14). Participants in the intervention group performed EMS to stimulate the bilateral lower limb muscle for four weeks (20 min/3 days/week). The control group received no EMS intervention. To understand the effects of EMS, the following measurements were made at baseline and four weeks: knee extension torque, muscle mass, and spatial distribution of neuromuscular activation during a target torques [10%, 30%, 50%, and 70% of the maximal voluntary contraction (MVC)] using multi-channel SEMG. The knee extension torque was significantly increased in intervention group compared with control group (p < 0.0001). However, the muscle mass did not show a significant difference between pre and post intervention in each group. The muscle activation patterns of 50% and 70% MVC task showed significant enhancement between baseline and four weeks in the intervention group. Furthermore, a moderate correlation between Δ knee extension torque and Δ spatial distribution pattern of electromyographic activity of 50% and 70% MVC in the intervention group was observed. These results suggested EMS intervention induced different distribution of muscle activity at high-intensity muscle contraction compared with low-intensity muscle contraction.
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Affiliation(s)
- Yuichi Nishikawa
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.,Faculty of Frontier Engineering, Institute of Science & Engineering, Kanazawa University, Kanazawa-shi, Japan
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya-shi, Japan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Noriaki Maeda
- Division of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroaki Kimura
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
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30
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Bong JH, Jung S, Park N, Kim SJ, Park S. Development of a Novel Robotic Rehabilitation System With Muscle-to-Muscle Interface. Front Neurorobot 2020; 14:3. [PMID: 32132916 PMCID: PMC7040493 DOI: 10.3389/fnbot.2020.00003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/14/2020] [Indexed: 11/24/2022] Open
Abstract
In this study, we developed a novel robotic system with a muscle-to-muscle interface to enhance rehabilitation of post-stroke patients. The developed robotic rehabilitation system was designed to provide patients with stage appropriate physical rehabilitation exercise and muscular stimulation. Unlike the position-based control of conventional bimanual robotic therapies, the developed system stimulates the activities of the target muscles, as well as the joint movements of the paretic limb. The robot-assisted motion and the electrical stimulation on the muscles of the paretic side are controlled by on-line comparison of the motion and the muscle activities between the paretic and unaffected sides. With the developed system, the rehabilitation exercise can be customized and modulated depending on the patient’s stage of motor recovery after stroke. The system can be operated in three different modes allowing both passive and active exercises. The effectiveness of the developed system was verified with healthy human subjects, where the subjects were paired to serve as the unaffected side and the paretic side of a hemiplegic patient.
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Affiliation(s)
- Jae Hwan Bong
- Department of Mechanical Engineering, Korea University, Seoul, South Korea
| | - Suhun Jung
- Department of Mechanical Engineering, Korea University, Seoul, South Korea
| | - Namji Park
- School of Dentistry, Seoul National University, Seoul, South Korea
| | - Seung-Jong Kim
- College of Medicine, Korea University, Seoul, South Korea
| | - Shinsuk Park
- Department of Mechanical Engineering, Korea University, Seoul, South Korea
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31
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Neuromuscular electrical stimulation in critically ill traumatic brain injury patients attenuates muscle atrophy, neurophysiological disorders, and weakness: a randomized controlled trial. J Intensive Care 2019; 7:59. [PMID: 31890221 PMCID: PMC6909464 DOI: 10.1186/s40560-019-0417-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/03/2019] [Indexed: 12/15/2022] Open
Abstract
Background Critically ill traumatic brain injury (TBI) patients experience extensive muscle damage during their stay in the intensive care unit. Neuromuscular electrical stimulation (NMES) has been considered a promising treatment to reduce the functional and clinical impacts of this. However, the time needed for NMES to produce effects over the muscles is still unclear. This study primarily aimed to assess the time needed and effects of an NMES protocol on muscle architecture, neuromuscular electrophysiological disorder (NED), and muscle strength, and secondarily, to evaluate the effects on plasma systemic inflammation, catabolic responses, and clinical outcomes. Methods We performed a randomized clinical trial in critically ill TBI patients. The control group received only conventional physiotherapy, while the NMES group additionally underwent daily NMES for 14 days in the lower limb muscles. Participants were assessed at baseline and on days 3, 7, and 14 of their stay in the intensive care unit. The primary outcomes were assessed with muscle ultrasound, neuromuscular electrophysiology, and evoked peak force, and the secondary outcomes with plasma cytokines, matrix metalloproteinases, and clinical outcomes. Results Sixty participants were randomized, and twenty completed the trial from each group. After 14 days, the control group presented a significant reduction in muscle thickness of tibialis anterior and rectus femoris, mean of - 0.33 mm (- 14%) and - 0.49 mm (- 21%), p < 0.0001, respectively, while muscle thickness was preserved in the NMES group. The control group presented a higher incidence of NED: 47% vs. 0% in the NMES group, p < 0.0001, risk ratio of 16, and the NMES group demonstrated an increase in the evoked peak force (2.34 kg/f, p < 0.0001), in contrast to the control group (- 1.55 kg/f, p < 0.0001). The time needed for the NMES protocol to prevent muscle architecture disorders and treat weakness was at least 7 days, and 14 days to treat NED. The secondary outcomes exhibited less precise results, with confidence intervals that spanned worthwhile or trivial effects. Conclusions NMES applied daily for fourteen consecutive days reduced muscle atrophy, the incidence of NED, and muscle weakness in critically ill TBI patients. At least 7 days of NMES were required to elicit the first significant results. Trial registration The trial was registered at ensaiosclinicos.gov.br under protocol RBR-8kdrbz on 17 January 2016.
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32
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Rinaldin CDP, Cabral LPA, Krueger E, Nogueira-Neto GN, Nohama P, Scheeren EM. Fatigue in complete spinal cord injury and implications on total delay. Artif Organs 2019; 44:305-313. [PMID: 31553061 DOI: 10.1111/aor.13573] [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] [Received: 02/13/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/11/2022]
Abstract
The use of neuromuscular electrical stimulation (NMES) to artificially restore movement in people with complete spinal cord injury (SCI) induces an accelerated process of muscle fatigue. Fatigue increases the time between the beginning of NMES and the onset of muscle force (DelayTOT ). Understanding how much muscle fatigue affects the DelayTOT in people with SCI could help in the design of closed-loop neuroprostheses that compensate for this delay, thus making the control system more stable. The aim of this study was to evaluate the impact of the extent of fatigue on DelayTOT and peak force of the lower limbs in people with complete SCI. Fifteen men-young adults with complete SCI (paraplegia and tetraplegia) and stable health-participated in the experiment. DelayTOT was defined as the time interval between the beginning of NMES application until the onset of muscle force. The electrical intensity of NMES applied was adjusted individually and consisted of the amplitude required to obtain a full extension of the knee (0°), considering the maximum electrically stimulated extension (MESE). Subsequently, 70% of the MESE was applied during the fatigue induction protocol. Significant differences were identified between the moments before and after the fatigue protocol, both for peak force (P ≤ .026) and DelayTOT (P ≤ .001). The medians and interquartile range of the DelayTOT were higher in postfatigue (199.0 ms) when compared to the moment before fatigue (146.5 ms). The medians and interquartile range of the peak force were higher in unfatigued lower limbs (0.43 kgf) when compared to the moment postfatigue (0.27 kgf). The results support the hypothesis that muscle fatigue influences the increase in DelayTOT and decrease in force production in people with SCI. For future applications, the combined evaluation of the delay and force in SCI patients provides valuable feedback for NMES paradigms. The study will provide potentially critical muscle mechanical evidence for the investigation of the evolution of atrophy.
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Affiliation(s)
| | - Luciane Patrícia Adreani Cabral
- Human Motricity Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil.,Regional University Hospital of Campos Gerais, Campus of Ponta Grossa State University, Ponta Grossa, Brazil
| | - Eddy Krueger
- Neural Engineering and Rehabilitation Laboratory, Master and Doctoral Program in Rehabilitation Sciences UEL-UNOPAR, Anatomy Department, State University of Londrina, Londrina, Brazil.,Rehabilitation Engineering Laboratory/CPGEI/PPGEB, Federal Technological University of Paraná (UTFPR), Curitiba, Brazil
| | - Guilherme N Nogueira-Neto
- Rehabilitation Engineering Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Percy Nohama
- Rehabilitation Engineering Laboratory/CPGEI/PPGEB, Federal Technological University of Paraná (UTFPR), Curitiba, Brazil.,Rehabilitation Engineering Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Eduardo M Scheeren
- Human Motricity Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
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A journey in the complex interactions between electrochemistry and bacteriology: From electroactivity to electromodulation of bacterial biofilms. Bioelectrochemistry 2019; 131:107401. [PMID: 31707278 DOI: 10.1016/j.bioelechem.2019.107401] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 02/06/2023]
Abstract
Although the term bioelectrochemistry tends to be associated with animal and human tissues, bioelectric currents exist also in plants and bacteria. Especially the latter, when agglomerated in the form of biofilms, can exhibit electroactivity and susceptibility to electrical stimulation. Therefore, electrochemical methods appear to become powerful techniques to expand the conventional strategies of biofilm characterization and modification. In this review, we aim to provide the insight into the electrochemical behaviour of bacteria and present the variety of electrochemical techniques that can be used either for the non-destructive monitoring of bacterial communities or modulation of their growth. The most common applications of electrical stimulation on biofilms are presented, including the prevention of bacterial growth by charging the surface of the materials, changing the direction of bacterial movement under the influence of the electric field and increasing of the potency of antibiotics when bactericides are coupled with the electric field. Also, the industrial applications of microbial electro-technologies are described, such as bioremediation, wastewater treatment, and microbial fuel cells. Consequently, we are showing the complexity of interactions that exist between electrochemistry and bacteriology that can be used for the benefit of these two disciplines.
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Carson RG, Buick AR. Neuromuscular electrical stimulation-promoted plasticity of the human brain. J Physiol 2019; 599:2375-2399. [PMID: 31495924 DOI: 10.1113/jp278298] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022] Open
Abstract
The application of neuromuscular electrical stimulation (NMES) to paretic limbs has demonstrated utility for motor rehabilitation following brain injury. When NMES is delivered to a mixed peripheral nerve, typically both efferent and afferent fibres are recruited. Muscle contractions brought about by the excitation of motor neurons are often used to compensate for disability by assisting actions such as the formation of hand aperture, or by preventing others including foot drop. In this context, exogenous stimulation provides a direct substitute for endogenous neural drive. The goal of the present narrative review is to describe the means through which NMES may also promote sustained adaptations within central motor pathways, leading ultimately to increases in (intrinsic) functional capacity. There is an obvious practical motivation, in that detailed knowledge concerning the mechanisms of adaptation has the potential to inform neurorehabilitation practice. In addition, responses to NMES provide a means of studying CNS plasticity at a systems level in humans. We summarize the fundamental aspects of NMES, focusing on the forms that are employed most commonly in clinical and experimental practice. Specific attention is devoted to adjuvant techniques that further promote adaptive responses to NMES thereby offering the prospect of increased therapeutic potential. The emergent theme is that an association with centrally initiated neural activity, whether this is generated in the context of NMES triggered by efferent drive or via indirect methods such as mental imagery, may in some circumstances promote the physiological changes that can be induced through peripheral electrical stimulation.
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Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin 2, Ireland.,School of Psychology, Queen's University Belfast, Belfast, BT7 1NN, UK.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison R Buick
- School of Psychology, Queen's University Belfast, Belfast, BT7 1NN, UK
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Klotz T, Gizzi L, Yavuz UŞ, Röhrle O. Modelling the electrical activity of skeletal muscle tissue using a multi-domain approach. Biomech Model Mechanobiol 2019; 19:335-349. [PMID: 31529291 DOI: 10.1007/s10237-019-01214-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/17/2019] [Indexed: 11/27/2022]
Abstract
Electromyography (EMG) can be used to study the behaviour of the motor neurons and thus provides insights into the physiology of the central nervous system. However, due to the high complexity of neuromuscular control, EMG signals are challenging to interpret. While the exact knowledge of the excitation patterns of a specific muscle within an in vivo experimental setting remains elusive, simulations allow to systematically investigate EMG signals in a controlled environment. Within this context, simulations can provide virtual EMG data, which, for example, can be used to validate and optimise signal analysis methods that aim to estimate the relationship between EMG signals and the output of motor neuron pools. However, since existing methods, which are employed to compute EMG signals, exhibit deficiencies with respect to the physical model itself as well as with respect to numerical aspects, we propose a novel homogenised continuum model that closely resolves the electro-physiological behaviour of skeletal muscle tissue. The proposed model is based on an extension of the well-established bidomain model and includes a biophysically detailed description of the electrical activity within the tissue, which is due to the depolarisation of the muscle fibre membranes. In contrast to all other published EMG models, which assume that the electrical potential field for each muscle fibre can be calculated independently, the proposed model assumes that the electrical potential in the muscle fibres is coupled to the electrical potential in the extracellular space. We show that the newly proposed model is able to simulate realistic EMG signals and demonstrate the potential to employ the predicted virtual EMG signal in order to evaluate the goodness of automated decomposition algorithms.
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Affiliation(s)
- Thomas Klotz
- Institute for Modelling and Simulation of Biomechanical Systems, Pfaffenwaldring 5a, 70569, Stuttgart, Germany. .,Stuttgart Centre for Simulation Science (SimTech), Pfaffenwaldring 5a, 70569, Stuttgart, Germany.
| | - Leonardo Gizzi
- Institute for Modelling and Simulation of Biomechanical Systems, Pfaffenwaldring 5a, 70569, Stuttgart, Germany.,Stuttgart Centre for Simulation Science (SimTech), Pfaffenwaldring 5a, 70569, Stuttgart, Germany
| | - Utku Ş Yavuz
- Institute for Modelling and Simulation of Biomechanical Systems, Pfaffenwaldring 5a, 70569, Stuttgart, Germany.,Biomedical Signals and Systems, Universiteit Twente, 7500AE, Enschede, Netherlands
| | - Oliver Röhrle
- Institute for Modelling and Simulation of Biomechanical Systems, Pfaffenwaldring 5a, 70569, Stuttgart, Germany.,Stuttgart Centre for Simulation Science (SimTech), Pfaffenwaldring 5a, 70569, Stuttgart, Germany
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Jee YS. The effect of high-impulse- electromyostimulation on adipokine profiles, body composition and strength: A pilot study. ISOKINET EXERC SCI 2019. [DOI: 10.3233/ies-183201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, #46 Hanseo 1-Ro, Haemi-myeon, Seosan 31962, Korea
- Department of Physical Activity Design, Hanseo University, #46 Hanseo 1-Ro, Haemi-myeon, Seosan 31962, Seosan, Korea
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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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Wiest MJ, Bergquist AJ, Heffernan MG, Popovic M, Masani K. Fatigue and Discomfort During Spatially Distributed Sequential Stimulation of Tibialis Anterior. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1566-1573. [PMID: 31265401 DOI: 10.1109/tnsre.2019.2923117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Neuromuscular electrical stimulation is conventionally applied through a single pair of electrodes over the muscle belly, denominated single electrode stimulation (SES). SES is limited by discomfort and incomplete motor-unit recruitment, restricting electrically-evoked torque and promoting premature fatigue-induced torque-decline. Sequential stimulation involving rotation of pulses between multiple pairs of electrodes has been proposed as an alternative, denominated spatially distributed sequential stimulation (SDSS). The present aim was to compare discomfort, maximal-tolerated torque, and fatigue-related outcomes between SES and SDSS of tibialis anterior. Ten healthy participants completed two experimental sessions. The self-reported discomfort at sub-maximal torque, the maximal-tolerated torque, fatigue-induced torque-decline during, and doublet-twitch torque at 10- and 100-Hz before and after, 300 intermittent (0.6-s-ON-0.6-s-OFF) isokinetic contractions were compared between SES and SDSS. SDSS stimulation improved fatigue-related outcomes, whereas increased discomfort and reduced maximal-tolerated torque. SDSS holds promise for reducing fatigue. However, limited torque production and associated discomfort may limit its utility for rehabilitation/training.
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Nishikawa Y, Watanabe K, Kawade S, Takahashi T, Kimura H, Maruyama H, Hyngstrom A. The effect of a portable electrical muscle stimulation device at home on muscle strength and activation patterns in locomotive syndrome patients: A randomized control trial. J Electromyogr Kinesiol 2019; 45:46-52. [PMID: 30802718 DOI: 10.1016/j.jelekin.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/30/2019] [Accepted: 02/18/2019] [Indexed: 10/27/2022] Open
Abstract
The aim of the present study was to quantify the effect of electrical muscle stimulation (EMS) intervention using a portable device on muscle strength and activation patterns in locomotive syndrome. Nineteen women were randomly assigned to the intervention group (n = 10; age = 71-82 years) and control group (n = 9; age = 70-84 years). Participants in the intervention group used a portable EMS device to stimulate the bilateral quadriceps muscles for 8 weeks (23 min/5 days/week). To understand the effects of EMS, the following measurements were made at baseline, 8 weeks, and 12 weeks: locomotive syndrome assessment score, knee extensor strength, vastus lateralis muscle activation patterns during a maximal isometric knee extension contraction using multi-channel surface electromyography, and muscle thickness. The locomotive syndrome assessment, muscle strength, muscle thickness, and muscle activity patterns in the intervention group were significantly different to control after 8 weeks (p < 0.05). However, these results were not sustained at 12 weeks. EMS increased locomotor assessment scores, which were accompanied by enhanced muscle strength, increased muscle thickness, and changes in muscle activation patterns in locomotive syndrome patients. These results suggest that EMS is potentially useful for improving muscle neural activation and force output in locomotive syndrome.
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Affiliation(s)
- Yuichi Nishikawa
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan; Department of Physical Therapy, Marquette University, Milwaukee, United States.
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | | | - Tetsuya Takahashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroaki Kimura
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Allison Hyngstrom
- Department of Physical Therapy, Marquette University, Milwaukee, United States
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Palanova P, Mrkvicova V, Nedbalkova M, Sosikova M, Konecny P, Jarkovsky J, Marques E, Novakova M, Pohanka M, Soucek M, Dobsak P. Home‐based training using neuromuscular electrical stimulation in patients on continuous ambulatory peritoneal dialysis: A pilot study. Artif Organs 2019; 43:796-805. [DOI: 10.1111/aor.13421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/17/2018] [Accepted: 12/28/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Petra Palanova
- Institute of Public Health, Faculty of Medicine, Masaryk University Brno Czech Republic
| | - Veronika Mrkvicova
- Institute of Public Health, Faculty of Medicine, Masaryk University Brno Czech Republic
| | - Marta Nedbalkova
- 2nd Department of Internal Medicine, St. Anne´s Faculty Hospital Brno Czech Republic
| | - Michaela Sosikova
- Department of Sports Medicine and Rehabilitation, St. Anne´s Faculty Hospital Brno Czech Republic
| | - Petr Konecny
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University Brno Czech Republic
| | - Jiri Jarkovsky
- Institute of Biological Analyses, Faculty of Medicine, Masaryk University Brno Czech Republic
| | - Emanuel Marques
- Department of Dermatovenerology, Hospital na Bulovce Prague Czech Republic
| | - Marie Novakova
- Institute of Physiology, Faculty of Medicine, Masaryk University Brno Czech Republic
| | - Michal Pohanka
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University Brno Czech Republic
| | - Miroslav Soucek
- 2nd Department of Internal Medicine, St. Anne´s Faculty Hospital Brno Czech Republic
| | - Petr Dobsak
- Department of Sports Medicine and Rehabilitation, St. Anne´s Faculty Hospital Brno Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University Brno Czech Republic
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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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O'Connor D, Caulfield B, Lennon O. The efficacy and prescription of neuromuscular electrical stimulation (NMES) in adult cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2018; 26:3985-4000. [PMID: 30022346 DOI: 10.1007/s00520-018-4342-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/06/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE This study aims to (1) summarise and critically evaluate the effects of neuromuscular electrical stimulation (NMES) on indices of health and quality of life (QoL) in adult cancer survivors, (2) assess the safety of NMES as a rehabilitation method in this population, and (3) identify commonly used NMES treatment parameters and describe treatment progression. METHODS A systematic search of four electronic databases targeted studies evaluating the effects of NMES on physical function, aerobic fitness, muscle strength, body composition, and health-related quality of life (HR-QoL) in adult cancer survivors, published through March 2018. Two reviewers independently reviewed and appraised the risk of bias of each study. RESULTS Nine studies were included. Meta-analyses found that the overall pooled effect favoured NMES for improving muscle strength, but the standardised mean difference was not significant (0.36; 95% CI - 0.25, 0.96). Further meta-analyses indicated that NMES significantly improved HR-QoL (0.36; 95% CI 0.10, 0.62), with notable gains identified under the subcategories QoL Function (0.87; 95% CI 0.32, 1.42). Current NMES prescription is not standardised and NMES is prescribed to target secondary complications of treatment. Risk of bias was high for most studies. CONCLUSIONS NMES use in adult cancer survivors is an emerging field and current literature is limited by studies of poor quality and a lack of adequately powered RCTs. Existing evidence suggests that NMES is safe and may be more effective than usual care for improving HR-QoL. Prescription and progression should be tailored for the individual based on functional deficits.
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Affiliation(s)
- Dominic O'Connor
- The Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin Belfield Campus, Dublin, Ireland.
- UCD School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Dublin, Ireland.
| | - Brian Caulfield
- The Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin Belfield Campus, Dublin, Ireland
| | - Olive Lennon
- UCD School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Dublin, Ireland
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Kimura T, Kaneko F, Iwamoto E, Saitoh S, Yamada T. Neuromuscular electrical stimulation increases serum brain-derived neurotrophic factor in humans. Exp Brain Res 2018; 237:47-56. [PMID: 30306243 DOI: 10.1007/s00221-018-5396-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/04/2018] [Indexed: 01/05/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) plays several important roles in nervous system function including neuronal growth and plasticity. The purpose of the present study was to clarify whether neuromuscular electrical stimulation (NMES) and voluntary exercise to the same integrated force as by the NMES-induced exercise would enhance serum BDNF. Eleven healthy male subjects completed three interventions (NMES, voluntary exercise, and resting interventions) for 20 min on different days. In the NMES intervention, NMES was applied to the quadriceps femoris muscles. The stimulus intensity of NMES was progressively increased to the highest tolerated intensity during the experiment. In the voluntary exercise intervention, subjects performed an isometric knee-extension task; in this intervention, the target torque was calculated in accordance with the integrated force of knee extension obtained during the NMES intervention. In the resting intervention, subjects relaxed in a sitting posture. We measured serum BDNF, blood lactate, heart rate, oxygen uptake, respiratory ratio, and blood pressure. Serum BDNF was increased in the NMES (p = 0.003) and voluntary exercise interventions (p = 0.004) after each intervention. At the post-timepoint, serum BDNF in the NMES intervention was highest among all interventions (p = 0.038) and significantly higher than in the voluntary exercise (p = 0.036) and resting (p = 0.037) interventions. Our results showed that NMES was more effective for enhancing serum BDNF than voluntary exercise at least when employing the same method and integrated force.
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Affiliation(s)
- Takehide Kimura
- Graduate School of Health Sciences, Sapporo Medical University, W17-S1 Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan.,Shinoro Orthopedic Hospital, Shinoro 4-5-3-9, Kita-ku, Sapporo, 002-8024, Hokkaido, Japan.,Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, 6-8-33 Manabe, Tsuchiura, 300-0051, Ibaraki, Japan
| | - Fuminari Kaneko
- First Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, W17-S1 Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan. .,Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. .,Shonan Keiiku Hospital, 4360 Endo, Fujisawa, Kanagawa, 252-0816, Japan.
| | - Erika Iwamoto
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, W17-S1 Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Shigeyuki Saitoh
- Department of Nursing, School of Health Sciences, Sapporo Medical University, W17-S1 Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan.,Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, W17-S1 Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Takashi Yamada
- First Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, W17-S1 Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
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The use of neuromuscular electrical stimulation (NMES) for managing the complications of ageing related to reduced exercise participation. Maturitas 2018; 113:13-20. [DOI: 10.1016/j.maturitas.2018.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 12/17/2022]
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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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Natsume T, Ozaki H, Kakigi R, Kobayashi H, Naito H. Effects of training intensity in electromyostimulation on human skeletal muscle. Eur J Appl Physiol 2018; 118:1339-1347. [PMID: 29679248 DOI: 10.1007/s00421-018-3866-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/13/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE High-intensity neuromuscular electrical stimulation (NMES) training can induce muscle hypertrophy at the whole muscle and muscle fiber levels. However, whether low-intensity NMES training has a similar result is unknown. This study aimed to investigate whether low-intensity NMES training could elicit muscle hypertrophy at the whole muscle and muscle fiber levels in the human skeletal muscle. METHODS Eight untrained young males were subjected to 18 min of unilateral NMES training for 8 weeks. One leg received NMES at maximal tolerable intensity (HIGH); the other leg received NMES at an intensity half of that in the HIGH condition (LOW). Quadriceps muscle thickness (MT), muscle fiber cross-sectional area (CSA), and knee extension strength were measured before and after the training period. RESULTS The average training intensity throughout the intervention period in the HIGH and LOW conditions were 62.5 ± 4.6% maximal voluntary contraction (MVC) and 32.6 ± 2.6% MVC, respectively. MT, CSA, and muscle strength increased in both exercise conditions (p < 0.05); however, training effects in the LOW condition were lower than those in the HIGH condition (p < 0.05). The average training intensity showed a positive correlation with percent changes in muscle strength (r = 0.797, p = 0.001), MT (r = 0.876, p = 0.001), type I fiber CSA (r = 0.730, p = 0.01), and type II fiber CSA (r = 0.899, p = 0.001). CONCLUSIONS Low-intensity NMES could increase MT, muscle fiber CSA, and muscle strength in healthy human skeletal muscles. However, the magnitude of increase is lower in low-intensity than in high-intensity NMES training.
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Affiliation(s)
- Toshiharu Natsume
- Institute of Health and Sports Science & Medicine, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba, 270-1695, Japan.
| | - Hayao Ozaki
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba, 270-1695, Japan
| | - Ryo Kakigi
- School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroyuki Kobayashi
- Department of General Medicine, Mito Medical Center, Tsukuba University Hospital, 3-2-7 Miyamachi, Mito, Ibaraki, 310-0015, Japan
| | - Hisashi Naito
- Institute of Health and Sports Science & Medicine, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba, 270-1695, Japan
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba, 270-1695, Japan
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48
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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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49
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Hybrid FES–robotic gait rehabilitation technologies: a review on mechanical design, actuation, and control strategies. INTERNATIONAL JOURNAL OF INTELLIGENT ROBOTICS AND APPLICATIONS 2018. [DOI: 10.1007/s41315-017-0042-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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50
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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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