1
|
Dukkipati SS, Walker SJ, Trevarrow MP, Busboom M, Baker SE, Kurz MJ. Reduced wrist flexor H-reflex excitability is linked with increased wrist proprioceptive error in adults with cerebral palsy. Front Neurol 2022; 13:930303. [PMID: 36016542 PMCID: PMC9396222 DOI: 10.3389/fneur.2022.930303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Although most neurophysiological studies of persons with cerebral palsy (CP) have been focused on supraspinal networks, recent evidence points toward the spinal cord as a central contributor to their motor impairments. However, it is unclear if alterations in the spinal pathways are also linked to deficits in the sensory processing observed clinically. This investigation aimed to begin to address this knowledge gap by evaluating the flexor carpi radialis (FCR) H-reflex in adults with CP and neurotypical (NT) controls while at rest and during an isometric wrist flexion task. The maximal H-wave (Hmax) and M-wave (Mmax) at rest were calculated and utilized to compute Hmax/Mmax ratios (H:M ratios). Secondarily, the facilitation of the H-wave was measured while producing an isometric, voluntary wrist flexion contraction (i.e., active condition). Finally, a wrist position sense test was used to quantify the level of joint position sense. These results revealed that the adults with CP had a lower H:M ratio compared with the NT controls while at rest. The adults with CP were also unable to facilitate their H-reflexes with voluntary contraction and had greater position sense errors compared with the controls. Further, these results showed that the adults with CP that had greater wrist position sense errors tended to have a lower H:M ratio at rest. Overall, these findings highlight that aberration in the spinal cord pathways of adults with CP might play a role in the sensory processing deficiencies observed in adults with CP.
Collapse
Affiliation(s)
- S. Shekar Dukkipati
- Boys Town National Research Hospital, Omaha, NE, United States
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Sarah J. Walker
- Boys Town National Research Hospital, Omaha, NE, United States
| | | | - Morgan Busboom
- Boys Town National Research Hospital, Omaha, NE, United States
| | - Sarah E. Baker
- Boys Town National Research Hospital, Omaha, NE, United States
| | - Max J. Kurz
- Boys Town National Research Hospital, Omaha, NE, United States
- School of Medicine, Creighton University, Omaha, NE, United States
- *Correspondence: Max J. Kurz
| |
Collapse
|
2
|
Espeit L, Rozand V, Millet GY, Gondin J, Maffiuletti NA, Lapole T. Influence of wide-pulse neuromuscular electrical stimulation frequency and superimposed tendon vibration on occurrence and magnitude of extra torque. J Appl Physiol (1985) 2021; 131:302-312. [PMID: 34080917 DOI: 10.1152/japplphysiol.00968.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Low-frequency and high-frequency wide-pulse neuromuscular electrical stimulation (NMES) can generate extra torque (ET) via afferent pathways. Superimposing tendon vibration (TV) to NMES can increase the activation of these afferent pathways and favor ET generation. Knowledge of the characteristics of ET is essential to implement these stimulation paradigms in clinical practice. Thus, we aimed to investigate the effects of frequency and TV superimposition on the occurrence and magnitude of ET in response to wide-pulse NMES. NMES-induced isometric plantar flexion torque was recorded in 30 healthy individuals who performed five NMES protocols: wide-pulse low-frequency (1 ms; 20 Hz; WPLF) and wide-pulse high-frequency (1 ms; 100 Hz; WPHF) without and with superimposed TV (1 mm; 100 Hz) and conventional NMES (50 µs; 20 Hz; reference protocol). Each NMES protocol consisted of three 20-s trains interspersed by 90 s of rest, with NMES intensity being adjusted to reach 10% of maximal voluntary contraction. The ET occurrence was similar for WPLF and WPHF (P = 0.822). In the responders, the ET magnitude was greater for WPHF than WPLF (P < 0.001). There was no effect of superimposed TV on ET characteristics. This study reported an effect of NMES frequency on ET magnitude, whereas TV superimposition did not affect this parameter. In the context of our experimental design decisions, the present findings question the clinical use of wide-pulse NMES and its combination with superimposed TV. Yet, further research is needed to maximize force production through the occurrence and magnitude of ET.NEW & NOTEWORTHY This study is the first to assess the effect of stimulation frequency and superimposed tendon vibration on extra torque characteristics generated by wide-pulse neuromuscular electrical stimulation. The percentage of subjects showing extra torque (i.e., considered as responders) was similar for low-frequency and high-frequency wide-pulse neuromuscular electrical stimulation. In the responders, the extra torque was greater for high-frequency than for low-frequency wide-pulse neuromuscular electrical stimulation. The superimposition of tendon vibration had no effect on extra torque occurrence or magnitude.
Collapse
Affiliation(s)
- Loïc Espeit
- Univ Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, EA 7424, Saint-Etienne, France
| | - Vianney Rozand
- Univ Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, EA 7424, Saint-Etienne, France
| | - Guillaume Y Millet
- Univ Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, EA 7424, Saint-Etienne, France.,Institut Universitaire de France, Paris, France
| | - Julien Gondin
- Institut NeuroMyoGène, Université Claude Bernard Lyon 1, CNRS UMR-5310, INSERM U-1217, Lyon, France
| | | | - Thomas Lapole
- Univ Lyon, UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Biology, EA 7424, Saint-Etienne, France
| |
Collapse
|
3
|
Neyroud D, Gonzalez M, Mueller S, Agostino D, Grosprêtre S, Maffiuletti NA, Kayser B, Place N. Neuromuscular adaptations to wide-pulse high-frequency neuromuscular electrical stimulation training. Eur J Appl Physiol 2019; 119:1105-1116. [DOI: 10.1007/s00421-019-04100-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 02/11/2019] [Indexed: 11/30/2022]
|
4
|
Qi YC, Niu XL, Gao YR, Wang HB, Hu M, Dong LP, Li YZ. Therapeutic Effect Evaluation of Neuromuscular Electrical Stimulation With or Without Strengthening Exercise on Spastic Cerebral Palsy. Clin Pediatr (Phila) 2018; 57:580-583. [PMID: 28990434 DOI: 10.1177/0009922817732619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aims of this study were to investigate the effect of neuromuscular electrical stimulation (NMES) combined with strengthening exercise on movement in children with spastic cerebral palsy (CP). One hundred children with spastic CP were randomly divided into a treatment group (NMES and strengthening exercise, n = 50) and a control group (only NMES, n = 50). We compared the Comprehensive Spasticity Scale (CSS) score, Gross Motor Function Measure (GMFM) score, and walking speed before treatment and 6 weeks and 3 months after treatment between the 2 groups. There was no difference in CSS score between the treatment and control groups before the therapy (12.0 ± 3.4 vs 12.3 ± 3.6), which decreased much more in the treatment group after 6 weeks (7.6 ± 3.0 vs 9.5 ± 2.8) and 3 months (7.4 ± 2.4 vs 9.4 ± 2.6) with significant differences ( P < .05). No difference in GMFM score was observed between the treatment and control groups before the therapy (44.5 ± 13.2 vs 44.0 ± 12.6), which increased much more in the treatment group after 6 weeks (70.6 ± 15.2 vs 56.7 ± 14.3) and 3 months (71.0 ± 16.4 vs 58.0 ± 15.6) with significant differences ( P < .05). The walking speed improved over time, which was the same before the treatment (0.43 ± 0.13 m/s vs 0.45 ± 0.14 m/s), and was significantly greater in the treatment group than that in the control group (6 weeks: 0.69 ± 0.15 m/s vs 0.56 ± 0.12 m/s, P < .05; 3 months: 0.72 ± 0.17 m/s vs 0.57 ± 0.18 m/s, P < .05). NMES combined with strengthening exercise was more effective than NMES alone in the recovery of spastic CP.
Collapse
Affiliation(s)
- Ya-Chao Qi
- 1 Hebei General Hospital, Shijiazhuang, China
| | - Xiao-Li Niu
- 1 Hebei General Hospital, Shijiazhuang, China
| | - Ya-Ran Gao
- 1 Hebei General Hospital, Shijiazhuang, China
| | - He-Bo Wang
- 1 Hebei General Hospital, Shijiazhuang, China
| | - Ming Hu
- 1 Hebei General Hospital, Shijiazhuang, China
| | | | - Ya-Zhou Li
- 2 The Third Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
5
|
Bochkezanian V, Newton RU, Trajano GS, Vieira A, Pulverenti TS, Blazevich AJ. Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on muscle force production in people with spinal cord injury (SCI). BMC Neurol 2018; 18:17. [PMID: 29433467 PMCID: PMC5809925 DOI: 10.1186/s12883-018-1020-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 02/02/2018] [Indexed: 12/13/2022] Open
Abstract
Background Neuromuscular electrical stimulation (NMES) is commonly used in skeletal muscles in people with spinal cord injury (SCI) with the aim of increasing muscle recruitment and thus muscle force production. NMES has been conventionally used in clinical practice as functional electrical stimulation (FES), using low levels of evoked force that cannot optimally stimulate muscular strength and mass improvements, and thus trigger musculoskeletal changes in paralysed muscles. The use of high intensity intermittent NMES training using wide-pulse width and moderate-intensity as a strength training tool could be a promising method to increase muscle force production in people with SCI. However, this type of protocol has not been clinically adopted because it may generate rapid muscle fatigue and thus prevent the performance of repeated high-intensity muscular contractions in paralysed muscles. Moreover, superimposing patellar tendon vibration onto the wide-pulse width NMES has been shown to elicit further increases in impulse or, at least, reduce the rate of fatigue in repeated contractions in able-bodied populations, but there is a lack of evidence to support this argument in people with SCI. Methods Nine people with SCI received two NMES protocols with and without superimposing patellar tendon vibration on different days (i.e. STIM and STIM+vib), which consisted of repeated 30 Hz trains of 58 wide-pulse width (1000 μs) symmetric biphasic pulses (0.033-s inter-pulse interval; 2 s stimulation train; 2-s inter-train interval) being delivered to the dominant quadriceps femoris. Starting torque was 20% of maximal doublet-twitch torque and stimulations continued until torque declined to 50% of the starting torque. Total knee extensor impulse was calculated as the primary outcome variable. Results Total knee extensor impulse increased in four subjects when patellar tendon vibration was imposed (59.2 ± 15.8%) but decreased in five subjects (− 31.3 ± 25.7%). However, there were no statistically significant differences between these sub-groups or between conditions when the data were pooled. Conclusions Based on the present results there is insufficient evidence to conclude that patellar tendon vibration provides a clear benefit to muscle force production or delays muscle fatigue during wide-pulse width, moderate-intensity NMES in people with SCI. Trial registration ACTRN12618000022268. Date: 11/01/2018. Retrospectively registered.
Collapse
Affiliation(s)
- Vanesa Bochkezanian
- Department of Exercise and Health Sciences, School of Health, Medical and Applied Sciences, Central Queensland University, Building 34.1.02, Bruce Highway, North Rockhampton, Qld, 4702, Australia. .,Exercise Medicine Research Clinic, Edith Cowan University, Perth, Australia. .,Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
| | - Robert U Newton
- Exercise Medicine Research Clinic, Edith Cowan University, Perth, Australia.,Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Australia
| | | | - Timothy S Pulverenti
- Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Anthony J Blazevich
- Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
6
|
Martin A, Grosprêtre S, Vilmen C, Guye M, Mattei JP, LE Fur Y, Bendahan D, Gondin J. The Etiology of Muscle Fatigue Differs between Two Electrical Stimulation Protocols. Med Sci Sports Exerc 2017; 48:1474-84. [PMID: 27031743 DOI: 10.1249/mss.0000000000000930] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE This study aimed at investigating the mechanisms involved in the force reduction induced by two electrical stimulation (ES) protocols that were designed to activate motor units differently. METHODS The triceps surae of 11 healthy subjects (8 men; age, ~28 yr) was activated using ES applied over the tibial nerve. Two ES protocols (conventional [CONV]: 20 Hz, 0.05 ms vs wide-pulse high-frequency [WPHF]: 80 Hz, 1 ms) were performed and involved 40 trains (6 s on-6 s off) delivered at an intensity (IES) evoking 20% of maximal voluntary contraction. To analyze the mechanical properties of the motor units activated at IES, force-frequency relation was evoked before and after each protocol. H-reflex and M-wave responses evoked by the last stimulation pulse were also assessed during each ES protocol. Electromyographic responses (∑EMG) were recorded after each train to analyze the behavior of the motor units activated at IES. Metabolic variables, including relative concentrations of phosphocreatine and inorganic phosphate as well as intracellular pH, were assessed using P-MR spectroscopy during each protocol. RESULTS Larger H-reflex amplitudes were observed during WPHF as compared with CONV, whereas opposite findings were observed for M-wave amplitudes. Despite this difference, both the force reduction (-26%) and metabolic changes were similar between the two protocols. The CONV protocol induced a rightward shift of the force-frequency relation, whereas a significant reduction of the ∑EMG evoked at IES was observed only for the WPHF. CONCLUSIONS These results suggest that a decreased number of active motor units mainly contributed to WPHF-induced force decrease, whereas intracellular processes were most likely involved in the force reduction occurring during CONV stimulation.
Collapse
Affiliation(s)
- Alain Martin
- 1Aix-Marseille University, CNRS, Center for Magnetic Resonance in Biology and Medicine (CRMBM) UMR 7339, Marseille, FRANCE; 2INSERM, Cognition, Action, and Sensorimotor Plasticity (CAPS) UMR 1093, University of Burgundy, Faculty of Sport Sciences, Dijon, FRANCE; 3APHM, La Timone Hospital, Imaging Center, CEMEREM, Marseille, FRANCE; and 4Deparment of Rheumatology, Sainte Marguerite Hospital, Marseille, FRANCE
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Cheng AJ, Neyroud D, Kayser B, Westerblad H, Place N. Intramuscular Contributions to Low-Frequency Force Potentiation Induced by a High-Frequency Conditioning Stimulation. Front Physiol 2017; 8:712. [PMID: 28979214 PMCID: PMC5611669 DOI: 10.3389/fphys.2017.00712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/04/2017] [Indexed: 11/13/2022] Open
Abstract
Electrically-evoked low-frequency (submaximal) force is increased immediately following high-frequency stimulation in human skeletal muscle. Although central mechanisms have been suggested to be the major cause of this low-frequency force potentiation, intramuscular factors might contribute. Thus, we hypothesized that two intramuscular Ca2+-dependent mechanisms can contribute to the low-frequency force potentiation: increased sarcoplasmic reticulum Ca2+ release and increased myofibrillar Ca2+ sensitivity. Experiments in humans were performed on the plantar flexor muscles at a shortened, intermediate, and long muscle length and electrically evoked contractile force and membrane excitability (i.e., M-wave amplitude) were recorded during a stimulation protocol. Low-frequency force potentiation was assessed by stimulating with a low-frequency tetanus (25 Hz, 2 s duration), followed by a high-frequency tetanus (100 Hz, 2 s duration), and finally followed by another low-frequency (25 Hz, 2 s duration) tetanus. Similar stimulation protocols were performed on intact mouse single fibers from flexor digitorum brevis muscle, whereby force and myoplasmic free [Ca2+] ([Ca2+]i) were assessed. Our data show a low-frequency force potentiation that was not muscle length-dependent in human muscle and it was not accompanied by any increase in M-wave amplitude. A length-independent low-frequency force potentiation could be replicated in mouse single fibers, supporting an intramuscular mechanism. We show that at physiological temperature (31°C) this low-frequency force potentiation in mouse fibers corresponded with an increase in sarcoplasmic reticulum (SR) Ca2+ release. When mimicking the slower contractile properties of human muscle by cooling mouse single fibers to 18°C, the low-frequency force potentiation was accompanied by minimally increased SR Ca2+ release and hence it could be explained by increased myofibrillar Ca2+ sensitivity. Finally, introducing a brief 200 ms pause between the high- and low-frequency tetanus in human and mouse muscle revealed that the low-frequency force potentiation is abolished, arguing that increased myofibrillar Ca2+ sensitivity is the main intramuscular mechanism underlying the low-frequency force potentiation in humans.
Collapse
Affiliation(s)
- Arthur J Cheng
- Department of Physiology and Pharmacology, Karolinska InstitutetStockholm, Sweden
| | - Daria Neyroud
- Faculty of Biology-Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland.,Department of Physical Therapy, University of Florida Health Science CenterGainesville, FL, United States
| | - Bengt Kayser
- Faculty of Biology-Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland
| | - Håkan Westerblad
- Department of Physiology and Pharmacology, Karolinska InstitutetStockholm, Sweden
| | - Nicolas Place
- Faculty of Biology-Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland
| |
Collapse
|
8
|
Neyroud D, Grosprêtre S, Gondin J, Kayser B, Place N. Test-retest reliability of wide-pulse high-frequency neuromuscular electrical stimulation evoked force. Muscle Nerve 2017; 57:E70-E77. [PMID: 28722822 DOI: 10.1002/mus.25747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 07/05/2017] [Accepted: 07/15/2017] [Indexed: 01/13/2023]
Abstract
INTRODUCTION We compare forces evoked by wide-pulse high-frequency (WPHF) neuromuscular electrical stimulation (NMES) delivered to a nerve trunk versus muscle belly and assess their test-retest intraindividual and interindividual reliability. METHODS Forces evoked during 2 sessions with WPHF NMES delivered over the tibial nerve trunk and 2 sessions over the triceps surae muscle belly were compared. Ten individuals participated in 4 sessions involving ten 20-s WPHF NMES contractions interspaced by 40-s recovery. Mean evoked force and force time integral of each contraction were quantified. RESULTS For both nerve trunk and muscle belly stimulation, intraindividual test-retest reliability was good (intraclass correlation coefficient > 0.9), and interindividual variability was large (coefficient of variation between 140% and 180%). Nerve trunk and muscle belly stimulation resulted in similar evoked forces. DISCUSSION WPHF NMES locations might be chosen by individual preference because intraindividual reliability was relatively good for both locations. Muscle Nerve 57: E70-E77, 2018.
Collapse
Affiliation(s)
- Daria Neyroud
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sidney Grosprêtre
- EA4660-C3S Laboratory, Culture, Sport, Health and Society, University of Bourgogne Franche-Comté, Besançon, France
| | - Julien Gondin
- Institut NeuroMyoGène, Université Claude Bernard Lyon 1, INSERM U1217, CNRS UMR 5310, Villeurbanne, France
| | - Bengt Kayser
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Place
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
9
|
Wegrzyk J, Ranjeva JP, Fouré A, Kavounoudias A, Vilmen C, Mattei JP, Guye M, Maffiuletti NA, Place N, Bendahan D, Gondin J. Specific brain activation patterns associated with two neuromuscular electrical stimulation protocols. Sci Rep 2017; 7:2742. [PMID: 28577338 PMCID: PMC5457446 DOI: 10.1038/s41598-017-03188-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 04/27/2017] [Indexed: 11/24/2022] Open
Abstract
The influence of neuromuscular electrical stimulation (NMES) parameters on brain activation has been scarcely investigated. We aimed at comparing two frequently used NMES protocols - designed to vary in the extent of sensory input. Whole-brain functional magnetic resonance imaging was performed in sixteen healthy subjects during wide-pulse high-frequency (WPHF, 100 Hz–1 ms) and conventional (CONV, 25 Hz–0.05 ms) NMES applied over the triceps surae. Each protocol included 20 isometric contractions performed at 10% of maximal force. Voluntary plantar flexions (VOL) were performed as control trial. Mean force was not different among the three protocols, however, total current charge was higher for WPHF than for CONV. All protocols elicited significant activations of the sensorimotor network, cerebellum and thalamus. WPHF resulted in lower deactivation in the secondary somatosensory cortex and precuneus. Bilateral thalami and caudate nuclei were hyperactivated for CONV. The modulation of the NMES parameters resulted in differently activated/deactivated regions related to total current charge of the stimulation but not to mean force. By targeting different cerebral brain regions, the two NMES protocols might allow for individually-designed rehabilitation training in patients who can no longer execute voluntary movements.
Collapse
Affiliation(s)
- Jennifer Wegrzyk
- Aix Marseille Univ, CNRS, CRMBM, UMR 7339, 13385, Marseille, France
| | | | - Alexandre Fouré
- Aix Marseille Univ, CNRS, CRMBM, UMR 7339, 13385, Marseille, France
| | - Anne Kavounoudias
- Aix Marseille Univ, CNRS, Laboratoire Neurosciences Intégratives et Adaptatives, UMR 7260, 13385, Marseille, France
| | | | - Jean-Pierre Mattei
- Aix Marseille Univ, CNRS, CRMBM, UMR 7339, 13385, Marseille, France.,AP-HM, Hôpital de Sainte Marguerite, Service de Rhumatologie, Pôle Appareil Locomoteur, 13005, Marseille, France
| | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, UMR 7339, 13385, Marseille, France.,AP-HM, Hôpital de la Timone, CEMEREM, Pôle Imagerie Médicale, 13005, Marseille, France
| | | | - Nicolas Place
- University of Lausanne, Faculty of Biology and Medicine, Institute of Sport Sciences and Department of Physiology, Lausanne, Switzerland
| | - David Bendahan
- Aix Marseille Univ, CNRS, CRMBM, UMR 7339, 13385, Marseille, France
| | - Julien Gondin
- Aix Marseille Univ, CNRS, CRMBM, UMR 7339, 13385, Marseille, France. .,Institut NeuroMyoGène, Université Claude Bernard Lyon 1, INSERM U1217, CNRS UMR 5310, Villeurbanne, France.
| |
Collapse
|
10
|
Bochkezanian V, Newton RU, Trajano GS, Vieira A, Pulverenti TS, Blazevich AJ. Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on the decline and recovery of muscle force. BMC Neurol 2017; 17:82. [PMID: 28464800 PMCID: PMC5414318 DOI: 10.1186/s12883-017-0862-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/22/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) is commonly used to activate skeletal muscles and reverse muscle atrophy in clinical populations. Clinical recommendations for NMES suggest the use of short pulse widths (100-200 μs) and low-to-moderate pulse frequencies (30-50 Hz). However, this type of NMES causes rapid muscle fatigue due to the (non-physiological) high stimulation intensities and non-orderly recruitment of motor units. The use of both wide pulse widths (1000 μs) and tendon vibration might optimize motor unit activation through spinal reflex pathways and thus delay the onset of muscle fatigue, increasing muscle force and mass. Thus, the objective of this study was to examine the acute effects of patellar tendon vibration superimposed onto wide-pulse width (1000 μs) knee extensor electrical stimulation (NMES, 30 Hz) on peak muscle force, total impulse before "muscle fatigue", and the post-exercise recovery of muscle function. METHODS Tendon vibration (Vib), NMES (STIM) or NMES superimposed onto vibration (STIM + Vib) were applied in separate sessions to 16 healthy adults. Total torque-time integral (TTI), maximal voluntary contraction torque (MVIC) and indirect measures of muscle damage were tested before, immediately after, 1 h and 48 h after each stimulus. RESULTS TTI increased (145.0 ± 127.7%) in STIM only for "positive responders" to the tendon vibration (8/16 subjects), but decreased in "negative responders" (-43.5 ± 25.7%). MVIC (-8.7%) and rectus femoris electromyography (RF EMG) (-16.7%) decreased after STIM (group effect) for at least 1 h, but not after STIM + Vib. No changes were detected in indirect markers of muscle damage in any condition. CONCLUSIONS Tendon vibration superimposed onto wide-pulse width NMES increased TTI only in 8 of 16 subjects, but reduced voluntary force loss (fatigue) ubiquitously. Negative responders to tendon vibration may derive greater benefit from wide-pulse width NMES alone.
Collapse
Affiliation(s)
- Vanesa Bochkezanian
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia. .,Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia.,Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia.,UQ Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | | | - Timothy S Pulverenti
- Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Anthony J Blazevich
- Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Joondalup 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| |
Collapse
|
11
|
Chen CF, Bikson M, Chou LW, Shan C, Khadka N, Chen WS, Fregni F. Higher-order power harmonics of pulsed electrical stimulation modulates corticospinal contribution of peripheral nerve stimulation. Sci Rep 2017; 7:43619. [PMID: 28256638 PMCID: PMC5335254 DOI: 10.1038/srep43619] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 01/13/2017] [Indexed: 12/14/2022] Open
Abstract
It is well established that electrical-stimulation frequency is crucial to determining the scale of induced neuromodulation, particularly when attempting to modulate corticospinal excitability. However, the modulatory effects of stimulation frequency are not only determined by its absolute value but also by other parameters such as power at harmonics. The stimulus pulse shape further influences parameters such as excitation threshold and fiber selectivity. The explicit role of the power in these harmonics in determining the outcome of stimulation has not previously been analyzed. In this study, we adopted an animal model of peripheral electrical stimulation that includes an amplitude-adapted pulse train which induces force enhancements with a corticospinal contribution. We report that the electrical-stimulation-induced force enhancements were correlated with the amplitude of stimulation power harmonics during the amplitude-adapted pulse train. In an exploratory analysis, different levels of correlation were observed between force enhancement and power harmonics of 20–80 Hz (r = 0.4247, p = 0.0243), 100–180 Hz (r = 0.5894, p = 0.0001), 200–280 Hz (r = 0.7002, p < 0.0001), 300–380 Hz (r = 0.7449, p < 0.0001), 400–480 Hz (r = 0.7906, p < 0.0001), 500–600 Hz (r = 0.7717, p < 0.0001), indicating a trend of increasing correlation, specifically at higher order frequency power harmonics. This is a pilot, but important first demonstration that power at high order harmonics in the frequency spectrum of electrical stimulation pulses may contribute to neuromodulation, thus warrant explicit attention in therapy design and analysis.
Collapse
Affiliation(s)
- Chiun-Fan Chen
- Spaulding Neuromodulation Center, Department of Physical Medicine &Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Engineering Science, Loyola University Chicago, IL, USA
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of the City University of New York, NY, USA
| | - Li-Wei Chou
- Department of Physical Therapy and Assistive Technologies, National Yang-Ming University, Taipei, Taiwan
| | - Chunlei Shan
- Spaulding Neuromodulation Center, Department of Physical Medicine &Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Niranjan Khadka
- Department of Biomedical Engineering, The City College of the City University of New York, NY, USA
| | - Wen-Shiang Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Felipe Fregni
- Spaulding Neuromodulation Center, Department of Physical Medicine &Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
12
|
Neyroud D, Armand S, De Coulon G, Maffiuletti NA, Kayser B, Place N. Plantar flexor muscle weakness and fatigue in spastic cerebral palsy patients. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 61:66-76. [PMID: 28064025 DOI: 10.1016/j.ridd.2016.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 12/22/2016] [Accepted: 12/22/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Patients with cerebral palsy develop an important muscle weakness which might affect the aetiology and extent of exercise-induced neuromuscular fatigue. AIM This study evaluated the aetiology and extent of plantar flexor neuromuscular fatigue in patients with cerebral palsy. METHODS Ten patients with cerebral palsy and 10 age- and sex-matched healthy individuals (∼20 years old, 6 females) performed four 30-s maximal isometric plantar flexions interspaced by a resting period of 2-3s to elicit a resting twitch. Maximal voluntary contraction force, voluntary activation level and peak twitch were quantified before and immediately after the fatiguing task. RESULTS Before fatigue, patients with cerebral palsy were weaker than healthy individuals (341±134N vs. 858±151N, p<0.05) and presented lower voluntary activation (73±19% vs. 90±9%, p<0.05) and peak twitch (100±28N vs. 199±33N, p<0.05). Maximal voluntary contraction force was not significantly reduced in patients with cerebral palsy following the fatiguing task (-10±23%, p>0.05), whereas it decreased by 30±12% (p<0.05) in healthy individuals. CONCLUSIONS Plantar flexor muscles of patients with cerebral palsy were weaker than their healthy peers but showed greater fatigue resistance. WHAT THIS PAPER ADDS Cerebral palsy is a widely defined pathology that is known to result in muscle weakness. The extent and origin of muscle weakness were the topic of several previous investigations; however some discrepant results were reported in the literature regarding how it might affect the development of exercise-induced neuromuscular fatigue. Importantly, most of the studies interested in the assessment of fatigue in patients with cerebral palsy did so with general questionnaires and reported increased levels of fatigue. Yet, exercise-induced neuromuscular fatigue was quantified in just a few studies and it was found that young patients with cerebral palsy might be more fatigue resistant that their peers. Thus, it appears that (i) conflicting results exist regarding objectively-evaluated fatigue in patients with cerebral palsy and (ii) the mechanisms underlying this muscle fatigue - in comparison to those of healthy peers - remain poorly understood. The present study adds important knowledge to the field as it shows that when young adults with cerebral palsy perform sustained maximal isometric plantar flexions, they appear less fatigable than healthy peers. This difference can be ascribed to a better preservation of the neural drive to the muscle. We suggest that the inability to drive their muscles maximally accounts for the lower extent of exercise-induced neuromuscular fatigue in patients with cerebral palsy.
Collapse
Affiliation(s)
- Daria Neyroud
- Institute of Sport Sciences, Faculty of Biology Medicine, University of Lausanne, Lausanne, Switzerland; Institute of Movement Sciences and Sports Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Armand
- Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland
| | - Geraldo De Coulon
- Service of Pediatric Orthopaedics, Department of Child and Adolescent Health, Geneva University Hospitals and Geneva University, Geneva, Switzerland
| | | | - Bengt Kayser
- Institute of Sport Sciences, Faculty of Biology Medicine, University of Lausanne, Lausanne, Switzerland; Institute of Movement Sciences and Sports Medicine, University of Geneva, Geneva, Switzerland
| | - Nicolas Place
- Institute of Sport Sciences, Faculty of Biology Medicine, University of Lausanne, Lausanne, Switzerland.
| |
Collapse
|
13
|
Wegrzyk J, Fouré A, Le Fur Y, Maffiuletti NA, Vilmen C, Guye M, Mattei JP, Place N, Bendahan D, Gondin J. Responders to Wide-Pulse, High-Frequency Neuromuscular Electrical Stimulation Show Reduced Metabolic Demand: A 31P-MRS Study in Humans. PLoS One 2015; 10:e0143972. [PMID: 26619330 PMCID: PMC4664273 DOI: 10.1371/journal.pone.0143972] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 11/11/2015] [Indexed: 01/08/2023] Open
Abstract
Conventional (CONV) neuromuscular electrical stimulation (NMES) (i.e., short pulse duration, low frequencies) induces a higher energetic response as compared to voluntary contractions (VOL). In contrast, wide-pulse, high-frequency (WPHF) NMES might elicit--at least in some subjects (i.e., responders)--a different motor unit recruitment compared to CONV that resembles the physiological muscle activation pattern of VOL. We therefore hypothesized that for these responder subjects, the metabolic demand of WPHF would be lower than CONV and comparable to VOL. 18 healthy subjects performed isometric plantar flexions at 10% of their maximal voluntary contraction force for CONV (25 Hz, 0.05 ms), WPHF (100 Hz, 1 ms) and VOL protocols. For each protocol, force time integral (FTI) was quantified and subjects were classified as responders and non-responders to WPHF based on k-means clustering analysis. Furthermore, a fatigue index based on FTI loss at the end of each protocol compared with the beginning of the protocol was calculated. Phosphocreatine depletion (ΔPCr) was assessed using 31P magnetic resonance spectroscopy. Responders developed four times higher FTI's during WPHF (99 ± 37 × 10(3) N.s) than non-responders (26 ± 12 × 10(3) N.s). For both responders and non-responders, CONV was metabolically more demanding than VOL when ΔPCr was expressed relative to the FTI. Only for the responder group, the ∆PCr/FTI ratio of WPHF (0.74 ± 0.19 M/N.s) was significantly lower compared to CONV (1.48 ± 0.46 M/N.s) but similar to VOL (0.65 ± 0.21 M/N.s). Moreover, the fatigue index was not different between WPHF (-16%) and CONV (-25%) for the responders. WPHF could therefore be considered as the less demanding NMES modality--at least in this subgroup of subjects--by possibly exhibiting a muscle activation pattern similar to VOL contractions.
Collapse
Affiliation(s)
- Jennifer Wegrzyk
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - Alexandre Fouré
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - Yann Le Fur
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | | | | | - Maxime Guye
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital Sainte-Marguerite, Service de Rhumatologie, Pôle Appareil Locomoteur, Marseille, France
| | - Jean-Pierre Mattei
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital Sainte-Marguerite, Service de Rhumatologie, Pôle Appareil Locomoteur, Marseille, France
| | - Nicolas Place
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - David Bendahan
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - Julien Gondin
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- * E-mail:
| |
Collapse
|