1
|
Kim D, Nicoletti C, Soedirdjo SDH, Baghi R, Garcia MG, Läubli T, Wild P, Botter A, Martin BJ. Effect of Periodic Voluntary Interventions on Trapezius Activation and Fatigue During Light Upper Limb Activity. HUMAN FACTORS 2023; 65:1491-1505. [PMID: 34875887 DOI: 10.1177/00187208211050723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The effects of diverse periodic interventions on trapezius muscle fatigue and activity during a full day of computer work were investigated. BACKGROUND Musculoskeletal disorders, including trapezius myalgia, may be associated with repeated exposure to prolonged low-level activity, even during light upper-extremity tasks including computer work. METHODS Thirty healthy adults participated in a study that simulated two 6-hour workdays of computer work. One workday involved imposed periodic passive and active interventions aimed at disrupting trapezius contraction monotony (Intervention day), whereas the other workday did not (Control day). Trapezius muscle activity was quantified by the 3-dimensional acceleration of the jolt movement of the acromion produced by electrically induced muscle twitches. The spatio-temporal distribution of trapezius activity was measured through high-density surface electromyography (HD-EMG). RESULTS The twitch acceleration magnitude in one direction was significantly different across measurement periods (p = 0.0156) on Control day, whereas no significant differences in any direction were observed (p > 0.05) on Intervention day. The HD-EMG from Intervention day showed that only significant voluntary muscle contractions (swing arms, Jacobson maneuver) induced a decrease in the muscle activation time and an increase in the spatial muscle activation areas (p < 0.01). CONCLUSION Disruption of trapezius monotonous activity via brief voluntary contractions effectively modified the ensuing contraction pattern (twitch acceleration along one axis, active epochs reduction, and larger spatial distribution). The observed changes support an associated reduction of muscle fatigue. APPLICATION This study suggests that disruptive intervention activity is efficient in reducing the impact of trapezius muscle fatigue.
Collapse
Affiliation(s)
| | - Corine Nicoletti
- Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
- Institute of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Subaryani D H Soedirdjo
- Laboratory for Engineering of the Neuromuscular System (LISiN), Department of Electronics and Telecommunications, Politecnico di, Torino, Turin, Italy
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Raziyeh Baghi
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Maria-Gabriela Garcia
- Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
- Department of Industrial Engineering, School of Engineering, Universidad San Francisco de Quito, Quito, Ecuador
| | - Thomas Läubli
- Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
- Institute of Occupational and Social Medicine and Health Services Research, University of Tübingen, Tübingen, Germany
| | - Pascal Wild
- French National Research and Safety Institute (INRS), Vandœuvre lès Nancy, France
| | - Alberto Botter
- Laboratory for Engineering of the Neuromuscular System (LISiN), Department of Electronics and Telecommunications, Politecnico di, Torino, Turin, Italy
| | - Bernard J Martin
- Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
- Department of Industrial and Operations Engineering, School of Engineering, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
2
|
Kilohertz Frequency Alternating Current Induces Less Evoked Torque and Less Neuromuscular Efficiency Than Pulsed Current in Healthy People: A Randomized Crossover Trial. J Sport Rehabil 2023:1-9. [PMID: 36812919 DOI: 10.1123/jsr.2022-0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/29/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023]
Abstract
CONTEXT Pulsed current and kilohertz frequency alternating current are 2 types of neuromuscular electrical stimulation (NMES) currents often used by clinicians during rehabilitation. However, the low methodological quality and the different NMES parameters and protocols used in several studies might explain their inconclusive results in terms of their effects in the evoked torque and the discomfort level. In addition, the neuromuscular efficiency (ie, the NMES current type that evokes the highest torque with the lowest current intensity) has not been established yet. Therefore, our objective was to compare the evoked torque, current intensity, neuromuscular efficiency (evoked torque/current intensity ratio), and discomfort between pulsed current and kilohertz frequency alternating current in healthy people. DESIGN A double-blind, randomized crossover trial. METHODS Thirty healthy men (23.2 [4.5] y) participated in the study. Each participant was randomized to 4 current settings: 2 kilohertz frequency alternating currents with 2.5 kHz of carrier frequency and similar pulse duration (0.4 ms) and burst frequency (100 Hz) but with different burst duty cycles (20% and 50%) and burst durations (2 and 5 ms); and 2 pulsed currents with similar pulse frequency (100 Hz) and different pulse duration (2 and 0.4 ms). The evoked torque, current intensity at the maximal tolerated intensity, neuromuscular efficiency, and discomfort level were evaluated. RESULTS Both pulsed currents generated higher evoked torque than the kilohertz frequency alternating currents, despite the similar between-currents discomfort levels. The 2 ms pulsed current showed lower current intensity and higher neuromuscular efficiency compared with both alternated currents and with the 0.4 ms pulsed current. CONCLUSIONS The higher evoked torque, higher neuromuscular efficiency, and similar discomfort of the 2 ms pulsed current compared with 2.5-kHz frequency alternating current suggests this current as the best choice for clinicians to use in NMES-based protocols.
Collapse
|
3
|
KiloHertz currents on aspects of muscle function: A scoping review. J Bodyw Mov Ther 2022; 32:110-119. [DOI: 10.1016/j.jbmt.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 05/15/2022] [Indexed: 11/19/2022]
|
4
|
Acute Effects of 3 Neuromuscular Electrical Stimulation Waveforms on Exercising and Recovery Microvascular Oxygenation Responses. J Sport Rehabil 2022; 31:554-561. [PMID: 35135899 DOI: 10.1123/jsr.2021-0326] [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: 09/09/2021] [Revised: 11/17/2021] [Accepted: 01/04/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT When emphasizing muscular strength during postoperative rehabilitation it is recommended to use a neuromuscular electrical stimulation (NMES) waveform that elicits the greatest muscle force and local metabolic demand that is also well tolerated. The present investigation examined the effects that 3 different clinically used NMES waveforms had on the electrically elicited force (EEF), local metabolic demand (exercising muscle oxygen saturation [SmO2]), and the subsequent reactive hyperemia response (recovery total hemoglobin concentration [THb]) of the knee extensors. DESIGN Single session repeated-measures design. METHODS EEF, local metabolic demand, and reactive hyperemia responses were measured during and subsequent to 3 NMES waveforms: Russian burst modulated alternating current (RUS), biphasic pulsed current (VMS™), and burst modulated biphasic pulsed current (VMS-Burst™). Exercising SmO2 and recovery THb were assessed noninvasively using a near-infrared spectroscopy sensor placed on the vastus lateralis. Participants completed one set of 10 repetitions of each NMES waveform and were provided with 5 minutes of passive, interset recovery. Two-way, repeated-measures analysis of variance examined if NMES waveform or repetition significantly affected (P < .05) EEF or exercising SmO2. Two-way, repeated-measures analysis of variance examined if NMES waveform or recovery time affected recovery THb. RESULTS VMS™ and VMS-Burst™ yielded higher EEF (F = 11.839, P < .001) and greater local metabolic stress (lower exercising SmO2, F = 13.654, P < .001) compared with RUS. Greater rate of EEF decline throughout the NMES set was observed during RUS (%Δ = -50 [6] %Rep1) compared with VMS-Burst™ (%Δ = -30 [7] %Rep1) and VMS™ (%Δ = -32 [7] %Rep1). VMS™ elicited a higher reactive hyperemia response (higher recovery THb) compared with RUS (F = 3.427, P = .048). CONCLUSIONS The present findings support the use of VMS™ or VMS-Burst™ compared with RUS when promoting muscular strength. In addition, the use of VMS™ might provide a greater blood volume to the target muscle subsequent to NMES contractions compared with RUS.
Collapse
|
5
|
Noninvasive spinal stimulation safely enables upright posture in children with spinal cord injury. Nat Commun 2021; 12:5850. [PMID: 34615867 PMCID: PMC8494794 DOI: 10.1038/s41467-021-26026-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
In children with spinal cord injury (SCI), scoliosis due to trunk muscle paralysis frequently requires surgical treatment. Transcutaneous spinal stimulation enables trunk stability in adults with SCI and may pose a non-invasive preventative therapeutic alternative. This non-randomized, non-blinded pilot clinical trial (NCT03975634) determined the safety and efficacy of transcutaneous spinal stimulation to enable upright sitting posture in 8 children with trunk control impairment due to acquired SCI using within-subject repeated measures study design. Primary safety and efficacy outcomes (pain, hemodynamics stability, skin irritation, trunk kinematics) and secondary outcomes (center of pressure displacement, compliance rate) were assessed within the pre-specified endpoints. One participant did not complete the study due to pain with stimulation on the first day. One episode of autonomic dysreflexia during stimulation was recorded. Following hemodynamic normalization, the participant completed the study. Overall, spinal stimulation was well-tolerated and enabled upright sitting posture in 7 out of the 8 participants. Scoliosis due to trunk muscle paralysis frequently requires surgical treatment in children with spinal cord injury. The authors demonstrate the safety and efficacy of transcutaneous spinal stimulation to enable upright sitting posture in 7/8 children with trunk control impairment in a within-subjects, repeated measures pilot clinical trial.
Collapse
|
6
|
Recommendations to Increase Neuromuscular Electrical Stimulation Training Intensity During Quadriceps Treatments for Orthopedic Knee Conditions. Clin J Sport Med 2021; 31:330-334. [PMID: 30817324 DOI: 10.1097/jsm.0000000000000737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/21/2019] [Indexed: 02/02/2023]
Abstract
Neuromuscular electrical stimulation (NMES) is often used by clinicians as a therapeutic adjunct to improve quadriceps strength deficits following orthopedic knee conditions. The efficacy of NMES treatments is primarily dependent on the NMES training intensity, which is a direct result of NMES-induced torque production. The importance of NMES training intensity is well known, yet adequate NMES training intensities are often difficult to achieve due to a variety of limitations associated with NMES (eg, fatigue and patient discomfort). This article provides recommendations that a clinician can use to increase NMES training intensity when strengthening the quadriceps with NMES for orthopedic knee conditions. These recommendations should allow forceful contractions that can be sustained over a treatment with multiple repetitions without the rapid decline in force that is typically seen when NMES is used.
Collapse
|
7
|
Manson GA, Calvert JS, Ling J, Tychhon B, Ali A, Sayenko DG. The relationship between maximum tolerance and motor activation during transcutaneous spinal stimulation is unaffected by the carrier frequency or vibration. Physiol Rep 2020; 8:e14397. [PMID: 32170844 PMCID: PMC7070156 DOI: 10.14814/phy2.14397] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 12/24/2022] Open
Abstract
Transcutaneous spinal stimulation (TSS) is a useful tool to modulate spinal sensorimotor circuits and has emerged as a potential treatment for motor disorders in neurologically impaired populations. One major limitation of TSS is the discomfort associated with high levels of stimulation during the experimental procedure. The objective of this study was to examine if the discomfort caused by TSS can be alleviated using different stimulation paradigms in a neurologically intact population. Tolerance to TSS delivered using conventional biphasic balanced rectangular pulses was compared to two alternative stimulation paradigms: a 5 kHz carrier frequency and biphasic balanced rectangular pulses combined with vibrotactile stimulation. In ten healthy participants, tolerance to TSS was examined using both single-pulse (0.2 Hz) and continuous (30 Hz) stimulation protocols. In both the single-pulse and continuous stimulation protocols, participants tolerated significantly higher levels of stimulation with the carrier frequency paradigm compared to the other stimulation paradigms. However, when the maximum tolerable stimulation intensity of each stimulation paradigm was normalized to the intensity required to evoke a lower limb muscle response, there were no statistical differences between the stimulation paradigms. Our results suggest that, when considering the intensity of stimulation required to obtain spinally evoked motor potentials, neither alternative stimulation paradigm is more effective at reducing discomfort than the conventional, unmodulated pulse configuration.
Collapse
Affiliation(s)
- Gerome A Manson
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Jonathan S Calvert
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA.,Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jeremiah Ling
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Boranai Tychhon
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Amir Ali
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Dimitry G Sayenko
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|