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Arai S, Sasaki A, Tsugaya S, Nomura T, Milosevic M. Inhibition of tibialis anterior spinal reflex circuits using frequency-specific neuromuscular electrical stimulation. Artif Organs 2024; 48:891-901. [PMID: 38436108 DOI: 10.1111/aor.14737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/24/2024] [Accepted: 02/18/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) can generate muscle contractions and elicit excitability of neural circuits. However, the optimal stimulation frequency for effective neuromodulation remains unclear. METHODS Eleven able-bodied individuals participated in our study to examine the effects of: (1) low-frequency NMES at 25 Hz, (2) high-frequency NMES at 100 Hz; and (3) mixed-frequency NMES at 25 and 100 Hz switched every second. NMES was delivered to the right tibialis anterior (TA) muscle for 1 min in each condition. The order of interventions was pseudorandomized between participants with a washout of at least 15 min between conditions. Spinal reflexes were elicited using single-pulse transcutaneous spinal cord stimulation applied over the lumbar enlargement to evoke responses in multiple lower-limb muscles bilaterally and maximum motor responses (Mmax) were elicited in the TA muscle by stimulating the common peroneal nerve to assess fatigue at the baseline and immediately, 5, 10, and 15 min after each intervention. RESULTS Our results showed that spinal reflexes were significantly inhibited immediately after the mixed-frequency NMES, and for at least 15 min in follow-up. Low-frequency NMES inhibited spinal reflexes 5 min after the intervention, and also persisted for at least 10 min. These effects were present only in the stimulated TA muscle, while other contralateral and ipsilateral muscles were unaffected. Mmax responses were not affected by any intervention. CONCLUSIONS Our results indicate that even a short-duration (1 min) NMES intervention using low- and mixed-frequency NMES could inhibit spinal reflex excitability of the TA muscle without inducing fatigue.
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Affiliation(s)
- Suzufumi Arai
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Japan
| | - Atsushi Sasaki
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Japan
- The Miami Project to Cure Paralysis, University of Miami, Miami, Florida, USA
| | - Shota Tsugaya
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Japan
| | - Taishin Nomura
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Japan
- Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Matija Milosevic
- Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering, Osaka University, Toyonaka, Japan
- The Miami Project to Cure Paralysis, University of Miami, Miami, Florida, USA
- Department of Neurological Surgery, University of Miami, Miami, Florida, USA
- Department of Biomedical Engineering, University of Miami, Miami, Florida, USA
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Papavasileiou A, Xenofondos A, Baudry S, Lapole T, Amiridis IG, Metaxiotis D, Tsatalas T, Patikas DA. Protocols Targeting Afferent Pathways via Neuromuscular Electrical Stimulation for the Plantar Flexors: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:2347. [PMID: 36850945 PMCID: PMC9967278 DOI: 10.3390/s23042347] [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: 11/30/2022] [Revised: 02/02/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
This systematic review documents the protocol characteristics of studies that used neuromuscular electrical stimulation protocols (NMES) on the plantar flexors [through triceps surae (TS) or tibial nerve (TN) stimulation] to stimulate afferent pathways. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, was registered to PROSPERO (ID: CRD42022345194) and was funded by the Greek General Secretariat for Research and Technology (ERA-NET NEURON JTC 2020). Included were original research articles on healthy adults, with NMES interventions applied on TN or TS or both. Four databases (Cochrane Library, PubMed, Scopus, and Web of Science) were systematically searched, in addition to a manual search using the citations of included studies. Quality assessment was conducted on 32 eligible studies by estimating the risk of bias with the checklist of the Effective Public Health Practice Project Quality Assessment Tool. Eighty-seven protocols were analyzed, with descriptive statistics. Compared to TS, TN stimulation has been reported in a wider range of frequencies (5-100, vs. 20-200 Hz) and normalization methods for the contraction intensity. The pulse duration ranged from 0.2 to 1 ms for both TS and TN protocols. It is concluded that with increasing popularity of NMES protocols in intervention and rehabilitation, future studies may use a wider range of stimulation attributes, to stimulate motor neurons via afferent pathways, but, on the other hand, additional studies may explore new protocols, targeting for more optimal effectiveness. Furthermore, future studies should consider methodological issues, such as stimulation efficacy (e.g., positioning over the motor point) and reporting of level of discomfort during the application of NMES protocols to reduce the inherent variability of the results.
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Affiliation(s)
- Anastasia Papavasileiou
- Laboratory of Neuromechanics, School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62110 Serres, Greece
| | - Anthi Xenofondos
- Physical Education and Sports Sciences, Frederick University, 1036 Nicosia, Cyprus
| | - Stéphane Baudry
- Laboratory of Applied Biology, Research Unit in Applied Neurophysiology (LABNeuro), Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Thomas Lapole
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023 Saint-Etienne, France
| | - Ioannis G. Amiridis
- Laboratory of Neuromechanics, School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62110 Serres, Greece
| | | | - Themistoklis Tsatalas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Dimitrios A. Patikas
- Laboratory of Neuromechanics, School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62110 Serres, Greece
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Can motor imagery balance the acute fatigue induced by neuromuscular electrical stimulation? Eur J Appl Physiol 2023; 123:1003-1014. [PMID: 36622447 DOI: 10.1007/s00421-022-05129-5] [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: 07/04/2022] [Accepted: 12/26/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE The combination of motor imagery (MI) and neuromuscular electrical stimulation (NMES) can increase the corticospinal excitability suggesting that such association could be efficient in motor performance improvement. However, differential effect has been reported at spinal level after MI and NMES alone. The purpose of this study was to investigate the acute effect on motor performance and spinal excitability following MI, NMES and combining MI and NMES. METHODS Ten participants were enrolled in three experimental sessions of MI, NMES and MI + NMES targeting plantar flexor muscles. Each session underwent 60 imagined, evoked (20% MVC) or imagined and evoked contractions simultaneously. Before, immediately after and 10 min after each session, maximal M-wave and H-reflex were evoked by electrical nerve stimulation applied at rest and during maximal voluntary contraction (MVC). RESULTS The MVC decreased significantly between PRE-POST (- 12.14 ± 6.12%) and PRE-POST 10 (- 8.1 ± 6.35%) for NMES session, while this decrease was significant only between PRE-POST 10 (- 7.16 ± 11.25%) for the MI + NMES session. No significant modulation of the MVC was observed after MI session. The ratio Hmax/Mmax was reduced immediately after NMES session only. CONCLUSION The combination of MI to NMES seems to delay the onset of neuromuscular fatigue compared to NMES alone. This delay onset of neuromuscular fatigue was associated with specific modulation of the spinal excitability. These results suggested that MI could compensate the neuromuscular fatigue induced acutely by NMES until 10 min after the combination of both modalities.
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Ye X, Gockel N, Vala D, Devoe T, Brodoff P, Gaza V, Umali V, Walker H. Wide-Pulse High-Frequency Neuromuscular Electrical Stimulation Evokes Greater Relative Force in Women Than in Men: A Pilot Study. Sports (Basel) 2022; 10:sports10090134. [PMID: 36136389 PMCID: PMC9501951 DOI: 10.3390/sports10090134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to examine the potential sex differences in wide-pulse high-frequency neuromuscular electrical stimulation (WPHF NMES)-evoked force. Twenty-two subjects (10 women) completed this study. Prior to the stimulation, the visual analogue scale (VAS) for discomfort and the rating of perceived exertion (RPE) were measured, followed by the isometric strength of the dominant elbow flexor muscles. The subjects then completed ten, 10-s on 10-s off WPHF NMES (pulse width: 1 ms, frequency: 100 Hz) at maximum tolerable intensities. The subjects’ RPE was recorded after each set, and the VAS was measured following the last stimulation. The stimulation induced significant increase in discomfort for both sexes, with women having greater discomfort than men (men: 22.4 ± 14.9 mm, women: 39.7 ± 12.7 mm). The stimulation amplitude was significantly greater in men than in women (men: 16.2 ± 6.3 mA, women: 12.0 ± 4.5 mA). For the evoked force, only the relative NMES-evoked force was found greater in women than in men (men: 8.96 ± 6.51%, women: 17.08 ± 12.61%). In conclusion, even at the maximum tolerable intensity, WPHF NMES evoked larger relative elbow flexion force in women than in men, with women experiencing greater discomfort.
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Affiliation(s)
- Xin Ye
- Correspondence: ; Tel.: +1-860-768-5787
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5
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Alahmari SK, Shield AJ, Trajano GS. Effects of three neuromuscular electrical stimulation methods on muscle force production and neuromuscular fatigue. Scand J Med Sci Sports 2022; 32:1456-1463. [PMID: 35844045 PMCID: PMC9545897 DOI: 10.1111/sms.14210] [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: 11/26/2021] [Revised: 02/18/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
This study compared the acute responses of three neuromuscular electrical stimulation (NMES) methods on muscle torque-time integral (TTI) and neuromuscular fatigue. Narrow-pulse (0.2 ms; NP), wide-pulse (1 ms; WP), and tendon vibration superimposed onto wide-pulse (WP + VIB)-NMES conditions were applied to sixteen healthy individuals (n = 16) in three separate sessions in a randomized order. Stimulation intensity was set to elicit 20% of maximal voluntary contraction (MVC); the stimulus pattern comprised four sets of 20 repetitions (5 s On and 5 s Off) with a one-minute inter-set interval. TTI was measured for each NMES condition and MVC, voluntary activation (VA), peak twitch torque (Peaktwitch ), and peak soleus (EMGSOL ), medial (EMGMG ), and lateral gastrocnemius (EMGLG ) electromyography were measured before and immediately after each NMES condition. TTI was higher during WP + VIB (19.63 ± 6.34 MVC.s, mean difference = 3.66, p < 0.001, Cohen's d = 0.501) than during WP (15.97 ± 4.79 MVC.s) condition. TTI was higher during WP + VIB (mean difference = 3.79, p < 0.001, Cohen's d = 0.626) than during NP (15.84 ± 3.73 MVC.s) condition. MVC and Peaktwitch forces decreased (p ≤ 0.001) immediately after all conditions. No changes were observed for VA (p = 0.365). EMGSOL amplitude reduced (p = 0.040) only after NP, yet EMGLG and EMGMG amplitudes decreased immediately after all conditions (p = 0.003 and p = 0.013, respectively). WP + VIB produced a higher TTI than WP and NP-NMES, with similar amounts of neuromuscular fatigue across protocols. All NMES protocols induced similar amounts of peripheral fatigue and reduced EMG amplitudes.
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Affiliation(s)
- Sami K Alahmari
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia.,Department of Physical Therapy, College of Applied Medical Sciences, Taif University (TU), Taif, Mecca, Kingdom of Saudi Arabia
| | - Anthony J Shield
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
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Bastos JAI, Martins W, Junior GC, Collins DF, Durigan JLQ. CONTRACTION FATIGUE, STRENGTH ADAPTATIONS, AND DISCOMFORT DURING CONVENTIONAL VERSUS WIDE-PULSE, HIGH-FREQUENCY, NEUROMUSCULAR ELECTRICAL STIMULATION: A SYSTEMATIC REVIEW. Appl Physiol Nutr Metab 2021; 46:1314-1321. [PMID: 34260861 DOI: 10.1139/apnm-2021-0269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Neuromuscular electrical stimulation (NMES) can be delivered in a conventional form (CONVNMES) and using relatively wide-pulses and high-frequencies (WPHFNMES). WPHFNMES is proposed to reduce contraction fatigability and generate larger contractions with less discomfort than CONVNMES, however, there are no systematic reviews to guide the selection of NMES types. This systematic review compared the effects of CONVNMES versus WPHFNMES on contraction fatigability, strength adaptations, and perceived discomfort in clinical and non-clinical populations. Eight studies were included. When averaged across all non-clinical participants in individual short- and long-term studies, there was either no difference between CONVNMES and WPHFNMES for all outcomes or WPHFNMES produced more fatigability. In a subset of non-clinical participants ("responders"), however, WPHFNMES reduced contraction fatigability during a single session. Long-term studies found no differences between protocols for strength adaptations in non-clinical participants and those with multiple sclerosis. We concluded that WPHFNMES reduces contraction fatigability only in the short-term and in non-clinical responder participants and may exacerbate fatigability in non-responders. This review was registered in the prospective international registry of systematic reviews/PROSPERO (Registration Number: CRD42020153907, accessed at https://www.crd.york.ac.uk/PROSPERO/). Novelty bullets: • WPHF NMES may reduce fatigue in some participants and exacerbate fatigue in others. • There were no differences in long-term between WPHF and CONV NMES on strength adaptations. • Future high-quality research is needed to optimize outcomes of NMES-based programs.
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Affiliation(s)
| | - Wagner Martins
- Universidade de Brasilia, 28127, Faculdade de Fisioterapia, Ceilândia , Distrito Federal, Brazil;
| | | | - David F Collins
- University of Alberta, 3158, Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada, T6G 2R3;
| | - Joao Luiz Quaglioti Durigan
- UnB, Physical Therapy, D- Graduate program of Science and Technology of Health and Graduate program of Physical Education, University of Brasília, Distrito Federal, Brazil, Brasiia, Select a State / Province, Brazil, 13560210;
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Effect of transcranial direct current stimulation on the psychomotor, cognitive, and motor performances of power athletes. Sci Rep 2021; 11:9731. [PMID: 33958679 PMCID: PMC8102586 DOI: 10.1038/s41598-021-89159-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/19/2021] [Indexed: 11/08/2022] Open
Abstract
In sports science, transcranial direct current stimulation (tDCS) has many unknown effects on neuromuscular, psychomotor and cognitive aspects. Particularly, its impact on power performances remains poorly investigated. Eighteen healthy young males, all trained in a jumping sport (parkour) performed three experimental sessions: anodal tDCS applied either on the left dorsolateral prefrontal cortex (dlPFC, cathode in supraorbital area) or on the primary motor cortex (M1, cathode on contralateral shoulder), and a placebo condition (SHAM), each applied for 20 min at 2 mA. Pre and post, maximal vertical and horizontal jumps were performed, associated to leg neuromuscular assessment through electromyography and peripheral nerve stimulations. Actual and imagined pointing tasks were also performed to evaluate fine motor skills, and a full battery of cognitive and psychomotor tests was administered. M1 tDCS improved jump performance accompanied by an increase in supraspinal and spinal excitabilities. dlPFC stimulation only impacted the pointing tasks. No effect on cognitive tests was found for any of the tDCS conditions. To conclude, the type of performance (maximal versus accurate) affected depended upon the tDCS montage. Finally, athletes responded well to tDCS for motor performance while results to cognitive tests seemed unaffected, at least when implemented with the present rationale.
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8
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Luu MJ, Jones KE, Collins DF. Decreased excitability of motor axons contributes substantially to contraction fatigability during neuromuscular electrical stimulation. Appl Physiol Nutr Metab 2021; 46:346-355. [DOI: 10.1139/apnm-2020-0366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present study was designed to (i) determine the time course of changes in motor axon excitability during and after neuromuscular electrical stimulation (NMES); and (ii) characterize the relationship between contraction fatigability, NMES frequency, and changes at the axon, neuromuscular junction, and muscle. Eight neurologically intact participants attended 3 sessions. NMES was delivered over the common peroneal nerve at 20, 40, or 60 Hz for 8 min (0.3 s “on”, 0.7 s “off”). Threshold tracking was used to measure changes in axonal excitability. Supramaximal stimuli were used to assess neuromuscular transmission and force-generating capacity of the tibialis anterior muscle. Torque decreased by 49% and 62% during 8 min of 40 and 60 Hz NMES, respectively. Maximal twitch torque decreased only during 60 Hz NMES. Motor axon excitability decreased by 14%, 27%, and 35% during 20, 40, and 60 Hz NMES, respectively. Excitability recovered to baseline immediately (20 Hz) and at 2 min (40 Hz) and 4 min (60 Hz) following NMES. Overall, decreases in axonal excitability best predicted how torque declined over 8 min of NMES. During NMES, motor axons become less excitable and motor units “drop out” of the contraction, contributing substantially to contraction fatigability and its dependence on NMES frequency. Novelty: The excitability of motor axons decreased during NMES in a frequency-dependent manner. As excitability decreased, axons failed to reach threshold and motor units dropped out of the contraction. Overall, decreased excitability best predicted how torque declined and thus is a key contributor to fatigability during NMES.
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Affiliation(s)
- M. John Luu
- Faculty of Kinesiology, Sport, and Recreation, Neuroscience and Mental Health Institute, Sensorimotor Rehabilitation Neuroscience Group, University of Alberta, Edmonton, AB T6G 2H9, Canada
- Faculty of Kinesiology, Sport, and Recreation, Neuroscience and Mental Health Institute, Sensorimotor Rehabilitation Neuroscience Group, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Kelvin E. Jones
- Faculty of Kinesiology, Sport, and Recreation, Neuroscience and Mental Health Institute, Sensorimotor Rehabilitation Neuroscience Group, University of Alberta, Edmonton, AB T6G 2H9, Canada
- Faculty of Kinesiology, Sport, and Recreation, Neuroscience and Mental Health Institute, Sensorimotor Rehabilitation Neuroscience Group, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - David F. Collins
- Faculty of Kinesiology, Sport, and Recreation, Neuroscience and Mental Health Institute, Sensorimotor Rehabilitation Neuroscience Group, University of Alberta, Edmonton, AB T6G 2H9, Canada
- Faculty of Kinesiology, Sport, and Recreation, Neuroscience and Mental Health Institute, Sensorimotor Rehabilitation Neuroscience Group, University of Alberta, Edmonton, AB T6G 2H9, Canada
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Gonnelli F, Rejc E, Giovanelli N, Floreani M, Porcelli S, Harkema S, Willhite A, Stills S, Richardson T, Lazzer S. Effects of NMES pulse width and intensity on muscle mechanical output and oxygen extraction in able-bodied and paraplegic individuals. Eur J Appl Physiol 2021; 121:1653-1664. [PMID: 33656575 DOI: 10.1007/s00421-021-04647-y] [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: 09/17/2020] [Accepted: 02/15/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Neuromuscular Electrical Stimulation (NMES) is commonly used in neuromuscular rehabilitation protocols, and its parameters selection substantially affects the characteristics of muscle activation. Here, we investigated the effects of short pulse width (200 µs) and higher intensity (short-high) NMES or long pulse width (1000 µs) and lower intensity (long-low) NMES on muscle mechanical output and fractional oxygen extraction. Muscle contractions were elicited with 100 Hz stimulation frequency, and the initial torque output was matched by adjusting stimulation intensity. METHODS Fourteen able-bodied and six spinal cord-injured (SCI) individuals participated in the study. The NMES protocol (75 isometric contractions, 1-s on-3-s off) targeting the knee extensors was performed with long-low or short-high NMES applied over the midline between anterior superior iliac spine and patella protrusion in two different days. Muscle work was estimated by torque-time integral, contractile properties by rate of torque development and half-relaxation time, and vastus lateralis fractional oxygen extraction was assessed by Near-Infrared Spectroscopy (NIRS). RESULTS Torque-time integral elicited by the two NMES paradigms was similar throughout the stimulation protocol, with differences ranging between 1.4% (p = 0.877; able-bodied, mid-part of the protocol) and 9.9% (p = 0.147; SCI, mid-part of the protocol). Contractile properties were also comparable in the two NMES paradigms. However, long-low NMES resulted in higher fractional oxygen extraction in able-bodied (+ 36%; p = 0.006). CONCLUSION Long-low and short-high NMES recruited quadriceps femoris motor units that demonstrated similar contractile and fatigability properties. However, long-low NMES conceivably resulted in the preferential recruitment of vastus lateralis muscle fibers as detected by NIRS.
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Affiliation(s)
- Federica Gonnelli
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy.,Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY, 40202, USA
| | - Enrico Rejc
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY, 40202, USA. .,Department of Neurosurgery, University of Louisville, Louisville, KY, USA.
| | - Nicola Giovanelli
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy
| | - Mirco Floreani
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy
| | - Simone Porcelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - Susan Harkema
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY, 40202, USA.,Department of Neurosurgery, University of Louisville, Louisville, KY, USA.,Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Andrea Willhite
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY, 40202, USA
| | - Sean Stills
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY, 40202, USA
| | - Tine Richardson
- Kentucky Spinal Cord Injury Research Center, University of Louisville, 220 Abraham Flexner Way, Louisville, KY, 40202, USA
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy
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Tomita A, Kawade S, Moritani T, Watanabe K. Novel perspective on contractile properties and intensity-dependent verification of force-frequency relationship during neuromuscular electrical stimulation. Physiol Rep 2020; 8:e14598. [PMID: 33230975 PMCID: PMC7683877 DOI: 10.14814/phy2.14598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The aims of the present study were: (a) to examine the effect of the stimulus intensity on force-frequency and torque fluctuation-frequency relationships during Neuromuscular electrical stimulation; and (b) to identify a novel parameter that can be used to evaluate muscle contractile properties. METHODS Electrically elicited joint torque involving the quadriceps femoris muscle was recorded during neuromuscular electrical stimulation at two different stimulus intensities in 19 healthy men. Stimulation frequencies were set at 5-40 Hz with a duration of 10 s. Evoked joint torque was compared among all stimulation frequencies between the two stimulus intensities (68 and 113 V). The torque fluctuation at each stimulation frequency as the change in the contraction pattern was also compared between the intensities. Torque and torque fluctuation were normalized at each frequency by the largest torque or torque fluctuation, respectively. We extracted a novel parameter: the arrival point of tetanic contraction based on force-frequency and torque fluctuation-frequency curves. RESULTS There were significant differences in normalized torque at 5-25 and 40 Hz and in normalized torque fluctuation at 15-30 and 40 Hz between the two stimulus intensities. Extracted parameters showed no significant difference between the intensities. CONCLUSION The results suggest that force-frequency relationships during neuromuscular electrical stimulation are influenced by the intensity of stimulation applied to the quadriceps femoris muscle. However, we consider that it is possible to simultaneously evaluate contractile properties using the novel parameter.
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Affiliation(s)
- Aya Tomita
- Laboratory of Neuromuscular BiomechanicsFaculty of Liberal Arts and Sciences and School of International Liberal StudiesChukyo UniversityNagoyaJapan
| | | | | | - Kohei Watanabe
- Laboratory of Neuromuscular BiomechanicsFaculty of Liberal Arts and Sciences and School of International Liberal StudiesChukyo UniversityNagoyaJapan
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Borzuola R, Labanca L, Macaluso A, Laudani L. Modulation of spinal excitability following neuromuscular electrical stimulation superimposed to voluntary contraction. Eur J Appl Physiol 2020; 120:2105-2113. [PMID: 32676751 PMCID: PMC7419370 DOI: 10.1007/s00421-020-04430-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 07/03/2020] [Indexed: 02/03/2023]
Abstract
Purpose Neuromuscular electrical stimulation (NMES) superimposed on voluntary muscle contraction has been recently shown as an innovative training modality within sport and rehabilitation, but its effects on the neuromuscular system are still unclear. The aim of this study was to investigate acute responses in spinal excitability, as measured by the Hoffmann (H) reflex, and in maximal voluntary contraction (MVIC) following NMES superimposed to voluntary isometric contractions (NMES + ISO) compared to passive NMES only and to voluntary isometric contractions only (ISO). Method Fifteen young adults were required to maintain an ankle plantar-flexor torque of 20% MVC for 20 repetitions during each experimental condition (NMES + ISO, NMES and ISO). Surface electromyography was used to record peak-to-peak H-reflex and motor waves following percutaneous stimulation of the posterior tibial nerve in the dominant limb. An isokinetic dynamometer was used to assess maximal voluntary contraction output of the ankle plantar flexor muscles. Results H-reflex amplitude was increased by 4.5% after the NMES + ISO condition (p < 0.05), while passive NMES and ISO conditions showed a decrease by 7.8% (p < 0.05) and no change in reflex responses, respectively. There was no change in amplitude of maximal motor wave and in MVIC torque during each experimental condition. Conclusion The reported facilitation of spinal excitability following NMES + ISO could be due to a combination of greater motor neuronal and corticospinal excitability, thus suggesting that NMES superimposed onto isometric voluntary contractions may provide a more effective neuromuscular stimulus and, hence, training modality compared to NMES alone.
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Affiliation(s)
- Riccardo Borzuola
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Luciana Labanca
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luca Laudani
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK.
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Presynaptic inhibition mechanisms may subserve the spinal excitability modulation induced by neuromuscular electrical stimulation. J Electromyogr Kinesiol 2018; 40:95-101. [DOI: 10.1016/j.jelekin.2018.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/30/2018] [Accepted: 04/23/2018] [Indexed: 11/20/2022] Open
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13
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Rongsawad K, Ratanapinunchai J. Effects of Very High Stimulation Frequency and Wide-Pulse Duration on Stimulated Force and Fatigue of Quadriceps in Healthy Participants. Ann Rehabil Med 2018; 42:250-259. [PMID: 29765878 PMCID: PMC5940601 DOI: 10.5535/arm.2018.42.2.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/02/2017] [Indexed: 11/13/2022] Open
Abstract
Objective To determine the effect of very high stimulation frequency (150 and 200 Hz) with wide pulse duration versus 50 Hz with wide pulse duration on stimulated force and fatigue of quadriceps femoris in healthy participants. Methods Thirty-four healthy participants underwent fatigue test using three stimulation frequency conditions (50, 150, and 200 Hz) with pulse duration of 0.9 ms. Normalized force values at the end of each fatigue protocol and curve fitting patterns were compared among stimulated frequencies. Results Very high stimulation frequency (150 and 200 Hz) conditions showed a trend of having more decline in normalized stimulated force during fatigue test compared to a low stimulation frequency at 50 Hz. However, the difference was not statistically significant. Responder group showed the same slope of a linear fitting pattern, implying the same pattern of muscle fatigue among three stimulation frequency conditions (−3.32 in 50 Hz, −2.88 in 150 Hz, and −3.14 in 200 Hz, respectively). Conclusion There were high inter-subject variations in the response to different frequency stimulation conditions. However, very high stimulation frequency generated the same fatigue pattern as the low stimulation frequency in the responder group. Further research is needed to explore the mechanism involved.
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Affiliation(s)
- Kitima Rongsawad
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Jonjin Ratanapinunchai
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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14
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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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15
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Papcke C, Krueger E, Olandoski M, Nogueira-Neto GN, Nohama P, Scheeren EM. Investigation of the Relationship Between Electrical Stimulation Frequency and Muscle Frequency Response Under Submaximal Contractions. Artif Organs 2018; 42:655-663. [PMID: 29574805 DOI: 10.1111/aor.13083] [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] [Received: 05/25/2017] [Revised: 10/16/2017] [Accepted: 10/26/2017] [Indexed: 11/30/2022]
Abstract
Neuromuscular electrical stimulation (NMES) is a common tool that is used in clinical and laboratory experiments and can be combined with mechanomyography (MMG) for biofeedback in neuroprostheses. However, it is not clear if the electrical current applied to neuromuscular tissues influences the MMG signal in submaximal contractions. The objective of this study is to investigate whether the electrical stimulation frequency influences the mechanomyographic frequency response of the rectus femoris muscle during submaximal contractions. Thirteen male participants performed three maximal voluntary isometric contractions (MVIC) recorded in isometric conditions to determine the maximal force of knee extensors. This was followed by the application of nine modulated NMES frequencies (20, 25, 30, 35, 40, 45, 50, 75, and 100 Hz) to evoke 5% MVIC. Muscle behavior was monitored by the analysis of MMG signals, which were decomposed into frequency bands by using a Cauchy wavelet transform. For each applied electrical stimulus frequency, the mean MMG spectral/frequency response was estimated for each axis (X, Y, and Z axes) of the MMG sensor with the values of the frequency bands used as weights (weighted mean). Only with respect to the Z (perpendicular) axis of the MMG signal, the stimulus frequency of 20 Hz did not exhibit any difference with the weighted mean (P = 0.666). For the frequencies of 20 and 25 Hz, the MMG signal displayed the bands between 12 and 16 Hz in the three axes (P < 0.050). In the frequencies from 30 to 100 Hz, the muscle presented a higher concentration of the MMG signal between the 22 and 29 Hz bands for the X and Z axes, and between 16 and 34 Hz bands for the Y axis (P < 0.050 for all cases). We observed that MMG signals are not dependent on the applied NMES frequency, because their frequency contents tend to mainly remain between the 20- and 25-Hz bands. Hence, NMES does not interfere with the use of MMG in neuroprosthesis.
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Affiliation(s)
- Caluê Papcke
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Eddy Krueger
- Graduate Program in Rehabilitation Sciences, Anatomy Department, Universidade Estadual de Londrina, Londrina, Brazil.,Graduate Program in Biomedical Engineering, Universidade Tecnológica Federal do Paraná, Curitiba, Brazil
| | - Marcia Olandoski
- Medical School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Percy Nohama
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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16
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Barss TS, Ainsley EN, Claveria-Gonzalez FC, Luu MJ, Miller DJ, Wiest MJ, Collins DF. Utilizing Physiological Principles of Motor Unit Recruitment to Reduce Fatigability of Electrically-Evoked Contractions: A Narrative Review. Arch Phys Med Rehabil 2017; 99:779-791. [PMID: 28935232 DOI: 10.1016/j.apmr.2017.08.478] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 08/08/2017] [Accepted: 08/16/2017] [Indexed: 10/18/2022]
Abstract
Neuromuscular electrical stimulation (NMES) is used to produce contractions to restore movement and reduce secondary complications for individuals experiencing motor impairment. NMES is conventionally delivered through a single pair of electrodes over a muscle belly or nerve trunk using short pulse durations and frequencies between 20 and 40Hz (conventional NMES). Unfortunately, the benefits and widespread use of conventional NMES are limited by contraction fatigability, which is in large part because of the nonphysiological way that contractions are generated. This review provides a summary of approaches designed to reduce fatigability during NMES, by using physiological principles that help minimize fatigability of voluntary contractions. First, relevant principles of the recruitment and discharge of motor units (MUs) inherent to voluntary contractions and conventional NMES are introduced, and the main mechanisms of fatigability for each contraction type are briefly discussed. A variety of NMES approaches are then described that were designed to reduce fatigability by generating contractions that more closely mimic voluntary contractions. These approaches include altering stimulation parameters, to recruit MUs in their physiological order, and stimulating through multiple electrodes, to reduce MU discharge rates. Although each approach has unique advantages and disadvantages, approaches that minimize MU discharge rates hold the most promise for imminent translation into rehabilitation practice. The way that NMES is currently delivered limits its utility as a rehabilitative tool. Reducing fatigability by delivering NMES in ways that better mimic voluntary contractions holds promise for optimizing the benefits and widespread use of NMES-based programs.
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Affiliation(s)
- Trevor S Barss
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Emily N Ainsley
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Francisca C Claveria-Gonzalez
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada; Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - M John Luu
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Dylan J Miller
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Matheus J Wiest
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada; Biomechanics Laboratory, Department of Physical Education, Federal University of Santa Catarina, Florianópolis, Brazil
| | - David F Collins
- Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada.
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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.
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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
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GROSPRÊTRE SIDNEY, GUEUGNEAU NICOLAS, MARTIN ALAIN, LEPERS ROMUALD. Central Contribution to Electrically Induced Fatigue depends on Stimulation Frequency. Med Sci Sports Exerc 2017; 49:1530-1540. [DOI: 10.1249/mss.0000000000001270] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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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: 28] [Impact Index Per Article: 4.0] [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.
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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.
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