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Efthimiou TN, Hernandez MP, Elsenaar A, Mehu M, Korb S. Application of facial neuromuscular electrical stimulation (fNMES) in psychophysiological research: Practical recommendations based on a systematic review of the literature. Behav Res Methods 2024; 56:2941-2976. [PMID: 37864116 PMCID: PMC11133044 DOI: 10.3758/s13428-023-02262-7] [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] [Accepted: 09/29/2023] [Indexed: 10/22/2023]
Abstract
Facial neuromuscular electrical stimulation (fNMES), which allows for the non-invasive and physiologically sound activation of facial muscles, has great potential for investigating fundamental questions in psychology and neuroscience, such as the role of proprioceptive facial feedback in emotion induction and emotion recognition, and may serve for clinical applications, such as alleviating symptoms of depression. However, despite illustrious origins in the 19th-century work of Duchenne de Boulogne, the practical application of fNMES remains largely unknown to today's researchers in psychology. In addition, published studies vary dramatically in the stimulation parameters used, such as stimulation frequency, amplitude, duration, and electrode size, and in the way they reported them. Because fNMES parameters impact the comfort and safety of volunteers, as well as its physiological (and psychological) effects, it is of paramount importance to establish recommendations of good practice and to ensure studies can be better compared and integrated. Here, we provide an introduction to fNMES, systematically review the existing literature focusing on the stimulation parameters used, and offer recommendations on how to safely and reliably deliver fNMES and on how to report the fNMES parameters to allow better cross-study comparison. In addition, we provide a free webpage, to easily visualise fNMES parameters and verify their safety based on current density. As an example of a potential application, we focus on the use of fNMES for the investigation of the facial feedback hypothesis.
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Affiliation(s)
| | | | - Arthur Elsenaar
- ArtScience Interfaculty, Royal Academy of Art, Royal Conservatory, The Hague, Netherlands
| | - Marc Mehu
- Department of Psychology, Webster Vienna Private University, Vienna, Austria
| | - Sebastian Korb
- Department of Psychology, University of Essex, Colchester, UK.
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.
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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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O'Bryan SJ, Taylor JL, D'Amico JM, Rouffet DM. Quadriceps Muscle Fatigue Reduces Extension and Flexion Power During Maximal Cycling. Front Sports Act Living 2022; 3:797288. [PMID: 35072064 PMCID: PMC8777021 DOI: 10.3389/fspor.2021.797288] [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: 10/18/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate how quadriceps muscle fatigue affects power production over the extension and flexion phases and muscle activation during maximal cycling.Methods: Ten participants performed 10-s maximal cycling efforts without fatigue and after 120 bilateral maximal concentric contractions of the quadriceps muscles. Extension power, flexion power and electromyographic (EMG) activity were compared between maximal cycling trials. We also investigated the associations between changes in quadriceps force during isometric maximal voluntary contractions (IMVC) and power output (flexion and extension) during maximal cycling, in addition to inter-individual variability in muscle activation and pedal force profiles.Results: Quadriceps IMVC (−52 ± 21%, P = 0.002), voluntary activation (−24 ± 14%, P < 0.001) and resting twitch amplitude (−45 ± 19%, P = 0.002) were reduced following the fatiguing task, whereas vastus lateralis (P = 0.58) and vastus medialis (P = 0.15) M-wave amplitudes were unchanged. The reductions in extension power (−15 ± 8%, P < 0.001) and flexion power (−24 ± 18%, P < 0.001) recorded during maximal cycling with fatigue of the quadriceps were dissociated from the decreases in quadriceps IMVC. Peak EMG decreased across all muscles while inter-individual variability in pedal force and EMG profiles increased during maximal cycling with quadriceps fatigue.Conclusion: Quadriceps fatigue induced by voluntary contractions led to reduced activation of all lower limb muscles, increased inter-individual variability and decreased power production during maximal cycling. Interestingly, power production was further reduced over the flexion phase (24%) than the extension phase (15%), likely due to larger levels of peripheral fatigue developed in RF muscle and/or a higher contribution of the quadriceps muscle to flexion power production compared to extension power during maximal cycling.
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Affiliation(s)
- Steven J. O'Bryan
- Institute for Health and Sport (IHeS), Victoria University, Melbourne, VIC, Australia
| | - Janet L. Taylor
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Jessica M. D'Amico
- Department of Neurological Surgery, University of Louisville, Louisville, KY, United States
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States
| | - David M. Rouffet
- Institute for Health and Sport (IHeS), Victoria University, Melbourne, VIC, Australia
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States
- Department of Health and Sport Sciences, University of Louisville, Louisville, KY, United States
- *Correspondence: David M. Rouffet
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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.
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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
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Paz IDA, Rigo GT, Sgarioni A, Baroni BM, Frasson VB, Vaz MA. Alternating Current Is More Fatigable Than Pulsed Current in People Who Are Healthy: A Double-Blind, Randomized Crossover Trial. Phys Ther 2021; 101:6131761. [PMID: 33561279 DOI: 10.1093/ptj/pzab056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/12/2020] [Accepted: 12/27/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Tolerance level and rapid fatigue onset are limitations in the use of neuromuscular electrical stimulation (NMES) as an electrotherapeutic resource in rehabilitation and training protocols; however, it is unclear if pulsed current (PC) and alternating current (AC) produce different fatigue levels when applied at submaximal contraction level. The purpose of this study was to compare fatigue and discomfort levels between PC and AC during a submaximal contraction protocol in people who are healthy. METHODS In this double-blind, randomized crossover trial conducted in a laboratory setting, 30 male volunteers [23.23 years of age (SD = 4.59)] performed 2 submaximal fatigue protocols (with a 7-day interval) in a randomized order: PC (pulse duration = 2 milliseconds, pulse frequency = 100 Hz) and AC (2.5 kHz, pulse duration = 0.4 milliseconds, burst frequency = 100 Hz). NMES currents were applied to the knee extensor motor point of the dominant limb. The NMES protocol consisted of 80 evoked contractions (time on:off = 5:10 seconds) and lasted 20 minutes. The current was maintained at a constant intensity throughout the NMES protocol. The primary outcome measures were maximal voluntary isometric contraction, fatigue index (evoked torque decline), fatigability (number of contractions for a 50% drop in evoked-torque from the protocol start), total evoked torque-time integral (TTI), decline in TTI, and discomfort level. RESULTS AC at 2.5 kHz demonstrated higher maximal voluntary isometric contraction decline post-fatigue, higher fatigue index, higher fatigability (ie, fewer contractions to reach the 50% evoked torque decline from the protocol start), smaller total TTI, and higher TTI decline compared with PC. No between-currents difference was observed in discomfort level. CONCLUSION PC is less fatigable than AC at 2.5 kHz. IMPACT Based on this study, PC is the preferred current choice when the NMES goal is to generate higher muscle work, higher mechanical load, and smaller fatigability during training both for athletes who are healthy and for rehabilitation programs for people with disease or injury.
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Affiliation(s)
- Isabel de Almeida Paz
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Graciane Taglian Rigo
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Amanda Sgarioni
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Viviane Bortoluzzi Frasson
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil.,Physique Centro de Fisioterapia, Porto Alegre, RS, Brazil
| | - Marco Aurélio Vaz
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Physique Centro de Fisioterapia, Porto Alegre, RS, Brazil
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Mesquita RNO, Taylor JL, Kirk B, Blazevich AJ. Involuntary sustained firing of plantar flexor motor neurones: effect of electrical stimulation parameters during tendon vibration. Eur J Appl Physiol 2021; 121:881-891. [PMID: 33392744 PMCID: PMC7892516 DOI: 10.1007/s00421-020-04563-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/16/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Simultaneous application of tendon vibration and neuromuscular electrical stimulation (NMES) induces an involuntary sustained torque. We examined the effect of different NMES parameters (intensity, pattern of stimulation and pulse width) on the magnitude of the evoked involuntary torque. METHODS Plantar flexor torque was recorded during 33-s Achilles tendon vibration with simultaneous 20-Hz NMES bouts on triceps surae (n = 20; 13 women). Intensity was set to elicit 10, 20 or 30% of maximal voluntary contraction torque (MVC), pulse width was narrow (0.2 ms) or wide (1 ms), and the stimulus pattern varied (5 × 2-s or 10 × 1-s). Up to 12 different trials were performed in a randomized order, and then repeated in those who produced a sustained involuntary torque after the cessation of vibration. RESULTS Six of 7 men and 5 of 13 women produced a post-vibration sustained torque. Eight of 20 participants did not complete the 30% trials, as they were perceived as painful. Torque during vibration at the end of NMES and the increase in torque throughout the trial were significantly higher in 20 than 10% trials (n = 11; 9.7 ± 9.0 vs 7.1 ± 6.1% MVC and 4.3 ± 4.5 vs 3.6 ± 3.5% MVC, respectively). Post-vibration sustained torque was higher in wide pulse-width trials (5.4 ± 5.9 vs 4.1 ± 4.3% MVC). Measures of involuntary torque were not different between 20 and 30% trials (n = 8). CONCLUSION Bouts of 5 × 2-s NMES with wide pulse width eliciting 20% MVC provides the most robust responses and could be used to maximise the production of involuntary torque in triceps surae.
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Affiliation(s)
- Ricardo N O Mesquita
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
| | - Janet L Taylor
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Neuroscience Research Australia, Sydney, Australia
| | - Benjamin Kirk
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Anthony J Blazevich
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Monjo F, Zory R, Forestier N. Fatiguing Neuromuscular Electrical Stimulation Decreases the Sense of Effort During Subsequent Voluntary Contractions in Men. Neuroscience 2020; 446:113-123. [PMID: 32891703 DOI: 10.1016/j.neuroscience.2020.08.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022]
Abstract
As voluntary muscle fatigue increases, the perception of the effort required to produce a particular level of force also increases. This occurs because we produce greater neural outputs from the brain to compensate for the fatigue-induced loss of force. Muscle fatigue can also be generated following bouts of neuromuscular electrical stimulation (NMES), a technique widely used for rehabilitation and training purposes. Yet the effects of NMES-induced fatigue on the perception of effort have never been tested. In this study, we thus evaluated how electrically evoked fatigue would affect the sense of effort. For this purpose, we used two psychophysical tasks intended to assess effort perception: (i) a bilateral matching task in which subjects were asked to contract the elbow flexors of their reference and indicator arms with similar amounts of effort and (ii) a unilateral matching task in which they produced controlled levels of isometric force with their indicator arm and rated their perceived effort using the Borg CR10 scale. These tasks were performed before and after the biceps brachii of the indicator arm was submitted to a fatiguing NMES program that generated maximal force losses of 10-15%. Contrary to voluntary muscle fatigue, the sense of effort decreased post-NMES in both tasks despite increased neural outputs to the elbow flexors of the fatigued indicator arm. This shows that the relationship between motor command magnitude and effort perception was completely modified by NMES. It is proposed that NMES alters the sensory structures responsible for effort signal integration.
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Affiliation(s)
| | | | - Nicolas Forestier
- Université Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, Chambéry, France
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9
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D'Amico JM, Rouffet DM, Gandevia SC, Taylor JL. Unlike voluntary contractions, stimulated contractions of a hand muscle do not reduce voluntary activation or motoneuronal excitability. J Appl Physiol (1985) 2020; 128:1412-1422. [PMID: 32324475 DOI: 10.1152/japplphysiol.00553.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Voluntary force declines during sustained, maximal voluntary contractions (MVC) due to changes in muscle and central nervous system properties. Central fatigue, an exercise-induced reduction in voluntary activation, is influenced by multiple processes. Some may occur independently of descending voluntary drive. To differentiate the effects associated with voluntary drive from other central and peripheral influences, we measured voluntary activation and motoneuron excitability following fatiguing contractions produced voluntarily or by electrical stimulation. On two separate days, participants performed either a 2-min MVC of adductor pollicis muscle or received 2-min continuous supramaximal electrical stimulation of the ulnar nerve. In study 1 (n = 14), the superimposed twitch elicited by ulnar nerve stimulation during brief MVCs was increased, and, hence, voluntary activation was reduced, up to 240 s after the 2-min MVC [-20 ± 12% (SD), P = 0.002] but not the 2-min stimulated contraction (-4 ± 7%), despite large reductions in MVC force (voluntary, -54 ± 18%; stimulated, -46 ± 16%). In study 2 (n = 12), F-waves recorded from the adductor pollicis were reduced in area for 150 s following the 2-min MVC (-21 ± 16%, P = 0.007) but not after the stimulated contraction (5 ± 27%). Therefore, voluntary activation and motoneuron excitability decreased only when descending voluntary drive was present during the fatiguing task. The findings do not exclude a cortical or brain stem contribution to the reduced voluntary activation but suggest that neither sensory feedback from the fatigued muscle nor repetitive activation of motoneurons underlie the changes, whereas they are consistent with motoneuronal inhibition by released factors linked to voluntary drive.NEW & NOTEWORTHY We demonstrate that reductions in voluntary activation and motoneuron excitability following 2-min isometric maximal contractions in humans occur only when fatigue is produced through voluntary contractions and not through electrically stimulated contractions. This is contrary to studies that suggest that changes in the superimposed twitch and therefore voluntary activation are explained by changes in peripheral factors alone. Thus, the interpolated twitch technique remains a viable tool to assess voluntary activation and central fatigue.
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Affiliation(s)
- J M D'Amico
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - D M Rouffet
- Kentucky Spinal Cord Injury Research Center, Department of Health and Sport Sciences, University of Louisville, Louisville, Kentucky.,Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - S C Gandevia
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - J L Taylor
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
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Paired Associative Stimulation Fails to Induce Plasticity in Freely Behaving Intact Rats. eNeuro 2020; 7:ENEURO.0396-19.2020. [PMID: 32139377 PMCID: PMC7113557 DOI: 10.1523/eneuro.0396-19.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/17/2020] [Accepted: 01/22/2020] [Indexed: 12/21/2022] Open
Abstract
Paired associative stimulation (PAS) has been explored in humans as a noninvasive tool to drive plasticity and promote recovery after neurologic insult. A more thorough understanding of PAS-induced plasticity is needed to fully harness it as a clinical tool. Here, we tested the efficacy of PAS with multiple interstimulus intervals in an awake rat model to study the principles of associative plasticity. Using chronically implanted electrodes in motor cortex and forelimb, we explored PAS parameters to effectively drive plasticity. We assessed changes in corticomotor excitability using a closed-loop, EMG-controlled cortical stimulation paradigm. We tested 11 PAS intervals, chosen to force the coincidence of neuronal activity in the motor cortex and spinal cord of rats with timings relevant to the principles of Hebbian spike timing-dependent plasticity. However, despite a relatively large number of stimulus pairings (300), none of the tested intervals reliably changed corticospinal excitability relative to control conditions. Our results question PAS effectiveness under these conditions.
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Cole KR, Dudley-Javoroski S, Shields RK. Hybrid stimulation enhances torque as a function of muscle fusion in human paralyzed and non-paralyzed skeletal muscle. J Spinal Cord Med 2019; 42:562-570. [PMID: 29923814 PMCID: PMC6758724 DOI: 10.1080/10790268.2018.1485312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE After spinal cord injury (SCI), hybrid stimulation patterns that interpose paired-pulse doublets over a constant-frequency background may enhance the metabolic "work" (muscle torque) performed by paralyzed muscle. This study examined the effect of background stimulation frequency on the torque contribution of the doublet before and after fatigue. DESIGN Cross-sectional study. SETTING Research laboratory in an academic medical center. PARTICIPANTS Five men with chronic sensory and motor-complete SCI and ten non-SCI controls (6 males, 4 females). SCI subjects were recruited from a long-term study of unilateral plantar-flexor training; both limbs were tested for the present study. INTERVENTIONS Subjects underwent plantar flexor stimulation at 5, 7, 9, and 12 Hz. The four background frequencies were overlaid with 6 ms doublets delivered at the start, middle, or at both the start and middle of each train. The 5 Hz and 12 Hz frequencies were analyzed after fatigue. OUTCOME MEASURES Mean torque, peak torque, torque fusion index, doublet torque. RESULTS Trains with doublets at both the start and middle yielded the most consistent enhancement of torque (all P < 0.028). Torque contribution of the doublet was greatest at low stimulus frequencies (all P < 0.016). The low relative fusion of untrained paralyzed muscle preserved the efficacy of the doublet even during fatigue. CONCLUSION Hybrid stimulus trains may be an effective way to increase contractile work in paralyzed muscle, even after fatigue. They may be useful for rehabilitation strategies designed to enhance the metabolic work performed by paralyzed skeletal muscle.
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Affiliation(s)
- Keith R. Cole
- Department of Physical Therapy and Health Care Sciences, The George Washington University, Washington, DC, USA
| | - Shauna Dudley-Javoroski
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, Iowa, USA
| | - Richard K. Shields
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, Iowa, USA,Correspondence to: Richard K. Shields, Department of Physical Therapy and Rehabilitation Science, The University of Iowa, 1-252 Medical Education Building, Iowa City, IA 52242, USA.
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12
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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]
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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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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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