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Gkesou A, Papavasileiou A, Karagiaridis S, Kannas T, Amiridis IG, Hatzitaki V, Patikas DA. Fatigability of the thenar muscles using electrical nerve stimulation with fixed stimuli count, while varying the frequency and duty cycle. J Electromyogr Kinesiol 2023; 73:102838. [PMID: 37976607 DOI: 10.1016/j.jelekin.2023.102838] [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: 06/30/2023] [Revised: 09/30/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
Our aim was to compare three electrical stimulation protocols (P20, P30 and P40), with the same number of stimuli, but different stimulation frequencies (20, 30 and 40 Hz, respectively) and duty cycles [1.2:1.2 s (continuous), 0.8:1.2 s (intermittent) and 0.6:1.2 s (intermittent), respectively). Twitch force and the peak-to-peak M-wave amplitude of the thenar muscles were measured before, during and after each protocol at 1-40 Hz in random order. Twelve healthy adults (23-41 years old) were examined for each protocol in random order and in separate sessions. P20 elicited the highest mean force, and P40 the lowest decrease in percent force at the end of the protocol. Force evoked at 1 and 10 Hz decreased less after P40, compared with P20 and P30. The M-wave amplitude was significantly reduced throughout all protocols, with the largest decrease observed during P30. Although an increase in frequency typically induced earlier and greater decrement in force, this was compensated or even reversed by increasing the interval between each stimulation train, while keeping the number of pulses per stimulation cycle constant. The lesser decrease in M-wave amplitude during P40 compared with P20 indicates that longer between-train intervals may help maintaining the integrity of neuromuscular propagation.
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Affiliation(s)
- A Gkesou
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Greece
| | - A Papavasileiou
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Greece
| | - S Karagiaridis
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Greece
| | - T Kannas
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Greece
| | - I G Amiridis
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Greece
| | - V Hatzitaki
- School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Greece
| | - D A Patikas
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Greece.
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Abitante TJ, Rutkove SB, Duda KR, Newman DJ. Effect of Athletic Training on Fatigue During Neuromuscular Electrical Stimulation. Front Sports Act Living 2022; 4:894395. [PMID: 35774382 PMCID: PMC9237484 DOI: 10.3389/fspor.2022.894395] [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: 03/11/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to explore the effect an individual's exercise training type will have on muscle fatigability during repetitive contractions induced by Neuromuscular Electrical Stimulation (NMES). Thirty-four subjects comprising of competitive athletes and controls were recruited into three cohorts: Endurance (runners/cyclists) n = 13; nine male, four female; 27 ± 8 years old, Explosive (Lifters/Sprinters) n = 11; nine male, two female; 30 ± 7 years old, and controls n = 10, six male, four female, 26 ± 4 years old. Subjects were placed in a custom-made leg extension rig, and received NMES against a fixed resistance (NMES-FR), to the Vastus Medialis muscle resulting in isometric leg extensions, at a duty cycle of 1 s on/3 s rest, for 20 min. The force of the isometric contractions was recorded using a Hogan MicroFet2 dynamometer, and three separate fatigue metrics were calculated to compare the different cohorts, sports within each cohort, and gender within each cohort. For every fatigue metric, the endurance group fatigued significantly less than both the explosive and control cohorts, with no difference observed between the explosive and the controls. Within each cohort, no significant difference was observed in any fatigue metric between sport or gender, but these comparisons lacked power. The results show that only high capacity endurance activity will have any effect on reducing one's fatigability during repetitive NMES. The implications of this conclusion can aid in the development of NMES regimens for use in healthy populations, such as athletic training or astronaut musculoskeletal countermeasures, as well as clinical applications when fatigue is to be minimized.
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Affiliation(s)
- Thomas J. Abitante
- Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, United States
- The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
- *Correspondence: Thomas J. Abitante
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Kevin R. Duda
- The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
| | - Dava J. Newman
- MIT Media Lab, Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, United States
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Fang CY, Lien ASY, Tsai JL, Yang HC, Chan HL, Chen RS, Chang YJ. The Effect and Dose-Response of Functional Electrical Stimulation Cycling Training on Spasticity in Individuals With Spinal Cord Injury: A Systematic Review With Meta-Analysis. Front Physiol 2021; 12:756200. [PMID: 34867459 PMCID: PMC8640241 DOI: 10.3389/fphys.2021.756200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/21/2021] [Indexed: 01/10/2023] Open
Abstract
Background: To investigate the effect and dose-response of functional electrical stimulation cycling (FES-cycling) training on spasticity in the individuals with spinal cord injury (SCI). Method: Five electronic databases [PubMed, Scopus, Medline (Proquest), Embase, and Cochrane Central Register of Controlled Trials (CENTRAL)] were searched before September 2021. The human trials and studies of English language were only included. Two authors independently reviewed and extracted the searched studies. The primary outcome measure was spasticity assessed by Modified Ashworth Scale or Ashworth Scale for lower limbs. The secondary outcome measures were walking abilities, such as 6 Min Walk Test (6MWT), Timed Up and Go (TUG), and lower limbs muscle strength (LEMS). A subgroup analysis was performed to investigate the efficacious threshold number of training sessions. A meta-regression analysis was used to examine the linear relationship between the training sessions and the effect on spasticity. Results: A total of 764 studies were identified. After screening, 12 selected studies were used for the qualitative synthesis, in which eight of them were quantitatively analyzed. Eight studies included ninety-nine subjects in total with SCI (male: female = 83:16). The time since injury was from less than 4 weeks to 17 years. The age ranged from 20 to 67 years. American Spinal Injury Association (ASIA) impairment level of the number of participants was 59 for ASIA A, 11 for ASIA B, 18 for ASIA C, and 11 for ASIA D. There were 43 subjects with tetraplegia and 56 subjects with paraplegia. Spasticity decreased significantly (95% CI = - 1.538 to - 0.182, p = 0.013) in favor of FES-cycling training. The walking ability and LEMS also improved significantly in favor of FES-cycling training. The subgroup analysis showed that spasticity decreased significantly only in more than 20 training sessions (95% CI = - 1.749 to - 0.149, p = 0.020). The meta-regression analysis showed training sessions and spasticity were not significantly associated (coefficient = - 0.0025, SE = 0.0129, p = 0.849, R 2 analog = 0.37). Conclusion: Functional electrical stimulation-cycling training can improve spasticity, walking ability, and the strength of the lower limbs in the individuals with SCI. The number of training sessions is not linearly related to the decrease of spasticity. Twenty sessions of FES-cycling training are required to obtain the efficacy to decrease spasticity.
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Affiliation(s)
- Chia-Ying Fang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Angela Shin-Yu Lien
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jia-Ling Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiao-Chu Yang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiao-Lung Chan
- Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Rou-Shayn Chen
- Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Ju Chang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Badi M, Wurth S, Scarpato I, Roussinova E, Losanno E, Bogaard A, Delacombaz M, Borgognon S, C Vanc Ara P, Fallegger F, Su DK, Schmidlin E, Courtine G, Bloch J, Lacour SP, Stieglitz T, Rouiller EM, Capogrosso M, Micera S. Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates. Sci Transl Med 2021; 13:eabg6463. [PMID: 34705521 DOI: 10.1126/scitranslmed.abg6463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Marion Badi
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Sophie Wurth
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Ilaria Scarpato
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Evgenia Roussinova
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Elena Losanno
- Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
| | - Andrew Bogaard
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Maude Delacombaz
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Simon Borgognon
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.,Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, EPFL, 1015 Lausanne, Switzerland
| | - Paul C Vanc Ara
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg, and BrainLinks-BrainTools Center, University of Freiburg, 79110 Freiburg, Germany
| | - Florian Fallegger
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, 1202 Geneva, Switzerland
| | - David K Su
- Neurological Surgery, Harborview Medical Center, Seattle, WA 98104, USA
| | - Eric Schmidlin
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Grégoire Courtine
- Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, EPFL, 1015 Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV), and University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Jocelyne Bloch
- Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV), and University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Stéphanie P Lacour
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, 1202 Geneva, Switzerland
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg, and BrainLinks-BrainTools Center, University of Freiburg, 79110 Freiburg, Germany
| | - Eric M Rouiller
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Marco Capogrosso
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.,Department of Neurological Surgery, Rehabilitation and Neural Engineering Laboratories, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.,Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
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5
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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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6
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Ainsley EN, Barss TS, Collins DF. Contraction fatigability during interleaved neuromuscular electrical stimulation of the ankle dorsiflexors does not depend on contraction amplitude. Appl Physiol Nutr Metab 2020; 45:948-956. [DOI: 10.1139/apnm-2019-0851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Interleaved neuromuscular electrical stimulation (iNMES) involves alternating stimulus pulses between the tibialis anterior muscle and common peroneal nerve. The current investigation aimed to characterize the relationship between contraction amplitude, motor unit (MU) “overlap”, and contraction fatigability during iNMES. It was hypothesized that as iNMES generates progressively larger contractions, more MUs would be recruited from both sites (i.e., more MU overlap), resulting in more fatigability for larger than smaller contractions. Fourteen participants completed 3 sessions. Fatigability was assessed as the decline in torque over 180 contractions (0.3 s “on”, 0.7 s “off”) when iNMES was delivered to produce initial contractions of ∼5%, 15%, or 30% of a maximal voluntary contraction. Although MU overlap increased significantly with contraction amplitude, the relative (percent) decline in torque was not different between the contraction amplitudes and torque declined on average by 23%. Contraction fatigability was not significantly correlated with either MU overlap or initial contraction amplitude. In conclusion, iNMES can produce fatigue-resistant contractions across a functionally-meaningful range of contraction amplitudes for rehabilitation. Novelty Interleaved neuromuscular electrical stimulation progressively recruits MUs as contraction amplitude increases. However, the relative amount of fatigability of recruited MUs was not different as contraction amplitude increased. This suggests iNMES can be used effectively to produce fatigue-resistant and functionally meaningful contractions.
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Affiliation(s)
- Emily N. Ainsley
- Human Neurophysiology Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, AB T6G 2H9, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Trevor S. Barss
- Human Neurophysiology Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, AB T6G 2H9, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - David F. Collins
- Human Neurophysiology Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, AB T6G 2H9, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2E1, Canada
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7
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Ilves M, Rantanen V, Venesvirta H, Lylykangas J, Vehkaoja A, Mäkelä E, Verho J, Lekkala J, Rautiainen M, Surakka V. Functional electrical stimulation for facial pacing: Effects of waveforms on movement intensity and ratings of discomfort. Biomed Signal Process Control 2020. [DOI: 10.1016/j.bspc.2020.101992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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8
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Nekoukar V. Control of Functional Electrical Stimulation Systems Using Simultaneous Pulse Width, Amplitude, and Frequency Modulations. Neuromodulation 2020; 24:1467-1474. [PMID: 32084306 DOI: 10.1111/ner.13126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/02/2020] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND One significant challenge of developing a controller for functional electrical stimulation systems is the time-variant nonlinear dynamics of the neuromusculoskeletal system. In the conventional methods, the stimulation intensity is adjusted by a controller; however, the stimulation frequency is always constant. The previous studies have shown that the stimulation frequency is effective in fatigue formation. OBJECTIVES A simultaneous modulation of the stimulation intensity and frequency is proposed to improve the joint controllability and muscle endurance. The presented control method determines pulse width (PW), amplitude, and frequency of the electrical stimulation signal, synchronously. Three different modulations are applied for control of the knee joint to show the superiority of the proposed modulation. METHODS The stimulation intensity is controlled by the PW and pulse amplitude of the electrical signal using an adaptive fuzzy terminal sliding mode controller and a fuzzy logic controller, respectively. Also, a fuzzy logic controller is applied to adjust the stimulation frequency. The proposed method is utilized to control the knee joint movement using quadriceps femoris muscles for ten paraplegic subjects. RESULTS Two different test protocols are defined to evaluate the presented method: A protocol for testing the controllability and another protocol for evaluating the produced muscle endurance. The average value of the root mean square of the tracking error was 6.4° for the proposed method which is 5.1° and 9.6° less than PW modulation and synchronous PW and amplitude modulation, respectively. The average time duration of the knee full extension was 96 sec for the proposed method which is 17 and 26 sec more than PW modulation and synchronous PW and amplitude modulation, respectively. CONCLUSIONS The experimental results show that control performance and tracking ability of the joint reference trajectory are improved by using the simultaneous modulation of PW, amplitude, and frequency.
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Affiliation(s)
- Vahab Nekoukar
- Department of Control Engineering, Electrical Engineering School, Shahid Rajaee Teacher Training University, Lavizan, Tehran, Iran
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9
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Ruslee R, Miller J, Gollee H. Investigation of different stimulation patterns with doublet pulses to reduce muscle fatigue. J Rehabil Assist Technol Eng 2019; 6:2055668319825808. [PMID: 31245029 PMCID: PMC6582293 DOI: 10.1177/2055668319825808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/18/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction: Functional electrical stimulation is a common
technique used in the rehabilitation of individuals with a spinal cord injury to
produce functional movement of paralysed muscles. However, it is often
associated with rapid muscle fatigue which limits its applications.
Methods: The objective of this study is to investigate the
effects on the onset of fatigue of different multi-electrode patterns of
stimulation via multiple pairs of electrodes using doublet pulses: Synchronous
stimulation is compared to asynchronous stimulation patterns which are activated
sequentially (AsynS) or randomly (AsynR), mimicking voluntary muscle activation
by targeting different motor units. We investigated these three different
approaches by applying stimulation to the gastrocnemius muscle repeatedly for
10 min (300 ms stimulation followed by 700 ms of no-stimulation) with 40 Hz
effective frequency for all protocols and doublet pulses with an
inter-pulse-interval of 6 ms. Eleven able-bodied volunteers (28 ± 3 years old)
participated in this study. Ultrasound videos were recorded during stimulation
to allow evaluation of changes in muscle morphology. The main fatigue indicators
we focused on were the normalised fatigue index, fatigue time interval and
pre-post twitch–tetanus ratio. Results: The results demonstrate
that asynchronous stimulation with doublet pulses gives a higher normalised
fatigue index (0.80 ± 0.08 and 0.87 ± 0.08) for AsynS and AsynR, respectively,
than synchronous stimulation (0.62 ± 0.06). Furthermore, a longer fatigue time
interval for AsynS (302.2 ± 230.9 s) and AsynR (384.4 ± 279.0 s) compared to
synchronous stimulation (68.0 ± 30.5 s) indicates that fatigue occurs later
during asynchronous stimulation; however, this was only found to be
statistically significant for one of two methods used to calculate the group
mean. Although no significant difference was found in pre-post twitch–tetanus
ratio, there was a trend towards these effects. Conclusion: In this
study, we proposed an asynchronous stimulation pattern for the application of
functional electrical stimulation and investigated its suitability for reducing
muscle fatigue compared to previous methods. The results show that asynchronous
multi-electrode stimulation patterns with doublet pulses may improve fatigue
resistance in functional electrical stimulation applications in some
conditions.
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Affiliation(s)
- Ruslinda Ruslee
- Centre for Rehabilitation Engineering, University of Glasgow, Glasgow, UK.,Department of Electronics Engineering, MARA Japan Industrial Institute (MJII), Beranang, Selangor, Malaysia
| | - Jennifer Miller
- Centre for Rehabilitation Engineering, University of Glasgow, Glasgow, UK
| | - Henrik Gollee
- Centre for Rehabilitation Engineering, University of Glasgow, Glasgow, UK
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10
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Ben Hmed A, Bakir T, Garnier YM, Sakly A, Lepers R, Binczak S. An approach to a muscle force model with force-pulse amplitude relationship of human quadriceps muscles. Comput Biol Med 2018; 101:218-228. [PMID: 30199798 DOI: 10.1016/j.compbiomed.2018.08.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/25/2018] [Accepted: 08/26/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent advanced applications of the functional electrical stimulation (FES) mostly used closed-loop control strategies based on mathematical models to improve the performance of the FES systems. In most of them, the pulse amplitude was used as an input control. However, in controlling the muscle force, the most popular force model developed by Ding et al. does not take into account the pulse amplitude effect. The purpose of this study was to include the pulse amplitude in the existing Ding et al. model based on the recruitment curve function. METHODS Quadriceps femoris muscles of eight healthy subjects were tested. Forces responses to stimulation trains with different pulse amplitudes (30-100 mA) and frequencies (20-80 Hz) were recorded and analyzed. Then, specific model parameter values were identified by fitting the measured forces for one train (50 Hz, 100 mA). The obtained model parameters were then used to identify the recruitment curve parameter values by fitting the force responses for different pulse amplitudes at the same frequency train. Finally, the extended model was used to predict force responses for a range of stimulation pulse amplitudes and frequencies. RESULTS The experimental results indicated that our adapted model accurately predicts the force-pulse amplitude relationship with an excellent agreement between measured and predicted forces (R2=0.998, RMSE = 6.6 N). CONCLUSIONS This model could be used to predict the pulse amplitude effect and to design control strategies for controlling the muscle force in order to obtain precise movements during FES sessions using intensity modulation.
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Affiliation(s)
- Abdennacer Ben Hmed
- Laboratory Le2i, FRE CNRS 2005, Univ. de Bourgogne Franche-Comte, Dijon, France; Research Unit ESIER, National Engineering School of Monastir (ENIM), University of Monastir, Tunisia.
| | - Toufik Bakir
- Laboratory Le2i, FRE CNRS 2005, Univ. de Bourgogne Franche-Comte, Dijon, France
| | - Yoann M Garnier
- INSERM UMR1093-CAPS, Univ. Bourgogne Franche-Comte, UFR des Sciences du Sport, Dijon, France
| | - Anis Sakly
- Research Unit ESIER, National Engineering School of Monastir (ENIM), University of Monastir, Tunisia
| | - Romuald Lepers
- INSERM UMR1093-CAPS, Univ. Bourgogne Franche-Comte, UFR des Sciences du Sport, Dijon, France
| | - Stephane Binczak
- Laboratory Le2i, FRE CNRS 2005, Univ. de Bourgogne Franche-Comte, Dijon, France
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11
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Hmed AB, Bakir T, Sakly A, Binczak S. A New Mathematical Force Model that Predicts the Force-pulse Amplitude Relationship of Human Skeletal Muscle. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:3485-3488. [PMID: 30441132 DOI: 10.1109/embc.2018.8512946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Current functional electrical stimulation (FES) systems vary the stimulation intensity to control the muscle force in order to produce precise functional movements. However, mathematical model that predicts the intensity effect on the muscle force is required for model-based controller design. The most previous force model designed by Ding et al was validated only for a standardized stimulation pulse amplitude (intensity). Thus, the purpose of this study was to adapt the Ding et al model to be able to predict the force-pulse amplitude relationship. The experimental results tested on quadriceps femoris muscles of healthy subjects (N=5) show that our adapted model accurately predicts the force response for trains of a wide range of stimulation intensities (30-100 mA). The accurate predictions indicate that our adapted model could be used for designing model-based control strategies to control the muscle force through FES.
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Vromans M, Faghri P. Electrical Stimulation Frequency and Skeletal Muscle Characteristics: Effects on Force and Fatigue. Eur J Transl Myol 2017; 27:6816. [PMID: 29299218 PMCID: PMC5745385 DOI: 10.4081/ejtm.2017.6816] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/14/2017] [Accepted: 10/14/2017] [Indexed: 12/02/2022] Open
Abstract
This investigation aimed to determine the force and muscle surface electromyography (EMG) responses to different frequencies of electrical stimulation (ES) in two groups of muscles with different size and fiber composition (fast- and slow-twitch fiber proportions) during a fatigue-inducing protocol. Progression towards fatigue was evaluated in the abductor pollicis brevis (APB) and vastus lateralis (VL) when activated by ES at three frequencies (10, 35, and 50Hz). Ten healthy adults (mean age: 23.2 ± 3.0 years) were recruited; participants signed an IRB approved consent form prior to participation. Protocols were developed to 1) identify initial ES current intensity required to generate the 25% maximal voluntary contraction (MVC) at each ES frequency and 2) evaluate changes in force and EMG activity during ES-induced contraction at each frequency while progressing towards fatigue. For both muscles, stimulation at 10Hz required higher current intensity of ES to generate the initial force. There was a significant decline in force in response to ES-induced fatigue for all frequencies and for both muscles (p<0.05). However, the EMG response was not consistent between muscles. During the progression towards fatigue, the APB displayed an initial drop in force followed by an increase in EMG activity and the VL displayed a decrease in EMG activity for all frequencies. Overall, it appeared that there were some significant interactions between muscle size and fiber composition during progression towards fatigue for different ES frequencies. It could be postulated that muscle characteristics (size and fiber composition) should be considered when evaluating progression towards fatigue as EMG and force responses are not consistent between muscles.
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Affiliation(s)
- Maria Vromans
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Pouran Faghri
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA.,Department of Allied Health Sciences, Storrs, CT, USA
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Vromans M, Faghri PD. Functional electrical stimulation-induced muscular fatigue: Effect of fiber composition and stimulation frequency on rate of fatigue development. J Electromyogr Kinesiol 2017; 38:67-72. [PMID: 29169055 DOI: 10.1016/j.jelekin.2017.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/07/2017] [Accepted: 11/09/2017] [Indexed: 01/23/2023] Open
Abstract
This investigation evaluated the progression towards fatigue in two muscles of differing fast- and slow-twitch fiber proportions (abductor pollicis brevis (APB) and vastus lateralis (VL)) when activated by functional electrical stimulation (FES) at three frequencies (10, 35, and 50 Hz). Fatigue was defined as a 50% drop from the initial FES-induced force of 25% maximal voluntary contraction (MVC). Ten healthy adults (mean age: 23.2 ± 3.0 years) were recruited; participants signed an IRB approved consent form prior to participation. Protocols were developed to evaluate the effects of muscle size, fiber type and FES frequency on total time to fatigue. Results indicated that the predominantly fast-twitch VL fatigued more quickly than the slow-twitch APB at the higher frequencies (p < 0.05), but did not significantly differ with stimulation at 10 Hz. Overall, muscle size and FES frequencies showed some significant interactions when generating a defined force and during fatigue development. Furthermore, it appears that to reduce fatigue, FES treatments should not extend past ∼14-16 min for large and small muscle groups, respectively, when the muscle group's optimal stimulation frequency is applied.
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Affiliation(s)
- Maria Vromans
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Pouran D Faghri
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA; Department of Allied Health Sciences, Storrs, CT, USA.
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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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