scholarly journals Extra excitation of biceps femoris during neuromuscular electrical stimulation reduces knee medial loading

2019 ◽  
Vol 6 (3) ◽  
pp. 181545 ◽  
Author(s):  
Rui Xu ◽  
Dong Ming ◽  
Ziyun Ding ◽  
Anthony M. J. Bull
Keyword(s):  
Electrical Stimulation ◽  
Knee Joint ◽  
Neuromuscular Electrical Stimulation ◽  
Biceps Femoris ◽  
Step Length ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Medial Knee ◽  
Before And After ◽  
Reaction Forces

Medial knee joint osteoarthritis (OA) is a debilitating and prevalent condition. Surgical treatment consists of redistributing the forces from the medial to the lateral compartment through osteotomy, or replacing the joint surfaces. As the mediolateral load distribution is related to the action of the musculature around the knee, the aim of this study was to devise a technique to redistribute these forces non-surgically through changes in muscle excitation. Eight healthy subjects participated in the experiment, and neuromuscular electrical stimulation was used to change the muscle forces around the knee. A musculoskeletal model was used to quantify the loading on the medial compartment of the knee, and a novel algorithm devised and implemented to simulate neuromuscular electrical stimulation. The forces and moments at the knee, ground reaction forces, walking velocity and step length were quantified before and after stimulation. Stimulation of the biceps femoris resulted in a significant decrease in the second peak of the medial knee joint loading by up to 0.17 body weight ( p = 0.016). Kinematic parameters were not significantly affected. Neuromuscular electrical stimulation can decrease the peak loads on the medial compartment of the knee, and thus offers a promising therapy for medial knee joint OA.

scholarly journals Insights into the combination of neuromuscular electrical stimulation and motor imagery in a training-based approach

2021 ◽  
Author(s):  
Amandine Bouguetoch ◽  
Alain Martin ◽  
Sidney Grosprêtre
Keyword(s):  
Electrical Stimulation ◽  
Motor Imagery ◽  
Neural Plasticity ◽  
Neuromuscular Electrical Stimulation ◽  
Voluntary Contraction ◽  
Muscle Architecture ◽  
Fascicle Length ◽  
Before And After ◽  
V Wave ◽  
And Control

Abstract Introduction Training stimuli that partially activate the neuromuscular system, such as motor imagery (MI) or neuromuscular electrical stimulation (NMES), have been previously shown as efficient tools to induce strength gains. Here the efficacy of MI, NMES or NMES + MI trainings has been compared. Methods Thirty-seven participants were enrolled in a training program of ten sessions in 2 weeks targeting plantar flexor muscles, distributed in four groups: MI, NMES, NMES + MI and control. Each group underwent forty contractions in each session, NMES + MI group doing 20 contractions of each modality. Before and after, the neuromuscular function was tested through the recording of maximal voluntary contraction (MVC), but also electrophysiological and mechanical responses associated with electrical nerve stimulation. Muscle architecture was assessed by ultrasonography. Results MVC increased by 11.3 ± 3.5% in NMES group, by 13.8 ± 5.6% in MI, while unchanged for NMES + MI and control. During MVC, a significant increase in V-wave without associated changes in superimposed H-reflex has been observed for NMES and MI, suggesting that neural adaptations occurred at supraspinal level. Rest spinal excitability was increased in the MI group while decreased in the NMES group. No change in muscle architecture (pennation angle, fascicle length) has been found in any group but muscular peak twitch and soleus maximal M-wave increased in the NMES group only. Conclusion Finally, MI and NMES seem to be efficient stimuli to improve strength, although both exhibited different and specific neural plasticity. On its side, NMES + MI combination did not provide the expected gains, suggesting that their effects are not simply cumulative, or even are competitive.

Effect Of Neuromuscular Electrical Stimulation On Peak Torque Knee Joint

2014 ◽  
Vol 46 ◽  
pp. 671
Author(s):  
Flávia Medeiros ◽  
Amilton Vieira ◽  
Martim Bottaro ◽  
João Durigan
Keyword(s):  
Electrical Stimulation ◽  
Knee Joint ◽  
Neuromuscular Electrical Stimulation ◽  
Peak Torque

Neuromuscular electrical stimulation training induces atypical adaptations of the human skeletal muscle phenotype: a functional and proteomic analysis

2011 ◽  
Vol 110 (2) ◽  
pp. 433-450 ◽  
Author(s):  
Julien Gondin ◽  
Lorenza Brocca ◽  
Elena Bellinzona ◽  
Giuseppe D'Antona ◽  
Nicola A. Maffiuletti ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Electrical Stimulation ◽  
Proteomic Analysis ◽  
Metabolic Profile ◽  
Human Skeletal Muscle ◽  
Protein Pattern ◽  
Neuromuscular Electrical Stimulation ◽  
Vastus Lateralis Muscle ◽  
Before And After ◽  
Antioxidant Defense Systems

The aim of the present study was to define the chronic effects of neuromuscular electrical stimulation (NMES) on the neuromuscular properties of human skeletal muscle. Eight young healthy male subjects were subjected to 25 sessions of isometric NMES of the quadriceps muscle over an 8-wk period. Needle biopsies were taken from the vastus lateralis muscle before and after training. The training status, myosin heavy chain (MHC) isoform distribution, and global protein pattern, as assessed by proteomic analysis, widely varied among subjects at baseline and prompted the identification of two subgroups: an “active” (ACT) group, which performed regular exercise and had a slower MHC profile, and a sedentary (SED) group, which did not perform any exercise and had a faster MHC profile. Maximum voluntary force and neural activation significantly increased after NMES in both groups (+∼30% and +∼10%, respectively). Both type 1 and 2 fibers showed significant muscle hypertrophy. After NMES, both groups showed a significant shift from MHC-2X toward MHC-2A and MHC-1, i.e., a fast-to-slow transition. Proteomic maps showing ∼500 spots were obtained before and after training in both groups. Differentially expressed proteins were identified and grouped into functional categories. The most relevant changes regarded 1) myofibrillar proteins, whose changes were consistent with a fast-to-slow phenotype shift and with a strengthening of the cytoskeleton; 2) energy production systems, whose changes indicated a glycolytic-to-oxidative shift in the metabolic profile; and 3) antioxidant defense systems, whose changes indicated an enhancement of intracellular defenses against reactive oxygen species. The adaptations in the protein pattern of the ACT and SED groups were different but were, in both groups, typical of both resistance (i.e., strength gains and hypertrophy) and endurance (i.e., a fast-to-slow shift in MHC and metabolic profile) training. These training-induced adaptations can be ascribed to the peculiar motor unit recruitment pattern associated with NMES.

scholarly journals Static Loading of the Knee Joint Results in Modified Single Leg Landing Biomechanics

2019 ◽  
Author(s):  
Michael W. Olson
Keyword(s):  
Knee Joint ◽  
Static Loading ◽  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Biceps Femoris ◽  
Rate Of Force Development ◽  
External Loading ◽  
Force Development ◽  
Before And After ◽  
Angular Velocities

ABSTRACTBackgroundExternal loading of the ligamentous tissues induces mechanical creep, which modifies neuromuscular response to perturbations. It is not well understood how ligamentous creep affects athletic performance and contributes to modifications of knee biomechanics during functional tasks.Hypothesis/PurposeThe purpose of this study was to examine the mechanical and neuromuscular responses to single leg drop landing perturbations before and after passive loading of the knee joint.Study DesignDescriptive laboratory studyMethodsMale (n=7) and female (n=14) participants’ (21.3 ± 2.1 yrs, 1.69 ± 0.09 m, 69.3 ± 13.0 kg) right hip, knee, and ankle kinematics were assessed during drop landings performed from a 30 cm height onto a force platform before and after a 10 min creep protocol. Electromyography (EMG) signals were recorded from rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), semimembranosus (SM), and biceps femoris (BF) muscles. The creep protocol involved fixing the knee joint at 35° during static loading with perpendicular loads of either 200 N (males) or 150 N (females). Maximum, minimum, range of motion (ROM), and angular velocities were assessed for the hip, knee, and ankle joints, while normalized average EMG (NAEMG), average vertical ground reaction forces (aVGRF), and rate of force development (RFD) were assessed at landing. Rate of force development (RFD) was calculated during the landings using ANOVAs. Alpha was set at 0.05.ResultsMaximum hip flexion velocity decreased (p < 0.01). Minimum knee flexion velocity increased (p < 0.02). Minimum knee ad/abduction velocity decreased (p < 0.001). Ankle ROM decreased (p < 0.001). aVGRF decreased (p < 0.02). RFD had a non-significant trend (p = 0.076). NAEMG was significant between muscle groups (p < 0.02).ConclusionDistinct changes in velocity parameters are attributed to the altered mechanical behavior of the knee joint tissues and may contribute to changes in the loading of the leg during landing.

scholarly journals Radiographic vs. MRI vs. arthroscopic assessment and grading of knee osteoarthritis - are we using appropriate imaging?

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Samuel Newman ◽  
Huzefah Ahmed ◽  
Nader Rehmatullah
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Imaging Techniques ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Actual Condition ◽  
Tertiary Centre ◽  
Arthroscopic Findings ◽  
Mri Scans ◽  
Outerbridge Grade

Abstract Purpose Radiographs and MRI scans are commonly used imaging techniques in the assessment of knee osteoarthritis. However, it currently remains uncertain how good a representation of the actual condition of the knee joint these investigations provide. By comparing them against arthroscopic findings the aim of our study was to conclude how accurate these imaging techniques are at grading knee osteoarthritis. Methods This was a retrospective study looking at knee arthroscopies performed at a tertiary centre over a 5 year period. The Outerbridge grade given at arthroscopy was correlated with pre-operative radiograph and MRI scores, so as to assess the reliability of these imaging techniques at predicting the actual severity of knee osteoarthritis seen. Results Kellgren-Lawrence (KL) grading of radiographs was moderately correlated with Outerbridge grades from arthroscopy for the medial compartment of the knee (Spearman’s rho (SR) 0.483, p < 0.001), with a milder correlation in the lateral compartment (SR 0.218, p = 0.003). MRI reporting of knee osteoarthritis was moderately correlated with Outerbridge grades in the medial compartment (SR 0.451, p < 0.001), mildly correlated for both the lateral (SR 0.299, p < 0.001) and patellofemoral joint compartments (SR 0.142, p = 0.054). KL and MRI grading was moderately correlated for the medial compartment (SR 0.475, p < 0.001) and mildly correlated for the lateral compartment (SR 0.277, p < 0.001). Conclusion The ability of radiographs to represent the actual condition of knee osteoarthritis is underestimated. KL grading especially best represents the disease seen in the medial compartment of the knee joint, with a moderate correlation to Outerbridge scores given on arthroscopic assessment. We suggest that whilst MRI is a useful tool in the investigation of knee symptoms, it is often unnecessarily used in patients with OA, when in fact, radiographs alone would be sufficient. Evidence level III

scholarly journals Effects of neuromuscular electrical stimulation and core muscle strengthening on trunk instability following stroke

2021 ◽  
Vol 9 (12) ◽  
pp. 3596
Author(s):  
Riyas Basheer K. B. ◽  
Dinesh K. V. ◽  
Subhashchandra Rai ◽  
Mohammed Arshak A. T.
Keyword(s):  
Electrical Stimulation ◽  
Neuromuscular Electrical Stimulation ◽  
Berg Balance Scale ◽  
Rehabilitation Program ◽  
Secondary Outcome ◽  
Combination Group ◽  
Muscle Strengthening ◽  
Before And After ◽  
Trunk Balance ◽  
Risk Of Fall

Background: Postural instability leads to balance dysfunction in stroke subjects, which always increase the risk of fall. This study aimed to compare the effect of neuromuscular electrical stimulation and core muscle strengthening on trunk balance following stroke.Methods: Forty five stroke subjects were participated and assigned randomly into three groups; all groups received standard rehabilitation program; and core group received additional core strengthening, neuromuscular electrical stimulation (NMES) group received added electrical stimulation over paraspinal region and combination group received core muscle strengthening and NMES along with standard rehabilitation protocol. After four weeks of the interventions, primary and secondary outcome measures are evaluated. Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Trunk Impairment Scale (TIS) and Barthel Index (BI) were evaluated before and after the intervention.Results: All the three (core MS, NMES and combination) groups showed significant improvement after the intervention (BBS 10.07, 15.54 and 18.27, PASS 6.54, 13.06 and 14.00, TIS 0.25, 0.25 and 0.51, BI 16.40, 29.93 and 36.53). The combination group (NMES and core muscle strengthening) showed better improvement than other two groups. TIS and BI total score showed positive (0.849) correlation.Conclusions: Addition of NMES along with core muscle strengthening for stroke rehabilitation will improve trunk stability, balance and ADLs.

Identifying the knee joint angular position under neuromuscular electrical stimulation via long short-term memory neural networks

2020 ◽  
Vol 36 (4) ◽  
pp. 511-526
Author(s):  
Héber H. Arcolezi ◽  
Willian R. B. M. Nunes ◽  
Selene Cerna ◽  
Rafael A. de Araujo ◽  
Marcelo Augusto Assunção Sanches ◽  
...  
Keyword(s):  
Neural Networks ◽  
Electrical Stimulation ◽  
Knee Joint ◽  
Short Term Memory ◽  
Angular Position ◽  
Neuromuscular Electrical Stimulation ◽  
Short Term ◽  
Term Memory ◽  
Long Short Term Memory

The effect of knee orthoses on gait parameters in medial knee compartment osteoarthritis: A literature review

2014 ◽  
Vol 40 (2) ◽  
pp. 193-201 ◽  
Author(s):  
Maryam Maleki ◽  
Mokhtar Arazpour ◽  
Mahmoud Joghtaei ◽  
Stephen W Hutchins ◽  
Atefeh Aboutorabi ◽  
...  
Keyword(s):  
Literature Review ◽  
Knee Osteoarthritis ◽  
Step Length ◽  
Medial Compartment ◽  
Medial Knee ◽  
Pain Disability ◽  
Gait Parameters ◽  
Osteoarthritis Knee ◽  
Measure Methods ◽  
Knee Braces

Background: Knee osteoarthritis is a musculoskeletal condition which is most prevalent in the medial compartment. This injury causes considerable pain, disability, and negative changes in kinetic and kinematic parameters. The efficiency of unloader valgus brace as a conservative treatment for medial knee osteoarthritis is not well documented. Objectives: The aim of this study was to review the previous research regarding the biomechanical effects of knee valgus braces on walking in medial compartment knee osteoarthritis patients. Study design: Literature review Methods: According to the population intervention comparison outcome measure methods and based on selected keywords, 12 studies were chosen according to (met) the inclusion criteria. Results: The results indicated that treatment with knee braces was effective in decreasing pain, improving function, ameliorating improvement in range of motion, and increasing speed of walking and step length in conjunction with a reduction in the adduction moment applied to the knee. Conclusion: Osteoarthritis knee braces may be considered for improvement of walking and treatment of medial compartment knee osteoarthritis. Clinical relevance Knee braces are an orthotic intervention that could potentially be significant in assisting in improving the walking parameters and treatment of medial compartment knee osteoarthritis.

scholarly journals A Novel Implant System for Unloading the Medial Compartment of the Knee by Lateral Displacement of the Iliotibial Band

2017 ◽  
Vol 5 (3) ◽  
pp. 232596711769361 ◽  
Author(s):  
Vivek N. Shenoy ◽  
Hanson S. Gifford ◽  
John T. Kao
Keyword(s):  
Mechanical Load ◽  
Early Stage ◽  
Lateral Displacement ◽  
Femoral Condyle ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Iliotibial Band ◽  
Moment Arm ◽  
Treatment Gap ◽  
Medial Knee

Background: Medial knee osteoarthritis (OA) typically occurs with excessive mechanical load within the medial compartment, resulting in degeneration of the articular cartilage. Purpose: A novel extracapsular implant (Latella Knee Implant) has been developed to unload the medial compartment of the knee. The implant displaces the iliotibial band (ITB) over the lateral femoral condyle, thereby increasing its effective moment arm, resulting in a transfer of load from the medial compartment to the lateral compartment of the knee. A cadaveric study was performed to evaluate the effect of altering the moment arm of the ITB on knee biomechanics. Study Design: Controlled laboratory study. Methods: A 6-degrees-of-freedom robotic testing system was utilized to measure medial and lateral compartment loads in 8 fresh-frozen cadaveric knees at various ITB loads and knee flexion angles. Measurements were made with and without the implant in place. The system measured the compartment forces at flexion angles between 0° and 30° under 3 simulated loading conditions (300 N quadriceps, 100 N hamstrings, and [1] 0 N ITB, [2] 50 N ITB, [3] 100 N ITB). Results: Lateral displacement of the ITB between 15 and 20 mm resulted in medial compartment unloading between 34% and 65%. Conclusion: Unloading the medial compartment with this novel implant has the potential to address the treatment gap for patients with medial knee OA. Clinical Relevance: Currently, there exists a treatment gap for patients with medial compartment OA who have exhausted conservative management but whose disease and symptoms do not warrant more invasive surgical procedures. An extracapsular implant to unload the medial compartment could fill this treatment gap by providing patients and surgeons with a less invasive option for early to mid-stage OA. Unloading the medial compartment may alleviate pain and improve function, allowing patients with early-stage medial OA to remain active longer prior to considering more invasive options such as arthroplasty.

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