scholarly journals Assessment of muscle activity using electrical stimulation and mechanomyography: a systematic review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Raphael Uwamahoro ◽  
Kenneth Sundaraj ◽  
Indra Devi Subramaniam
Keyword(s):  
Electrical Stimulation ◽  
Processing Speed ◽  
Muscle Activity ◽  
Neuromuscular Electrical Stimulation ◽  
Voluntary Contraction ◽  
Electrical Signal ◽  
Muscle Performance ◽  
Inclusion Criteria ◽  
Activity Assessment ◽  
Experimental Protocols

AbstractThis research has proved that mechanomyographic (MMG) signals can be used for evaluating muscle performance. Stimulation of the lost physiological functions of a muscle using an electrical signal has been determined crucial in clinical and experimental settings in which voluntary contraction fails in stimulating specific muscles. Previous studies have already indicated that characterizing contractile properties of muscles using MMG through neuromuscular electrical stimulation (NMES) showed excellent reliability. Thus, this review highlights the use of MMG signals on evaluating skeletal muscles under electrical stimulation. In total, 336 original articles were identified from the Scopus and SpringerLink electronic databases using search keywords for studies published between 2000 and 2020, and their eligibility for inclusion in this review has been screened using various inclusion criteria. After screening, 62 studies remained for analysis, with two additional articles from the bibliography, were categorized into the following: (1) fatigue, (2) torque, (3) force, (4) stiffness, (5) electrode development, (6) reliability of MMG and NMES approaches, and (7) validation of these techniques in clinical monitoring. This review has found that MMG through NMES provides feature factors for muscle activity assessment, highlighting standardized electromyostimulation and MMG parameters from different experimental protocols. Despite the evidence of mathematical computations in quantifying MMG along with NMES, the requirement of the processing speed, and fluctuation of MMG signals influence the technique to be prone to errors. Interestingly, although this review does not focus on machine learning, there are only few studies that have adopted it as an alternative to statistical analysis in the assessment of muscle fatigue, torque, and force. The results confirm the need for further investigation on the use of sophisticated computations of features of MMG signals from electrically stimulated muscles in muscle function assessment and assistive technology such as prosthetics control.

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 adding neuromuscular electrical stimulation training to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: randomized clinical trial

2018 ◽  
Vol 33 (2) ◽  
pp. 195-206 ◽  
Author(s):  
Marwa Mekki ◽  
Thierry Paillard ◽  
Sonia Sahli ◽  
Zouhair Tabka ◽  
Yassine Trabelsi
Keyword(s):  
Electrical Stimulation ◽  
Pulmonary Rehabilitation ◽  
Center Of Pressure ◽  
Intervention Group ◽  
Neuromuscular Electrical Stimulation ◽  
Berg Balance Scale ◽  
Voluntary Contraction ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Objective: To investigate the effectiveness of neuromuscular electrical stimulation added to pulmonary rehabilitation on walking tolerance and balance in patients with chronic obstructive pulmonary disease (COPD). Design: Randomized clinical trial. Setting: Outpatient, Faculty of Medicine of Sousse, Tunisia. Subjects: A total of 45 patients with COPD were assigned to an intervention group ( n = 25) or a control group ( n = 20). Interventions: The intervention group underwent a neuromuscular electrical stimulation added to pulmonary rehabilitation, and the control group underwent only a pulmonary rehabilitation, three times per week during six months. Main Measures: Measures were taken at baseline and after six months of training. A stabilometric platform, time up and go, Berg balance scale tests, 6 minute walking test, and the maximal voluntary contraction were measured. Results: In the intervention group, an increase in an exercise tolerance manifested by a longer distance walked in 6 minute walking test 619.5 (39.6) m was observed in comparison to the control group 576.3 (31.5) m. The values of the time up and go, Berg balance scale, and maximal voluntary contraction in the intervention group at follow-up were significantly higher than those in the control group ( P  = 0.02, P  = 0.01, P  = 0.0002, respectively). The center of pressure in the mediolateral and in the anteroposterior directions, as well as the center of pressure area was significantly more improved in open eyes and closed eyes in the intervention group compared to the control group ( P < 0.001). Conclusion: The neuromuscular electrical stimulation added to pulmonary rehabilitation group benefited from better walking tolerance and greater balance improvement than the only pulmonary rehabilitation.

scholarly journals Exploring Neuromuscular Electrical Stimulation Intensity Effects on Multifidus Muscle Activity in Adults With Chronic Low Back Pain: An Ultrasound Imaging–Informed Investigation

2019 ◽  
Vol 12 ◽  
pp. 117954411984957 ◽  
Author(s):  
Jaclyn Megan Sions ◽  
DeJ’a Chyanna Crippen ◽  
Gregory Evan Hicks ◽  
Abdulmohsen Meshari Alroumi ◽  
Tara Jo Manal ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Muscle Activity ◽  
Neuromuscular Electrical Stimulation ◽  
Low Back ◽  
High Tolerance ◽  
Multifidus Muscle ◽  
Thickness Change

Study design: Cross-sectional study. Background: Neuromuscular electrical stimulation (NMES) is an effective tool for stimulating multifidus muscle contractions. Ultrasound imaging (USI) is valid and reliable for quantifying multifidus activity represented by percent thickness change from a resting to contracted state. Thus, USI may be used to help determine optimal NMES intensity. Objectives: To explore NMES intensity effects on multifidus thickening in adults with chronic low back pain (CLBP). Methods: Sixty patients with CLBP participated. L4/5 multifidus ultrasound images were obtained and percent thickness change from a resting to a contracted state was determined at baseline with a limb lift and during NMES application. During NMES, the examiner recorded the intensity, in milliampere, when the multifidus first started to thicken as observed with USI. The examiner also recorded the NMES intensity that resulted in no further multifidus thickening (ie, high-tolerance group) or, in cases where maximal thickening was not observed, the NMES intensity of the submaximal contraction (ie, low-tolerance group). Differences between participants with high versus low NMES tolerance were evaluated. Results: During NMES, the multifidus began thickening at a higher intensity for the high-tolerance group (n = 39), that is, 34 mA, compared with the low-tolerance group (n = 21), that is, 32 mA ( P = .001). A greater mean intensity in the high-tolerance group, that is, 62 mA, as compared to 45 mA in the low-tolerance group, resulted in a larger percent thickness change, that is, 30.89% compared to 20.60%, respectively ( P < .001). Conclusions: Results provide clinicians with NMES intensity targets to facilitate multifidus muscle thickening, which provides insight into muscle activity.

scholarly journals Quadriceps Femoris Muscle Torques and Fatigue Generated by Neuromuscular Electrical Stimulation With Three Different Waveforms

2001 ◽  
Vol 81 (7) ◽  
pp. 1307-1316 ◽  
Author(s):  
Yocheved Laufer ◽  
Julie Deanne Ries ◽  
Peter M Leininger ◽  
Gad Alon
Keyword(s):  
Electrical Stimulation ◽  
Mixed Model ◽  
Neuromuscular Electrical Stimulation ◽  
Quadriceps Femoris ◽  
Muscle Performance ◽  
Current Phase ◽  
Quadriceps Femoris Muscle ◽  
Male Subjects ◽  
Femoris Muscle ◽  
Female Subjects

Abstract Background and Purpose. Neuromuscular electrical stimulation is used by physical therapists to improve muscle performance. Optimal forms of stimulation settings are yet to be determined, as are possible sex-related differences in responsiveness to electrical stimulation. The objectives of the study were: (1) to compare the ability of 3 different waveforms to generate isometric contractions of the quadriceps femoris muscles of individuals without known impairments, (2) to compare muscle fatigue caused by repeated contractions induced by these same waveforms, and (3) to examine the effect of sex on muscle force production and fatigue induced by electrical stimulation. Subjects. Fifteen women and 15 men (mean age=29.5 years, SD=5.4, range=22–38) participated in the study. Methods. A portable battery-operated stimulator was used to generate either a monophasic or biphasic rectangular waveform. A stimulator that was plugged into an electrical outlet was used to generate a 2,500-Hz alternating current. Phase duration, frequency, and on-off ratios were kept identical for both stimulators. Participants did not know the type of waveform being used. Torque was measured using a computerized dynamometer: a maximal voluntary isometric contraction (MVIC) of the right quadriceps femoris muscle set at 60 degrees of knee flexion was determined during the first session. In each of the 3 testing sessions, torque of contraction and fatigue elicited by one waveform were measured. Order of testing was randomized. Torque elicited by electrical stimulation was expressed as a percentage of average MVIC. A mixed-model analysis of variance was used to determine the effect of stimulation and sex on strength of contraction and fatigue. Bonferroni-corrected post hoc tests were used to further distinguish between the effects of the 3 stimulus waveforms. Results. The results indicated that the monophasic and biphasic waveforms generated contractions with greater torque than the polyphasic waveform. These 2 waveforms also were less fatiguing. The torques from the maximally tolerated electrically elicited contractions were greater for the male subjects than for the female subjects. Discussion and Conclusion. Muscle torque and fatigue of electrically induced contractions depend on the waveform used to stimulate the contraction, with monophasic and biphasic waveforms having an advantage over the polyphasic waveform. All tested waveforms elicited, on average, stronger contractions in male subjects than in female subjects when measured as a percentage of MVIC.

scholarly journals Feedback-controlled stimulation enhances human paralyzed muscle performance

2006 ◽  
Vol 101 (5) ◽  
pp. 1312-1319 ◽  
Author(s):  
Richard K. Shields ◽  
Shauna Dudley-Javoroski ◽  
Keith R. Cole
Keyword(s):  
Electrical Stimulation ◽  
High Frequency ◽  
Neuromuscular Electrical Stimulation ◽  
Peak Torque ◽  
Open Loop ◽  
Muscle Performance ◽  
Constant Frequency ◽  
Extensive Training ◽  
Long Duration ◽  
Repetitive Stress

Chronically paralyzed muscle requires extensive training before it can deliver a therapeutic dose of repetitive stress to the musculoskeletal system. Neuromuscular electrical stimulation, under feedback control, may subvert the effects of fatigue, yielding more rapid and extensive adaptations to training. The purposes of this investigation were to 1) compare the effectiveness of torque feedback-controlled (FDBCK) electrical stimulation with classic open-loop constant-frequency (CONST) stimulation, and 2) ascertain which of three stimulation strategies best maintains soleus torque during repetitive stimulation. When torque declined by 10%, the FDBCK protocol modulated the base stimulation frequency in three ways: by a fixed increase, by a paired pulse (doublet) at the beginning of the stimulation train, and by a fixed decrease. The stimulation strategy that most effectively restored torque continued for successive contractions. This process repeated each time torque declined by 10%. In fresh muscle, FDBCK stimulation offered minimal advantage in maintaining peak torque or mean torque over CONST stimulation. As long-duration fatigue developed in subsequent bouts, FDBCK stimulation became most effective (∼40% higher final normalized torque than CONST). The high-frequency strategy was selected ∼90% of the time, supporting that excitation-contraction coupling compromise and not neuromuscular transmission failure contributed to fatigue of paralyzed muscle. Ideal stimulation strategies may vary according to the site of fatigue; this stimulation approach offered the advantage of online modulation of stimulation strategies in response to fatigue conditions. Based on stress-adaptation principles, FDBCK-controlled stimulation may enhance training effects in chronically paralyzed muscle.

scholarly journals A Narrative Review of the Use of Neuromuscular Electrical Stimulation in Individuals With Diabetic Foot Ulceration

2020 ◽  
Vol 19 (3) ◽  
pp. 242-250 ◽  
Author(s):  
Richard James Goodall ◽  
Benjamin Langridge ◽  
Tristan Lane ◽  
Alun Huw Davies ◽  
Joseph Shalhoub
Keyword(s):  
Electrical Stimulation ◽  
Diabetic Foot ◽  
Potential Role ◽  
Healing Rate ◽  
Heat Exposure ◽  
Neuromuscular Electrical Stimulation ◽  
Inclusion Criteria ◽  
Foot Ulceration ◽  
Positive Effects ◽  
Search Terms

This review aims to summarize the evidence reported on the use of neuromuscular electrical stimulation (NMES) in individuals with diabetic foot ulceration (DFU). A systematic search of EMBASE and MEDLINE databases was performed in February 2019, using search terms relating to the domains DFU and NMES. All primary evidence assessing outcomes of NMES in DFU were included. Of 344 references obtained from database searching, 7 met the inclusion criteria and included a total of 140 participants, 77 of whom had DFU. All included studies used prospective designs. Two studies demonstrated improvements in chronic ulcer healing with NMES use; however, in each study, only 3 of the included participants had DFU and subgroup analyses based on ulcer etiology was omitted. The remaining 5 studies were produced by the same research group and positive effects of NMES (in combination with heat therapy) on DFU healing were consistently demonstrated. They reported significantly better healing rates with NMES in DFU than in nondiabetic wounds of a similar grade (healing rate: 70.0 ± 32.3% in DFU vs 38.4 ± 22.3% in nondiabetic ulcers [ P < .01]). These studies did not provide data assessing the isolated effects of NMES without concomitant heat exposure. Data on device tolerability and compliance were lacking. The existing data support a potential role for NMES in individuals with DFU; however, the identified studies inadequately controlled for confounding and were underpowered. Given the significant morbidity and mortality associated with DFU, higher quality evidence is needed to assess the adjunctive role for NMES in this group.

Influence of wide-pulse neuromuscular electrical stimulation frequency and superimposed tendon vibration on occurrence and magnitude of extra torque

2021 ◽  
Author(s):  
Loïc Espeit ◽  
Vianney Rozand ◽  
Guillaume Y. Millet ◽  
Julien Gondin ◽  
Nicola A. Maffiuletti ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
High Frequency ◽  
Plantar Flexion ◽  
Neuromuscular Electrical Stimulation ◽  
Low Frequency ◽  
Force Production ◽  
Voluntary Contraction ◽  
Tendon Vibration ◽  
Afferent Pathways ◽  
Design Decisions

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 favour ET generation. Knowledge of the characteristics of ET is essential to implement these stimulation paradigms in clinical practice. Thus, we aimed at investigating 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 began with an adjustment of NMES intensity in order to reach 10% of maximal voluntary contraction then consisted of three 20-s trains interspersed by 90 s of rest. 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 in order to maximize force production through the occurrence and magnitude of ET.

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