scholarly journals The Effect of Quadriceps Muscle Length on Maximum Neuromuscular Electrical Stimulation Evoked Contraction, Muscle Architecture, and Tendon-Aponeurosis Stiffness

2021 ◽  
Vol 12 ◽  
Author(s):  
Jonathan Galvão Tenório Cavalcante ◽  
Rita de Cassia Marqueti ◽  
Jeam Marcel Geremia ◽  
Ivo Vieira de Sousa Neto ◽  
Bruno Manfredini Baroni ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Current Efficiency ◽  
Knee Flexion ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Length ◽  
Physiological Adaptation ◽  
Repeated Measure ◽  
Stiffness Index ◽  
Force Transmission ◽  
The Impact

Muscle-tendon unit length plays a crucial role in quadriceps femoris muscle (QF) physiological adaptation, but the influence of hip and knee angles during QF neuromuscular electrical stimulation (NMES) is poorly investigated. We investigated the effect of muscle length on maximum electrically induced contraction (MEIC) and current efficiency. We secondarily assessed the architecture of all QF constituents and their tendon-aponeurosis complex (TAC) displacement to calculate a stiffness index. This study was a randomized, repeated measure, blinded design with a sample of twenty healthy men aged 24.0 ± 4.6. The MEIC was assessed in four different positions: supine with knee flexion of 60° (SUP60); seated with knee flexion of 60° (SIT60); supine with knee flexion of 20° (SUP20), and seated with knee flexion of 20° (SIT20). The current efficiency (MEIC/maximum tolerated current amplitude) was calculated. Ultrasonography of the QF was performed at rest and during NMES to measure pennation angle (θp) and fascicle length (Lf), and the TAC stiffness index. MEIC and current efficiency were greater for SUP60 and SIT60 compared to SUP20 and SIT20. The vastus lateralis and medialis showed lower θp and higher Lf at SUP60 and SIT60, while for the rectus femoris, in SUP60 there were lower θp and higher Lf than in all positions. The vastus intermedius had a similar pattern to the other vastii, except for lack of difference in θp between SIT60 compared to SUP20 and SIT20. The TAC stiffness index was greater for SUP60. We concluded that NMES generate greater torque and current efficiency at 60° of knee flexion, compared to 20°. For these knee angles, lengthening the QF at the hip did not promote significant change. Each QF constituent demonstrated muscle physiology patterns according to hip and/or knee angles, even though a greater Lf and lower θp were predominant in SUP60 and SIT60. QF TAC index stiffened in more elongated positions, which probably contributed to enhanced force transmission and slightly higher torque in SUP60. Our findings may help exercise physiologist better understand the impact of hip and knee angles on designing more rational NMES stimulation strategies.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT03822221.

scholarly journals IMPACT OF DISTAL ULNAR RESECTION AND ELBOW JOINT POSITIONS IN RELATION TO LOAD TRANSMISSION ACROSS THE RADIOCAPITELLAR JOINT

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0007
Author(s):  
Shivani Sadwal ◽  
Gregory Shmeling ◽  
Jason Grey ◽  
Alexander Graf ◽  
Roger Daley ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Elbow Flexion ◽  
Distal Humerus ◽  
Sensor Data ◽  
Repeated Measure ◽  
Force Transmission ◽  
Average Force ◽  
Fresh Frozen ◽  
Length Step ◽  
The Impact

Introduction: The ulna is often resected to treat injuries resulting from trauma, congenital anomalies, as well as a result of procedures for tumors and arthritis in the wrist. However, there is no literature discussing the impact of ulnar shortening on force transmission. This study looks at how force is transmitted across the radiocapitellar joint (RCJ) after varying lengths of ulnar resection. Methods: 4 fresh-frozen cadaveric forearms (mean age 44.5 years) each with an intact elbow and distal humerus were secured onto a mounting plate, allowing for range of elbow motion to be tested: 45 degrees and 90 degrees in flexion, as well as supination, pronation, and neutral positioning of the forearm. Tests were done with varying ulnar conditions: normal intact, resected by 2 cm, resection of a quarter of the length, and resection of half of the length. Step loading was applied to a maximum of 150 N and resultant force across the RCJ was measured using a joint pressure sensor. Data from the four ulnar conditions were compared using repeated measure ANOVA with statistical significance set at p=0.05. Results: With the radioulnocarpal joint intact, the average force transmitted to the RCJ was 94.3±72.3 N with the elbow in 45-degree flexion and 123.6±69.3 N with 90-degree flexion and neutral pronation/supination. 45-degree supination caused a decrease in radiocapitellar force to 87.2±49.2 N and 81.7±56.2 N respectively, while 45-deree pronation increased the force to 123.2±67.5 N and 131.7±66.8 N respectively. In comparison to the control, an increase of statistical significance was found in supinated 90-degree flexion and supinated 45-degree flexion for both quarter- and half-length ulnar resections. In 45-degree flexion with neutral supination/pronation, the RCJ force was significantly higher than the intact after 2-cm ulna resection (p<0.03). Conclusion: This study demonstrates that with an intact ulna, 63% of applied axial force was transmitted to the RCJ when the elbow was flexed at 45, and 85% at 90 degrees. It also showed that the RCJ force transmission decreases with supination and increases with pronation. As the ulna is progressively shortened, increased force is transmitted across the RCJ, especially in elbow flexion and supination. A pronated position was observed to be protective of the RCJ.

A Clinical Approach to Neuromuscular Electrical Stimulation for Speech and Swallow in an Acute Rehabilitation Facility

2019 ◽  
Vol 4 (5) ◽  
pp. 1044-1048
Author(s):  
Melissa M. Howard ◽  
Emily R. Rosario
Keyword(s):  
Electrical Stimulation ◽  
Brain Injury ◽  
Patient Population ◽  
Neuromuscular Electrical Stimulation ◽  
Inpatient Rehabilitation ◽  
Future Research ◽  
Clinical Approach ◽  
Rehabilitation Facility ◽  
Acute Rehabilitation ◽  
The Impact

Purpose Neuromuscular Electrical Stimulation (NMES) is a widely used treatment modality for dysphagia therapy despite the inconclusive evidence of its effectiveness. Our objective was to complete a retrospective review to analyze the results of NMES with our patient population in an acute rehabilitation facility. In this clinical focus article, we briefly review the current literature on NMES, discuss a clinical protocol of NMES use in an inpatient rehabilitation hospital, and discuss the need for future research in this area. Conclusions As with much of the NMES literature, we observed improvement in the ability to swallow following a cerebrovascular accident and traumatic brain injury when a combination of swallowing therapy and NMES treatment was used. Although this combination works for our patients to improve swallow function, the impact of swallow therapy alone remains unclear. Further investigative research to clarify NMES protocols and patient population is needed to optimize results. Therefore, a large randomized clinical trial would be beneficial to clearly define the role of NMES in recovery of swallowing ability following a brain injury.

scholarly journals Impact of treadmill gait training with neuromuscular electrical stimulation on the urodynamic profile of patients with high cervical spinal cord injury

2010 ◽  
Vol 8 (3) ◽  
pp. 325-328
Author(s):  
Carlos Arturo Levi D’Ancona ◽  
Alberto Clilclet ◽  
Lia Yumi Ikari ◽  
Renato Jesus Pedro ◽  
Walter da Silva Júnior
Keyword(s):  
Electrical Stimulation ◽  
Urinary Tract ◽  
Cervical Spinal Cord ◽  
Neuromuscular Electrical Stimulation ◽  
Gait Training ◽  
Neuromuscular Training ◽  
Significant Difference ◽  
Cord Injury ◽  
The Impact ◽  
Urodynamic Parameters

ABSTRACT Objective: To evaluate the impact of gait training with neuromuscular electrical stimulation on urodynamic parameters of patients with neurogenic bladder. Methods: Eight male quadriplegic patients with complete cervical injury level ranging from C4 to C7 comprised the study population. They underwent treadmill gait training with neuromuscular electrical stimulation for six months, only after having their quadriceps and tibialis anterior muscles stimulated for five months in order to support at least 50% of their body weight (pre-gait training). Urodynamic testing was performed before the treadmill gait training and six months after. Results: The mean time after cervical lesion was 74.63 months. The urodynamic parameters before and after neuromuscular training by electrical stimulation did not show significant difference. Conclusion: This study demonstrated that neuromuscular training with electrical stimulation can benefit the urinary tract. This promising minimally invasive field requires further and more complete studies to confirm a possible benefit to the low urinary tract.

Cardiovascular and Metabolic Responses to Electrical Stimulation-Induced Leg Exercise in Spinal Cord Injury

1997 ◽  
Vol 36 (04/05) ◽  
pp. 372-375 ◽  
Author(s):  
J. R. Sutton ◽  
A. J. Thomas ◽  
G. M. Davis
Keyword(s):  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Cardiac Output ◽  
Electrical Stimulation ◽  
Knee Flexion ◽  
Flexion Extension ◽  
Cord Injury ◽  
Leg Exercise ◽  
Leg Muscle

Abstract:Electrical stimulation-induced leg muscle contractions provide a useful model for examining the role of leg muscle neural afferents during low-intensity exercise in persons with spinal cord-injury and their able-bodied cohorts. Eight persons with paraplegia (SCI) and 8 non-disabled subjects (CONTROL) performed passive knee flexion/extension (PAS), electrical stimulation-induced knee flexion/extension (ES) and voluntary knee flexion/extension (VOL) on an isokinetic dynamometer. In CONTROLS, exercise heart rate was significantly increased during ES (94 ± 6 bpm) and VOL (85 ± 4 bpm) over PAS (69 ± 4 bpm), but no changes were observed in SCI individuals. Stroke volume was significantly augmented in SCI during ES (59 ± 5 ml) compared to PAS (46 ± 4 ml). The results of this study suggest that, in able-bodied humans, Group III and IV leg muscle afferents contribute to increased cardiac output during exercise primarily via augmented heart rate. In contrast, SCI achieve raised cardiac output during ES leg exercise via increased venous return in the absence of any change in heart rate.

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