Skinfold thickness affects the isometric knee extension torque evoked by Neuromuscular Electrical Stimulation

Medeiros, Flávia; Vieira, Amilton; Carregaro, Rodrigo Luiz; Bottaro, Martim; Maffiuletti, Nicola A.; Durigan, João Luíz Quagliotti

doi:10.1590/bjpt-rbf.2014.0114

Cited by 22 publications

(23 citation statements)

References 27 publications

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“…A design allowing for withinparticipant comparisons was selected in an effort to eliminate the possibility of interparticipant differences resulting in confounding factors. For example, subcutaneous tissue thickness differences 156,161 and personality factors 25 have been shown to impact neuromuscular electrical stimulation (NMES) related outcomes similar to those included in this project. This project was subdivided in the form of two separate manuscripts (Chapter IV and Chapter V).…”

Section: Chapter III -Methodology Study Designmentioning

confidence: 99%

“…Medeiros et al 161 stimulated the quadriceps in a cohort of healthy women while using a maximum tolerable stimulus intensity, and the women were separated into two groups representing thick and thin subcutaneous tissue amounts. As with Miller et al 156 they observed that greater stimulus intensities were tolerated by those with greater amounts of subcutaneous tissue.…”

Section: Additional Comfort Strategiesmentioning

confidence: 99%

“…However, in contrast to Miller et al, Medeiros et al observed significantly lower NMES training intensities within the thick subcutaneous tissue group despite the greater stimulus intensities used by this group; which is also in direct contrast to studies reporting no difference between groups using significantly different stimulus intensities. 73,97 With respect to self-reported discomfort levels and subcutaneous tissue thickness, Medeiros et al 161 predictor of the intensity required to achieve motor threshold than the subcutaneous tissue thickness measured at the site of stimulation, with BMI explaining 56%-61% of the differences in the stimulus intensity required to achieve motor thresholds and subcutaneous tissue thickness only explaining 26%-50%.…”

Section: Additional Comfort Strategiesmentioning

confidence: 99%

“…It is important that clinicians consider patient body type while providing NMES treatments, since obesity may influence the amount of stimulus intensity required to achieve motor thresholds. 160 As with gender, the influence of subcutaneous tissue thickness and/or obesity on patient comfort is unclear due to methodological limitations of the aforementioned studies, 160,161 but it does appear that individuals with greater amounts of subcutaneous tissue tolerate greater stimulus intensities. 156,161 However, Maffiuletti et al 160 concluded that obese participants demonstrated a lower tolerance to NMES, as evidenced by the fact that a larger number of obese participants were unable to reach the motor thresholds during their study.…”

Section: Additional Comfort Strategiesmentioning

confidence: 99%

“…A VAS, which consists of a 100 mm horizontal line with vertical anchors and verbal descriptors at each end, has been frequently utilized in the literature as a measure of self-reported discomfort during NMES treatments. 21,23,27,29,[36][37][38]69,72,160,161 In general, the verbal descriptors placed at each end of a VAS are "no pain" and "worst imaginable pain" 168 ; however, it is important to note that during NMES studies the descriptors are often altered from "pain" to "discomfort" (e.g., "no discomfort", "worst possible discomfort"). 21,27,29,36,37,159,161 The most frequent form of validity evidence with respect to the VAS is construct validity, particularly in the form of convergent validity.…”

Section: Visual Analog Scale Validity Evidencementioning

confidence: 99%

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A Comparison of Multipath and Conventional Neuromuscular Electrical Stimulation

Bremner¹

2019

Athletic Training & Sports Health Care

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Neuromuscular electrical stimulation (NMES) is the use of an electrical current for the purpose of eliciting a muscular response, and these treatments are most often used clinically for the specific purpose of increasing quadriceps strength. It is commonly accepted that the effectiveness of NMES for this purpose is primarily determined by the NMES training intensity. However, spatially limited motor unit recruitment, fatigue and discomfort negatively impact NMES-induced torque, which subsequently reduces NMES training intensities. Due to the importance of NMES training intensity, a substantial amount of research has focused on strategies designed to increase NMES-induced torque production, as well as to reduce NMES-induced fatigue and discomfort. However, authors have indicated that additional strategies are needed, as many of the strategies supported by empirical evidence cannot be easily applied in clinical settings. The Kneehab® XP (Theragen LLC, Leesburg, VA) is an electrical stimulator that incorporates a novel multipath current distribution strategy (m-NMES) marketed to address the primary factors limiting NMES training intensity, and as such it has gained a significant amount of attention in the literature. Relative to conventional NMES (c-NMES), authors have reported improved outcomes while using the novel m-NMES but due to a series of methodological limitations the influence of the multipath current distribution strategy on these outcomes remains unclear. Therefore, the purpose of this iii project was to further investigate the influence that m-NMES has on NMES related outcomes. A convenience sample of 21 participants completed two basic studies designed to compare the influence of m-NMES and c-NMES on maximum comfortable stimulus intensity and NMES-induced peak torque, as well as fatigue and discomfort related outcomes. The statistical analyses of each study did not reveal any significant differences across the two conditions deemed to be clinically relevant. Therefore, it does not appear that the novel multipath current distribution method influences the outcomes included during this project in a clinically meaningful manner. The large declines in NMESinduced torque that occurred, irrespective of the NMES condition, suggest the need for the development of additional strategies. iv ACKNOWLEDGMENTS I would like to recognize the following individuals for their support; without each of their individual contributions this project would not have been possible. My Committee Chair and advisor Dr. Bill Holcomb. Thank you for the countless hours you spent patiently teaching and guiding me throughout my entire collegiate experience. I chose to attend USM for the opportunity to learn from you, and you exceeded my expectations. I will be forever indebted to your mentorship.

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Section: Chapter III -Methodology Study Designmentioning

confidence: 99%

Section: Additional Comfort Strategiesmentioning

confidence: 99%

Section: Additional Comfort Strategiesmentioning

confidence: 99%

Section: Additional Comfort Strategiesmentioning

confidence: 99%

Section: Visual Analog Scale Validity Evidencementioning

confidence: 99%

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A Comparison of Multipath and Conventional Neuromuscular Electrical Stimulation

Bremner¹

2019

Athletic Training & Sports Health Care

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Knee extensor force production and discomfort during neuromuscular electrical stimulation of quadriceps with and without gluteal muscle co-stimulation

2022

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Purpose To investigate whether Neuromuscular Electrical Stimulation (NMES) simultaneously applied on the quadriceps (Q) and gluteal (G) muscles, as compared to single Q-stimulation alters the knee extensor force production and discomfort. Methods A total of 11 healthy participants (6 females), with normal weight and age between 19 and 54 years were included. The unilateral, isometric maximal voluntary contraction (MVC) was assessed for each participant in an isokinetic dynamometer (Biodex, system 3). NMES was, in a randomized order, applied only on the Q-muscle and on the Q- and G-muscles (QG) simultaneously. NMES-intensity was increased stepwise until the maximal tolerable level was reached regarding discomfort, graded according to the visual analogue scale (VAS). VAS and the % of MVC produced by NMES, were registered for each level, expressed as median (inter-quartile range). Results The maximum tolerated NMES-intensity applied on Q compared to QG resulted in equally high discomfort, 8.0 (6.0–9.0) vs 8.0 (6.3–9.0), and in equivalent knee extensor force production, 36.7 (29.9–47.5) and 36.2 (28.9–49.3), respectively, in % of MVC. At 20% of MVC, NMES applied on Q compared to QG resulted in equal acceptable discomfort, 3.0 (2.0–4.5) vs 3.0 (3–5.5), and comparable intensity levels, 41.5 (38.0–45.8) vs 43.5 (37.0–48.8), respectively. Conclusions Simultaneous QG-NMES, as compared to single Q-NMES, does not seem to affect the knee extensor force production or discomfort. Q-NMES, without voluntary muscle contraction, can with an acceptable level of discomfort result in at least 20% of MVC.

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