Effects of electrical stimulation pattern on quadriceps isometric force and fatigue in individuals with spinal cord injury

Deley, Gaëlle; Denuziller, Jérémy; Babault, Nicolas; Taylor, J. Andrew

doi:10.1002/mus.24530

Cited by 22 publications

(17 citation statements)

References 30 publications

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“…e ., from a constant frequency trains (CFT, where six 200 s square wave pulses separated by 70 ms were used) to a double frequency train (DFT, where a train of pairs of closely spaced pulses (doublets, 5ms) separated by longer intervals were used)) demonstrated improvements in fatigue resistance [ 14 ], whereas administration of CFT and DFT separately were less optimal [ 21 ]. In addition, during paralyzed quadriceps’ strength training, Deley et al, [ 20 ] verified that variable frequency train (VFT, where a train identical to the CFT were used, except that the first 2 pulses were separated by 5 ms) stimulation pattern and VFT followed by CFT generated less fatiguing contractions. Taken together, these findings suggest that the frequency modification of different stimulation trains offsets rapid muscle fatigue.…”

Section: Resultsmentioning

confidence: 99%

“…The low ‘take-up’ of FES interventions within conventional clinical practice, should not be assumed to indicate any lack of medical benefits, since scientific understanding of electrical stimulus-induced fatigue in the clinical population is still rudimentary [ 6 , 20 ]. Previous studies, that have sought to improve fatigue-resistance during FES therapy, have investigated the effects of size of stimulating electrodes or their position over some specific locations (such as anatomical landmarks and motor points) [ 16 ], modulation of neuromuscular stimulation parameters [ 21 ], optimization of the mode and frequency of exercise [ 22 ] and biofeedback-controlled stimulation [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Strategies for Rapid Muscle Fatigue Reduction during FES Exercise in Individuals with Spinal Cord Injury: A Systematic Review

et al. 2016

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BackgroundRapid muscle fatigue during functional electrical stimulation (FES)-evoked muscle contractions in individuals with spinal cord injury (SCI) is a significant limitation to attaining health benefits of FES-exercise. Delaying the onset of muscle fatigue is often cited as an important goal linked to FES clinical efficacy. Although the basic concept of fatigue-resistance has a long history, recent advances in biomedical engineering, physiotherapy and clinical exercise science have achieved improved clinical benefits, especially for reducing muscle fatigue during FES-exercise. This review evaluated the methodological quality of strategies underlying muscle fatigue-resistance that have been used to optimize FES therapeutic approaches. The review also sought to synthesize the effectiveness of these strategies for persons with SCI in order to establish their functional impacts and clinical relevance.MethodsPublished scientific literature pertaining to the reduction of FES-induced muscle fatigue was identified through searches of the following databases: Science Direct, Medline, IEEE Xplore, SpringerLink, PubMed and Nature, from the earliest returned record until June 2015. Titles and abstracts were screened to obtain 35 studies that met the inclusion criteria for this systematic review.ResultsFollowing the evaluation of methodological quality (mean (SD), 50 (6) %) of the reviewed studies using the Downs and Black scale, the largest treatment effects reported to reduce muscle fatigue mainly investigated isometric contractions of limited functional and clinical relevance (n = 28). Some investigations (n = 13) lacked randomisation, while others were characterised by small sample sizes with low statistical power. Nevertheless, the clinical significance of emerging trends to improve fatigue-resistance during FES included (i) optimizing electrode positioning, (ii) fine-tuning of stimulation patterns and other FES parameters, (iii) adjustments to the mode and frequency of exercise training, and (iv) biofeedback-assisted FES-exercise to promote selective recruitment of fatigue-resistant motor units.ConclusionAlthough the need for further in-depth clinical trials (especially RCTs) was clearly warranted to establish external validity of outcomes, current evidence was sufficient to support the validity of certain techniques for rapid fatigue-reduction in order to promote FES therapy as an integral part of SCI rehabilitation. It is anticipated that this information will be valuable to clinicians and other allied health professionals administering FES as a treatment option in rehabilitation and aid the development of effective rehabilitation interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Strategies for Rapid Muscle Fatigue Reduction during FES Exercise in Individuals with Spinal Cord Injury: A Systematic Review

et al. 2016

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“…This stimulation strategy would increase the total force output during a given exercise session that could be of interest more particularly for FES rehabilitation procedures. Nevertheless, this preliminary study was conducted on able-bodied individuals and the efficiency of such stimulation procedure should be investigated in patients such as spinal cord injured and in combination with other stimulation pattern for training optimization [ 40 ]. Indeed, able-bodied and those with spinal cord injury widely differed in muscle composition and function and cardiovascular function, for example [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Constant and Doublet Frequency Electrical Stimulation Patterns on Force Production of Knee Extensor Muscles

Cometti¹,

Babault²,

Deley³

2016

PLoS ONE

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This study compared knee extensors’ neuromuscular fatigue in response to two 30-minute stimulation patterns: constant frequency train (CFT) and doublet frequency train (DFT). Fifteen men underwent two separate sessions corresponding to each pattern. Measurements included torque evoked by each contraction and maximal voluntary contractions (MVC) measured before and immediately after the stimulation sessions. In addition, activation level and torque evoked during doublets (Pd) and tetanic contractions at 80-Hz (P80) and 20-Hz (P20) were determined in six subjects. Results indicated greater mean torque during the DFT stimulation session as compared with CFT. But, no difference was obtained between the two stimulation patterns for MVC and evoked torque decreases. Measurements conducted in the subgroup depicted a significant reduction of Pd, P20 and P80. Statistical analyses also revealed bigger P20 immediate reductions after CFT than after DFT. We concluded that DFT could be a useful stimulation pattern to produce and maintain greater force with quite similar fatigue than CFT.

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“…However, its application for prolonged stimulation is limited due to fast occurring muscular fatigue. Several methods can be used to slow down the fatigue (Deley et al 2015). Variations in stimulation frequency, as well as the use of distributed and asynchronous stimulation, significantly increase the effective duration of sustained electrical stimulation (Malešević et al 2010;Popović et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Neuromuscular fatigue detection by mechanomyography in people with complete spinal cord injury

et al. 2020

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Purpose Functional electrical stimulation (FES) is a method of activating paralyzed muscles. During FES application, fast muscle fatigue can occur (the inability of stimulated muscles to generate force). Therefore, it is beneficial to estimate the muscle fatigue for FES closed-loop control for walking to prevent unexpected muscle collapse and adapt the FES strategy in real time. Mechanomyography (MMG) is a noninvasive technique for registering myofiber vibrations, representing an ideal candidate for the provision of feedback. The hypothesis was that MMG signals could effectively detect muscle fatigue and, thus, provide feedback. Methods We tested this hypothesis by analyzing the wavelet transform of signals from an MMG sensor positioned over the rectus femoris muscle during electrically evoked contractions in subjects with spinal cord injury (SCI). The signals were collected from a total of 24 lower limb muscles. We investigated both legs of 15 participants with spinal cord injury (male, YOA = 27.13 ± 5.05, M = 75.8 ± 10.35 kg, and H = 1.78 ± 0.07 m, American Spinal Injury Impairment Scale (AIS) A and B). All MMG signals were analyzed in 12 frequency bands from 5 to 53 Hz. Results We found different trends in the magnitudes in different frequency bands. The magnitude decreased in 13, 16, 20, 25, and 35 Hz bands in correlation with fatigue. The greatest statistical difference was found at 20 Hz and 25 Hz. Conclusion This result suggests that processed MMG signals indicate muscle fatigue and can, thus, be used as the feedback in FES systems.

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Effects of electrical stimulation pattern on quadriceps isometric force and fatigue in individuals with spinal cord injury

Abstract: These findings suggest that for the same initial forces the VFT pattern is less fatiguing than CFT and that when combining train types, VFT should be used first.

Cited by 22 publications

References 30 publications

Strategies for Rapid Muscle Fatigue Reduction during FES Exercise in Individuals with Spinal Cord Injury: A Systematic Review

Strategies for Rapid Muscle Fatigue Reduction during FES Exercise in Individuals with Spinal Cord Injury: A Systematic Review

Effects of Constant and Doublet Frequency Electrical Stimulation Patterns on Force Production of Knee Extensor Muscles

Neuromuscular fatigue detection by mechanomyography in people with complete spinal cord injury

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