Pulse Width Does Not Influence the Gains Achieved With Neuromuscular Electrical Stimulation in People With Multiple Sclerosis: Double-Blind, Randomized Trial

Almuklass, Awad M.; Davis, Leah A.; Hamilton, Landon D.; Hebert, Jeffrey R.; Alvarez, Enríque; Enoka, Roger M.

doi:10.1177/1545968317753681

Cited by 15 publications

(11 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite both groups leading to improve functionality with lower pain, EMS/CG resulted in better improvements compared to the CG, assuming the more beneficial effect of EMS training on PFP women. These results agree with previous studies and expand our knowledge about the effects of EMS training on PFP individuals, showing that EMS could provoke better results compared to the conventional alone [20] This finding is also consistent with previous studies, showing positive effects of EMS training both in healthy [36], non-healthy individuals [37] and in post-operation rehabilitation [27]. Besides the benefits in muscle strength, the use of EMS training in healthy older persons led to improved speed gait and walking endurance after the first six weeks of intervention, while the dynamic balance improved after the seventh week [36].…”

Section: Discussionsupporting

confidence: 93%

“…Besides the benefits in muscle strength, the use of EMS training in healthy older persons led to improved speed gait and walking endurance after the first six weeks of intervention, while the dynamic balance improved after the seventh week [36]. Similarly, it was previously found that people with multiple sclerosis increase gait velocity, and walking endurance with the use of EMS in their rehabilitation process [37], suggesting the global influence of EMS [29]. It has been reported a possible global effect of the EMS training applied to the quadriceps muscle, leading to increases in hamstrings strength as well [27].…”

Section: Discussionmentioning

confidence: 60%

See 1 more Smart Citation

Changes in Functionality Induced by Conventional and Combined Electromyostimulation Knee Training, in Women with Patellofemoral Knee Syndrome

2023

PSMPH

View full text Add to dashboard Cite

Background: Patellofemoral pain (PFP) is a chronic condition that usually results in long-term functional impairments both in adults and adolescents PFP has been found to decrease activity levels in individuals. Purpose:The purpose of the present study was to investigate whether the additional use of electrical stimulation to an intervention program could result in greater improvements in the knee function and the level of pain compared with the intervention program itself. Material and Methods: 22 women reported anterior knee pain symptoms clinically allocated in the patellofemoral region and confirmed through the patellar position, analyzed by magnetic resonance imaging (MRI). They randomly assigned into two groups with the same strengthening program. The experimental group used electrical stimulation combined with knee extensors and flexors strengthening exercises. The main outcome of the study was the visual analogue scale (VAS) in order to assess pain and the Anterior Knee Pain Scale (AKPS) to evaluate the functionality of the knee joint. All the outcomes were analyzed and compared pre and post a 6-weeks intervention period. Results: Statistically significant differences were found between the two rehabilitation groups at the end of the intervention period both in VAS (F1,20 = 44.083, p < 0.001) and functional assessment (F1,20 = 35.687, p < 0,001), suggesting that the conventional intervention program with the use of electrical stimulation is more effective regarding the pain degrees and the knee function. PriMera Scientific Medicine and Public Health https://primerascientific.com/psmph Changes in Functionality Induced by Conventional and Combined Electromyostimulation Knee Training, in Women with Patellofemoral Knee Syndrome 46 Conclusion: The use of electrical stimulation, combined with conventional strengthening program, could provide greater beneficial effects on PFP female individuals compared to the strengthening program itself.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 60%

Changes in Functionality Induced by Conventional and Combined Electromyostimulation Knee Training, in Women with Patellofemoral Knee Syndrome

2023

PSMPH

View full text Add to dashboard Cite

show abstract

“…The authors explain the discrepancy by a reduced voluntary muscle activation of agonists muscles, which cause limitations in muscle activation as reflected by a lower amplitude in PwMS 55 . Reduced firing rates in PwMS were also associated with reduced walking speed and distance 72 . Rice et al offer some explanation into the underlying mechanisms in a small study examining muscle weakness including 4 PwMS and 16 HC.…”

Section: Discussionmentioning

confidence: 99%

Neurophysiological impairments in multiple sclerosis—Central and peripheral motor pathways

et al. 2020

View full text Add to dashboard Cite

A systematic review of the literature was conducted comparing neurophysiological outcomes in persons with multiple sclerosis (PwMS) to healthy controls (HC), in studies of the central nervous system (CNS) function comprising motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) and in studies of the peripheral nervous system (PNS) function comprising electroneuronography (ENG) outcomes elicited by peripheral nerve stimulation. Studies comparing neuromuscular function, assessed during maximal voluntary contraction (MVC) of muscle, were included if they reported muscle strength along with muscle activation by use of electromyography (EMG) and/or interpolated twitch technique (ITT). Studies investigating CNS function showed prolonged central motor conduction times, asymmetry of nerve conduction motor pathways, and prolonged latencies in PwMS when compared to HC. Resting motor threshold, amplitude, and cortical silent periods showed conflicting results. CNS findings generally correlated with disabilities. Studies of PNS function showed near significant prolongation in motor latency of the median nerve, reduced nerve conduction velocities in the tibial and peroneal nerves, and decreased compound muscle action potential amplitudes of the tibial nerve in PwMS. ENG findings did not correlate with clinical severity of disabilities. Studies of neuromuscular function showed lower voluntary muscle activation and increased central fatigue in PwMS, whereas EMG showed divergent muscle activation (ie, EMG amplitude) during MVC. When comparing the existing literature on neurophysiological motor examinations in PwMS and HC, consistent and substantial impairments of CNS function were seen in PwMS, whereas impairments of the PNS were less pronounced and inconsistent. In addition, impairments in muscle activation were observed in PwMS.

show abstract

“…Both wide pulses (1 ms [10]) and narrow pulses (200 μs [12]) increased motor unit outputs in the targeted muscle. In a clinical setting where patients with multiple sclerosis participated in TENS and training sessions to improve motor function, Almukass et al [42] found similar clinical outcomes with stimulators delivering narrow (200 μs) and wide (1 ms) pulses. When considering the frequency, stimulations at 100 Hz were the most effective to increase motor unit output [10, 11] or increase corticospinal excitability [43].…”

Section: Discussionmentioning

confidence: 99%

Transcutaneous electrical nerve stimulation modulates corticospinal excitability while preserving motor unit discharge properties during isometric contractions

Hernandez-Pavon

Avrillon

Hoo

et al. 2022

Preprint

View full text Add to dashboard Cite

Aim: Transcutaneous electrical nerve stimulation (TENS) aims to supplement sensory feedback to improve force steadiness or motor function. In this study, we directly assessed potential changes in corticospinal excitability and motor unit discharge characteristics from the first dorsal interosseous (FDI) muscle due to TENS by using transcranial magnetic stimulation (TMS) and high-density surface electromyography (HDsEMG). Methods: Eleven healthy young adults performed a series of submaximal isometric index abductions. We estimated i) motor evoked potential (MEP) amplitudes, ii) persistent inward current amplitudes (PIC, i.e., delta F), iii) motor unit recruitment thresholds and discharge rates, and iv) common synaptic input to motor units before and after TENS. Results: TENS did not affect force steadiness (2.5 ± 0.9% and 3.3 ± 1.9% (p = 0.010)). MEP amplitudes decreased at 110% of the resting motor threshold (rMT; 0.72 ± 0.66 mV vs. 0.59 ± 0.63 mV; p < 0.001), increased at 130% rMT (1.18 ± 1.10 mV vs. 1.41 ± 1.29 mV; p < 0.001). Delta F increased after TENS (3.7 ± 2.2 pps vs. 4.5 ± 2.6 pps; p = 0.010). We did not find a change in the level of common synaptic input or in the temporal variability of motor unit discharge rates after the session of TENS. Conclusion: These results suggest that TENS can modulate corticospinal excitability through supraspinal and spinal processes and, thus act as a priming technique. At the same time, TENS does not generate short-term changes in the neural control of force in young, healthy adults.

show abstract

Pulse Width Does Not Influence the Gains Achieved With Neuromuscular Electrical Stimulation in People With Multiple Sclerosis: Double-Blind, Randomized Trial

Cited by 15 publications

References 46 publications

Changes in Functionality Induced by Conventional and Combined Electromyostimulation Knee Training, in Women with Patellofemoral Knee Syndrome

Changes in Functionality Induced by Conventional and Combined Electromyostimulation Knee Training, in Women with Patellofemoral Knee Syndrome

Neurophysiological impairments in multiple sclerosis—Central and peripheral motor pathways

Transcutaneous electrical nerve stimulation modulates corticospinal excitability while preserving motor unit discharge properties during isometric contractions

Contact Info

Product

Resources

About