Textile Electrodes: Influence of Electrode Construction and Pressure on Stimulation Performance in Neuromuscular Electrical Stimulation (NMES)

Euler, Luisa; Juthberg, Robin; Flodin, Johanna; Guo, Li; Ackermann, Paul W.; Persson, Nils‐Krister

doi:10.1109/embc46164.2021.9630649

Cited by 3 publications

(6 citation statements)

References 18 publications

(18 reference statements)

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“…Another limitation is the potentially differing impedances of the TTE and MPE setups, as well as of the skin of the different participants, which is likely to have influenced results. However, we believe that such measurements would have been unreliable considering that manipulation of the calf in the form of ultrasound measurements and NMES, among other factors (Euler et al 2021a , b ). The main purpose of this study was not primarily to compare isolated factors related to NMES, but rather to compare two different concepts in the form of two different electrode setups, which may represent future alternatives for NMES users.…”

Section: Discussionmentioning

confidence: 99%

“…The purpose of the floats was to hold a moisture-containing sponge (0.5 × 3 × 3 cm, injected with 2 ml NaCl 0.9 mg/ml) in direct contact with each of the underlying electrodes, to increase the local pressure and humidity of the electrode/skin-interface, and thus uphold an adequate electrical conduction (Fig. 2 ) (Euler et al 2021a , b ). Since the TTE-sock was only a prototype, a simple “off the shelf” melamine cleaning sponge was used as the moisture container.…”

Section: Methodsmentioning

confidence: 99%

“…However, as textile surfaces are rather complex, the interface of textile electrodes and the skin behaves differently than for example for standard gel electrodes. This means that findings for other electrode types cannot directly be translated and assumed to be the same for textile electrodes (Euler et al 2021a , b ). Furthermore, there are to the best of our knowledge no prior studies that have investigated the venous hemodynamic effects of NMES via textile electrodes integrated in fixed positions in a garment, compared to NMES via standard gel electrodes placed on individual motor points (MP).…”

Section: Introductionmentioning

confidence: 99%

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Effects on hemodynamic enhancement and discomfort of a new textile electrode integrated in a sock during calf neuromuscular electrical stimulation

et al. 2023

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Purpose To compare fixed transverse textile electrodes (TTE) knitted into a sock versus motor point placed standard gel electrodes (MPE) on peak venous velocity (PVV) and discomfort, during calf neuromuscular electrical stimulation (calf-NMES). Methods Ten healthy participants received calf-NMES with increasing intensity until plantar flexion (measurement level I = ML I), and an additional mean 4 mA intensity (ML II), utilizing TTE and MPE. PVV was measured with Doppler ultrasound in the popliteal and femoral veins at baseline, ML I and II. Discomfort was assessed with a numerical rating scale (NRS, 0–10). Significance was set to p < 0.05. Results TTE and MPE both induced significant increases in PVV from baseline to ML I and significantly higher increases to ML II, in both the popliteal and femoral veins (all p < 0.001). The popliteal increases of PVV from baseline to both ML I and II were significantly higher with TTE versus MPE (p < 0.05). The femoral increases of PVV from baseline to both ML I and II were not significantly different between TTE and MPE. TTE versus MPE resulted at ML I in higher mA and NRS (p < 0.001), and at ML II in higher mA (p = 0.005) while NRS was not significantly different. Conclusion TTE integrated in a sock produces intensity-dependent increases of popliteal and femoral hemodynamics comparable to MPE, but results in more discomfort at plantar flexion due to higher current required. TTE exhibits in the popliteal vein higher increases of PVV compared to MPE. Trial registration Trial_ID: ISRCTN49260430. Date: 11/01/2022. Retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects on hemodynamic enhancement and discomfort of a new textile electrode integrated in a sock during calf neuromuscular electrical stimulation

et al. 2023

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“…Therefore, the current ow is relying on a su cient physical contact of electrode and skin which means a tight contact with the body is required. [29] Air is an electrical insulator wherefore it cannot support the current ow to the body and the charge transfer resistance was highest for the dry electrodes. Furthermore, a direct electrode skin contact was hindered in some parts of the interface by air trapped inside which was acting as local blocking elements, as suggested by Polachan et al (2021).…”

Section: Charge Transfer Resistance and Double-layer Capacitancementioning

confidence: 99%

“…[24,25] However, they are often found to have an inferior performance to wet electrodes in terms of their electrical properties and their stimulation pain. [26][27][28][29] Hence, wet textile electrodes are preferred by many researchers, which must be wetted with tap water, saline solution or electrode gel or cream prior to use. [30][31][32] Indications for the best suitable moisture content in wet textile electrodes are rarely given.…”

Section: Introductionmentioning

confidence: 99%

Influence of the Electrolyte concentration and amount on the Performance of Textile Electrodes in Electrostimulation: a systematic study

Euler

Guo

Persson

2022

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Background: Textile-based stimulation electrodes are a fast-growing research area. With their advantages including reusability and the possibility for integration into garments, textile electrodes open up new possibilities that are not yet feasible today, e.g. various self-administrated treatments and rehabilitation based on neuromuscular electrical stimulation (NMES) or transcutaneous electrical nerve stimulation (TENS). So far, most research has shown that textile-based stimulation electrodes perform more reliable when wetted with an electrolyte. However, there is no systematic investigation about which type and amount of electrolyte to use. Methods: In this study, double-layered textile electrodes have been produced by machine knitting with a size of 3x3 cm2. The electrodes were wetted step-wise with a liquid amount from 5 µL up to 320 µL; four levels of sodium chloride (NaCl) concentrations, i.e. 0.9 %, 1.5 %, 5 % and 35 %, plus pure deionized water as a reference liquid were chosen. The study analyzed the behavior of the skin-electrode impedance when changing the moisture content and NaCl concentration. In addition, equivalent circuits were modelled for deeper insights into the mechanisms causing an impedance change.Results: Results showed that the impedance was greatly influenced by the liquid amount with amounts of 5 µL already significantly reducing the impedance compared to dry electrodes, caused by a substantial reduction in resistance. The reactance, on the other hand, was only partly influenced by the liquid amount showing a reduction upon higher liquid amounts only within a range of 5 – 40 µL. Further, a significant influence on the impedance by the presence of ions was found where the skin-electrode system wetted with saline NaCl solution were showing generally lower impedances than systems wetted with deionized water. However, within this, no remarkable influence of the NaCl concentration could be observed. Conclusion: Impedance was found to be very sensitive to the moisture content in the system, it is recommended to introduce standardizations for impedance testing of wet textile electrodes with precisely controlled electrolyte volumes and liquid migration properties to make independent studies of textile electrodes more comparable.

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Neuromuscular electrical stimulation in garments optimized for compliance

et al. 2023

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Purpose Physical inactivity is associated with muscle atrophy and venous thromboembolism, which may be prevented by neuromuscular electrical stimulation (NMES). This study aimed to investigate the effect on discomfort, current amplitude and energy consumption when varying the frequency and phase duration of low-intensity NMES (LI-NMES) via a sock with knitting-integrated transverse textile electrodes (TTE). Methods On eleven healthy participants (four females), calf-NMES via a TTE sock was applied with increasing intensity (mA) until ankle-plantar flexion at which point outcomes were compared when testing frequencies 1, 3, 10 and 36 Hz and phase durations 75, 150, 200, 300 and 400 µs. Discomfort was assessed with a numerical rating scale (NRS, 0–10) and energy consumption was calculated and expressed in milli-Joule (mJ). Significance set to p ≤ 0.05. Results 1 Hz yielded a median (inter-quartile range) NRS of 2.4 (1.0–3.4), significantly lower than both 3 Hz with NRS 2.8 (1.8–4.2), and 10 Hz with NRS 3.4 (1.4–5.4) (both p ≤ .014). Each increase in tested frequency resulted in significantly higher energy consumption, e.g. 0.6 mJ (0.5–0.8) for 1 Hz vs 14.9 mJ (12.3–21.2) for 36 Hz (p = .003). Longer phase durations had no significant effect on discomfort despite generally requiring significantly lower current amplitudes. Phase durations 150, 200 and 400 µs required significantly lower energy consumption compared to 75 µs (all p ≤ .037). Conclusion LI-NMES applied via a TTE sock produces a relevant plantar flexion of the ankle with the best comfort and lowest energy consumption using 1 Hz and phase durations 150, 200 or 400 µs.

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Textile Electrodes: Influence of Electrode Construction and Pressure on Stimulation Performance in Neuromuscular Electrical Stimulation (NMES)

Cited by 3 publications

References 18 publications

Effects on hemodynamic enhancement and discomfort of a new textile electrode integrated in a sock during calf neuromuscular electrical stimulation

Effects on hemodynamic enhancement and discomfort of a new textile electrode integrated in a sock during calf neuromuscular electrical stimulation

Influence of the Electrolyte concentration and amount on the Performance of Textile Electrodes in Electrostimulation: a systematic study

Neuromuscular electrical stimulation in garments optimized for compliance

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