Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on the decline and recovery of muscle force

Bochkezanian, Vanesa, Newton, Robert U., Trajano, Gabriel S., Vieira, Amilton, Pulverenti, Timothy S. and Blazevich, Anthony J. (2017) Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on the decline and recovery of muscle force. BMC Neurology, 17 1: 82-82. doi:10.1186/s12883-017-0862-x


Author Bochkezanian, Vanesa
Newton, Robert U.
Trajano, Gabriel S.
Vieira, Amilton
Pulverenti, Timothy S.
Blazevich, Anthony J.
Title Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on the decline and recovery of muscle force
Journal name BMC Neurology   Check publisher's open access policy
ISSN 1471-2377
Publication date 2017-05-02
Sub-type Article (original research)
DOI 10.1186/s12883-017-0862-x
Open Access Status DOI
Volume 17
Issue 1
Start page 82
End page 82
Total pages 14
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Abstract Neuromuscular electrical stimulation (NMES) is commonly used to activate skeletal muscles and reverse muscle atrophy in clinical populations. Clinical recommendations for NMES suggest the use of short pulse widths (100-200 μs) and low-to-moderate pulse frequencies (30-50 Hz). However, this type of NMES causes rapid muscle fatigue due to the (non-physiological) high stimulation intensities and non-orderly recruitment of motor units. The use of both wide pulse widths (1000 μs) and tendon vibration might optimize motor unit activation through spinal reflex pathways and thus delay the onset of muscle fatigue, increasing muscle force and mass. Thus, the objective of this study was to examine the acute effects of patellar tendon vibration superimposed onto wide-pulse width (1000 μs) knee extensor electrical stimulation (NMES, 30 Hz) on peak muscle force, total impulse before "muscle fatigue", and the post-exercise recovery of muscle function.
Formatted abstract
Background: Neuromuscular electrical stimulation (NMES) is commonly used to activate skeletal muscles and reverse muscle atrophy in clinical populations. Clinical recommendations for NMES suggest the use of short pulse widths (100-200 μs) and low-to-moderate pulse frequencies (30-50 Hz). However, this type of NMES causes rapid muscle fatigue due to the (non-physiological) high stimulation intensities and non-orderly recruitment of motor units. The use of both wide pulse widths (1000 μs) and tendon vibration might optimize motor unit activation through spinal reflex pathways and thus delay the onset of muscle fatigue, increasing muscle force and mass. Thus, the objective of this study was to examine the acute effects of patellar tendon vibration superimposed onto wide-pulse width (1000 μs) knee extensor electrical stimulation (NMES, 30 Hz) on peak muscle force, total impulse before "muscle fatigue", and the post-exercise recovery of muscle function.

Methods: Tendon vibration (Vib), NMES (STIM) or NMES superimposed onto vibration (STIM + Vib) were applied in separate sessions to 16 healthy adults. Total torque-time integral (TTI), maximal voluntary contraction torque (MVIC) and indirect measures of muscle damage were tested before, immediately after, 1 h and 48 h after each stimulus.

Results: TTI increased (145.0 ± 127.7%) in STIM only for "positive responders" to the tendon vibration (8/16 subjects), but decreased in "negative responders" (-43.5 ± 25.7%). MVIC (-8.7%) and rectus femoris electromyography (RF EMG) (-16.7%) decreased after STIM (group effect) for at least 1 h, but not after STIM + Vib. No changes were detected in indirect markers of muscle damage in any condition.

Conclusions: Tendon vibration superimposed onto wide-pulse width NMES increased TTI only in 8 of 16 subjects, but reduced voluntary force loss (fatigue) ubiquitously. Negative responders to tendon vibration may derive greater benefit from wide-pulse width NMES alone.
Keyword Meuro-rehabilitation
Muscle damage
Muscle fatigue
Muscle function
Muscle stimulation
Muscle strength
Q-Index Code C1
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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