Knee extensor force production and discomfort during neuromuscular electrical stimulation of quadriceps with and without gluteal muscle co-stimulation
Author: Flodin, J; Mikkelsen, C; Ackermann, P W; Flodin, Johanna
Department: Inst för molekylär medicin och kirurgi / Dept of Molecular Medicine and Surgery
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Abstract
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.
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.
Institution:
- Integrative Orthopedic Laboratory, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Trauma, Acute Surgery and Orthopaedics, Karolinska University Hospital, Stockholm, Sweden
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Capio Artro Clinic, Stockholm, Sweden
Citation: Eur J Appl Physiol. 2022 Jun;122(6):1521-1530.
Citation DOI: 10.1007/s00421-022-04949-9
Citation PMID: 35426510
Citation ISI: 000782751400001
Publishing journal: European journal of applied physiology
Eprint status: Peer Reviewed
Version: Published
Issue date: 2024-05-03
Sponsorship:
- Karolinska Institutet
- Stockholm County Council (ALF project), SLL20180348
- Swedish Research Council, 2017-00202
Rights:
CC BY 4.0
Publication year: 2022
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