An investigation of the effect of electrode size and electrode location on comfort during stimulation of the gastrocnemius muscle

Lyons, G.M.; Leane, Gemma; Clarke‐Moloney, Mary; O'Brien, Julie; Grace, Pierce A.

doi:10.1016/j.medengphy.2004.08.003

Cited by 90 publications

(76 citation statements)

References 12 publications

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“…Stimulation parameters and electrode size are the important factors that determine the perceived comfort during NMES. A symmetrical biphasic waveform, short pulse duration, graded onset of stimulation, and large electrodes are required for comfort and less fatigue [16], and these stimulation parameters were employed in the present study.…”

Section: Discussionmentioning

confidence: 99%

Neuromuscular Electrical Stimulation and an Ottoman-Type Seat Effectively Improve Popliteal Venous Flow in a Sitting Position

Morita¹,

Abe²,

Tanaka³

et al. 2006

J. Physiol. Sci

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Abstract:The aim of this study was to examine the effects of the sitting posture on the lower limb venous flow and to explore the beneficial effects of neuromuscular electrical stimulation (NMES) and an ottoman-type seat on the venous flow. Healthy adult volunteers without a history of lower limb surgery or thromboembolism were recruited, and the flow velocity, cross-sectional area, and flow volume of the popliteal vein were measured using Doppler ultrasound. A posture change from the prone position to the sitting position on the ottoman-type seat decreased the flow velocity and increased the cross-sectional area of the popliteal vein, and the flow volume was not altered over 120 min. The flow velocity was further decreased, and the crosssectional area was further increased by subjects sitting on a regular driving seat when compared with the values obtained with an ottoman-type seat. The popliteal flow velocity in the NMES leg was significantly higher than in the non-NMES leg throughout the 120-min testing in the sitting position, but no difference in the cross-sectional area was found between the NMES and the non-NMES legs. Thus lower limb venous stasis elicited by the sitting posture was improved by the ottoman-type seat and NMES.Key words: muscle contraction, electrical stimulation, blood flow.Scurr et al. [1] reported that after long-haul air travel, symptomless deep venous thrombosis (DVT) develops in 10% of passengers, which is a surprisingly large proportion. The sitting posture in an airplane exposes passengers to the combined effects of movement restriction and gravitational pressure gradient between the heart and the lower limbs; this might enhance venous pooling/stasis, thereby increasing the chances of the development of DVT. Accordingly, the effects of sitting posture on lower limb hemodynamics have been a matter of great interest, and it was found that the venous flow velocity in the lower limbs was decreased and the diameter of the popliteal vein was increased by a sitting posture [2][3][4][5]. Devices that increase the venous flow velocity are thought to be effective in reducing venous stasis, and many techniques, including neuromuscular electrical stimulation (NMES) [6][7][8], have been proposed for increasing venous flow velocity. The metabolic demands of exercising skeletal muscles are met by increasing their blood flow, thereby supplying additional oxygen; this is a well-known phenomenon. This is also true in the case of passive electrical stimulation [9,10]. Furthermore, venous flow velocity increases in response to muscle contraction, and the increased velocity contributes to venous expulsion [10]. NMES increases the venous flow velocity in a stimulation-dependent manner, and the effect lasts for 4 h [7]. However, the extent to which NMES can improve the suppression of venous flow induced by a sitting posture remains unclear. To examine this, the popliteal venous flow velocity was measured consecutively in the horizontal prone position and then in the sitting position in both NMES and non-N...

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Section: Discussionmentioning

confidence: 99%

Neuromuscular Electrical Stimulation and an Ottoman-Type Seat Effectively Improve Popliteal Venous Flow in a Sitting Position

Morita¹,

Abe²,

Tanaka³

et al. 2006

J. Physiol. Sci

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“…1, top panels). The motor points (MPs) have been deWned as the superWcial points of stimulation with the lowest motor threshold, i.e., the points on the skin over the muscle belly at which the smallest amount of current is required to produce muscle contraction (Delitto and Robinson 1989;KnaXitz et al 1990;Lions et al 2004). Accordingly, the main MP was identiWed, while stimulating at 2 Hz and gradually increasing the stimulation intensity, by moving a pen electrode (area = 1 cm 2 ) on the skin overlying the target muscle until a location providing a minimal detectable mechanical response was found.…”

Section: Methodsmentioning

confidence: 99%

Transcutaneous neuromuscular electrical stimulation: influence of electrode positioning and stimulus amplitude settings on muscle response

Gobbo

Gaffurini

Bissolotti³

et al. 2011

Eur J Appl Physiol

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The aim of the study was to investigate the influence of two different transcutaneous neuromuscular electrical stimulation procedures on evoked muscle torque and local tissue oxygenation. In the first one (MP mode), the cathode was facing the muscle main motor point and stimulus amplitude was set to the level eliciting the maximal myoelectrical activation according to the amplitude of the evoked electromyogram (EMG); in the second one (RC mode), the electrodes were positioned following common reference charts for electrode placement while stimulus amplitude was set according to subject tolerance. Tibialis Anterior (TA) and Vastus Lateralis (VL) muscles of 10 subjects (28.4 ± 8.2 years) were tested in specific dynamometers to measure the evoked isometric torque. The EMG and near-infrared spectroscopy probes were placed on muscle belly to detect the electrical activity and local metabolic modifications of the stimulated muscle, respectively. The stimulation protocol consisted of a gradually increasing frequency ramp from 2 to 50 Hz in 7.5 s. Compared to RC mode, in MP mode the contractile parameters (peak twitch, tetanic torque, area under the torque build-up) and the metabolic solicitation (oxygen consumption and hyperemia due to metabolites accumulation) resulted significantly higher for both TA and VL muscles. MP mode resulted also to be more comfortable for the subjects. Based on the assumption that proper mechanical and metabolic stimuli are necessary to induce muscle strengthening, our results witness the importance of an optimized, i.e., comfortable and effective, stimulation to promote the aforementioned muscle adaptive modifications.

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“…Here a maximum pulsewidth of 300µs is assumed, based on that used in commercial stimulators, and the range known to provide comfortable contraction [31]. This modulates mechanical impedance to maintain postural stability and is the method in which the central nervous system naturally activates antagonistic muscles during task performance [32], [33].…”

Section: Tremulous Wrist Modelmentioning

confidence: 99%

Repetitive Control of Electrical Stimulation for Tremor Suppression

Copur

Freeman

Chu

et al. 2019

IEEE Trans. Contr. Syst. Technol.

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Abstract-Tremor is a rapid involuntary movement often seen in patients with neurological conditions such as Multiple Sclerosis (MS) and Parkinson's disease. This debilitating oscillation can be suppressed by applying functional electrical stimulation (FES) within a closed-loop control system. However, conventional implementations use classical control methods and have proved capable of only limited performance. This paper establishes the feasibility of embedding repetitive control (RC) action to exploit the capability of learning from experience to completely suppress tremor at the wrist via FES regulated co-contraction of wrist extensors/flexors. A nonlinear model structure and associated identification procedure is first proposed to guarantee stability and performance of the RC system. Then a linearising control approach is developed to facilitate transparent RC design, together with a mechanism to preserve patients' voluntary intention. Experimental evaluation is performed with both unimpaired and neurologically impaired participants using a validated wristrig. For the former group a novel electromechanical system is employed to induce tremor artificially. Results are benchmarked against a well-known classical filtering technique to establish the efficacy of the RC approach. These confirm that the proposed control system with the developed model identification procedure can increase tremor suppression by 43.3% compared with conventional filtering. In addition, the mechanism decreases the interference of RC action with voluntary motion by 20.2% compared with conventional filtering.

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An investigation of the effect of electrode size and electrode location on comfort during stimulation of the gastrocnemius muscle

Cited by 90 publications

References 12 publications

Neuromuscular Electrical Stimulation and an Ottoman-Type Seat Effectively Improve Popliteal Venous Flow in a Sitting Position

Neuromuscular Electrical Stimulation and an Ottoman-Type Seat Effectively Improve Popliteal Venous Flow in a Sitting Position

Transcutaneous neuromuscular electrical stimulation: influence of electrode positioning and stimulus amplitude settings on muscle response

Repetitive Control of Electrical Stimulation for Tremor Suppression

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