Effect of the application of somatosensory and excitomotor electrical stimulation during quiet upright standing balance

Zéronian, Sacha; Noé, Frédéric; Paillard, Thierry

doi:10.1016/j.medengphy.2020.11.016

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…Interestingly, we found that the addition of TENS had no effect on static balance, as assessed by the mCTSIB. Much previous research has found external electric stimulation of the lower limbs to be effective at improving balance metrics [ 13 , 30 , 31 ]. However, Paillard et al [ 32 ] recently found that the participants’ responsiveness to the electrical stimulation of sensory nerves to improve balance depends on their baseline balance abilities.…”

Section: Discussionmentioning

confidence: 99%

“…When applied to improve the sensorimotor function of mobility, electrodes are placed on the muscles of the lower limbs and the applied current is set at a level below the motor threshold to minimize any evoked muscle contractions. Used in this way, action potentials in several sensory receptors are elicited both in and around the targeted muscle [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…While there is ample evidence of the benefit that TENS has on gait and mobility, the underlying mechanisms that lead to these improvements are not understood. Commonly when performing research with TENS, the amplitude is set at a level below the motor threshold (i.e., the minimal intensity of stimulation that generates an involuntary motor response) [ 13 ]. Thus, the argument that any benefit comes from the direct excitation of additional muscle activation is unlikely.…”

Section: Introductionmentioning

confidence: 99%

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I Can Step Clearly Now, the TENS Is On: Transcutaneous Electric Nerve Stimulation Decreases Sensorimotor Uncertainty during Stepping Movements

Whittier

Weller

Fling

2022

Sensors

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Transcutaneous electric nerve stimulation (TENS) is a method of electrical stimulation that elicits activity in sensory nerves and leads to improvements in the clinical metrics of mobility. However, the underlying perceptual mechanisms leading to this improvement are unknown. The aim of this study was to apply a Bayesian inference model to understand how TENS impacts sensorimotor uncertainty during full body stepping movements. Thirty healthy adults visited the lab on two occasions and completed a motor learning protocol in virtual reality (VR) on both visits. Participants were randomly assigned to one of three groups: TENS on first visit only (TN), TENS on second visit only (NT), or a control group where TENS was not applied on either visit (NN). Using methods of Bayesian inference, we calculated the amount of uncertainty in the participants’ center of mass (CoM) position estimates on each visit. We found that groups TN and NT decreased the amount of uncertainty in the CoM position estimates in their second visit while group NN showed no difference. The least amount of uncertainty was seen in the TN group. These results suggest that TENS reduces the amount of uncertainty in sensory information, which may be a cause for the observed benefits with TENS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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I Can Step Clearly Now, the TENS Is On: Transcutaneous Electric Nerve Stimulation Decreases Sensorimotor Uncertainty during Stepping Movements

Whittier

Weller

Fling

2022

Sensors

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“…Sensory electrical threshold of the median nerve of the non-dominant hand. The sensory threshold was defined as the minimal intensity of stimulation that can be perceived ( 59 ) in 5 out of 10 tests.…”

Section: Methodsmentioning

confidence: 99%

Effects of Skin Stimulation on Sensory-Motor Networks Excitability: Possible Implications for Physical Training in Amyotrophic Lateral Sclerosis

et al. 2022

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BackgroundMany different trials were assessed for rehabilitation of patients with amyotrophic lateral sclerosis (ALS), with non-unique results. Beside the effects on muscle trophism, some of the encouraging results of physical training could be ascribed to the modulation of cortical excitability, which was found hyperexcited in ALS.ObjectiveThe effects of tactile skin stimulation in the modulation of the sensory-motor integrative networks in healthy subjects were assayed through the paired associative stimulation (PAS) protocol.MethodsIn total, 15 healthy subjects were enrolled. In the standard PAS session, the average amplitude of the motor evoked potential (MEP) after 10 stimuli of transcranial magnetic stimulation (TMS) was measured at the baseline and after the PAS protocol (0, 10, 20, 30, and 60 min). In the skin stimulation session, the average amplitude of the MEP was measured before and after 10 min of skin stimulation over the hand. Subsequently, each subject underwent the PAS stimulation and the measure of the average amplitude of the MEP (0, 10, 20, 30, and 60 min).ResultsThe tactile skin stimulation on healthy subjects increases the PAS-induced sensory-motor network hyperexcitability in healthy subjects.ConclusionSkin stimulation should be avoided in the physiotherapeutic approaches for patients with ALS, given the possible hyperexciting effects on the already upmodulated sensory-motor networks. They can be taken into account for diseases characterized by downregulation of cortical and transcortical networks.

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“…To this end, it must be well below the motor threshold and close to the sensory threshold, that is, the minimum intensity of stimulation that can be perceived by individual. Indeed, the current intensity must be around the sensory threshold without exceeding it or only slightly, since a non-excito-motor current (low intensity) is already likely to lead to recruitment of type I muscle fibres from reflex pathways – mediated at spinal level, that is, homolateral monosynaptic connections of the Ia fibres with the α-motoneurons generate depolarisation of the latter and induce the contraction of the muscle fibres they innervate ( Zeronian et al, 2021 ). SES is painless (although there are possible sensations) and applied to a peripheral nerve, belly muscles (motor points) and/or joints at current intensities below, at or slightly above the sensory threshold ( Schröder et al, 2018 ; Paillard, 2021 ).…”

Section: Motor and Postural Adaptations Induced By Electrical Stimulationmentioning

confidence: 99%

Neuromuscular or Sensory Electrical Stimulation for Reconditioning Motor Output and Postural Balance in Older Subjects?

Paillard

2022

Front. Physiol.

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Percutaneous electrical stimulation is used for reconditioning functional capabilities in older subjects. However, its optimal application depends on the specific physiological needs of the individual. Depending on whether his/her needs are related to motor function or sensory and central functions, the relevant modality of electrical stimulation differs significantly. In fact, there are two main modalities of electrical stimulation, that is, neuromuscular electrical stimulation (NMES) and sensory electrical stimulation (SES). NMES involves high-intensity currents (above the motor threshold) and provokes involuntary visible direct muscle contractions. With chronic application, the induced adaptations occur mainly at the neuromuscular function level and thus enhance muscle strength/power and motor output. SES involves low-intensity currents (below, at or only just above the sensory threshold), does not induce any visible muscle contraction and provides only sensory information. With chronic application, the induced adaptations occur at the level of potentiation and transmission of proprioceptive afferents and thus facilitate sensorimotor activity (movement and balance). Overall, SES is interesting for the improvement/maintenance of sensorimotor capabilities in non-frail older subjects while NMES is relevant to develop muscle strength/power and thus reduce the risk of falls due to a lack of muscle strength/power in frail older subjects.

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Effect of the application of somatosensory and excitomotor electrical stimulation during quiet upright standing balance

Cited by 9 publications

References 24 publications

I Can Step Clearly Now, the TENS Is On: Transcutaneous Electric Nerve Stimulation Decreases Sensorimotor Uncertainty during Stepping Movements

I Can Step Clearly Now, the TENS Is On: Transcutaneous Electric Nerve Stimulation Decreases Sensorimotor Uncertainty during Stepping Movements

Effects of Skin Stimulation on Sensory-Motor Networks Excitability: Possible Implications for Physical Training in Amyotrophic Lateral Sclerosis

Neuromuscular or Sensory Electrical Stimulation for Reconditioning Motor Output and Postural Balance in Older Subjects?

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