Electrically Elicited Muscle Torque: Comparison Between 2500-Hz Burst-Modulated Alternating Current and Monophasic Pulsed Current

Scott, Wayne; Adams, Cheryl; Cyr, Shantelle; Hanscom, Brianna; Hill, Kevin T.; Lawson, Jeffrey H.; Ziegenbein, Colin

doi:10.2519/jospt.2015.5861

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…After reviewing titles and abstracts, an additional 368 articles were excluded. From the remaining 42 articles, a total of 8 studies were included for review 16,17,38,70,76,[82][83][84] and the remaining 34 studies were excluded 1,3,5,7,[11][12][13]18,22,30,[33][34][35][36][46][47][48]54,56,[59][60][61]63,65,67,69,71,72,74,75,[77][78][79]81 ( Figure 1).…”

Section: Resultsmentioning

confidence: 99%

A Comparison of Neuromuscular Electrical Stimulation Parameters for Postoperative Quadriceps Strength in Patients After Knee Surgery: A Systematic Review

Conley

Mattacola

Jochimsen

et al. 2021

Sports Health: A Multidisciplinary Approach

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Context: Postoperative quadriceps strength weakness after knee surgery is a persistent issue patients and health care providers encounter. Objective: To investigate the effect of neuromuscular electrical stimulation (NMES) parameters on quadriceps strength after knee surgery. Data Sources: CINAHL, MEDLINE, SPORTDiscus, and PubMed were systematically searched in December 2018. Study Selection: Studies were excluded if they did not assess quadriceps strength or if they failed to report the NMES parameters or quadriceps strength values. Additionally, studies that applied NMES to numerous muscle groups or simultaneously with other modalities/treatments were excluded. Study quality was assessed with the Physiotherapy Evidence Database (PEDro) scale for randomized controlled trials. Study Design: Systematic review. Level of Evidence: Level 1. Data Extraction: Treatment parameters for each NMES treatment was extracted for comparison. Quadriceps strength means and standard deviations were extracted and utilized to calculate Hedge g effect sizes with 95% CIs. Results: Eight RCTs were included with an average Physiotherapy Evidence Database scale score of 5 ± 2. Hedge g effect sizes ranged from small (−0.37; 95% CI, −1.00 to 0.25) to large (1.13; 95% CI, 0.49 to 1.77). Based on the Strength of Recommendation Taxonomy Quality of Evidence table, the majority of the studies included were low quality RCTs categorized as level 2: limited quality patient-oriented evidence. Conclusion: Because of inconsistent evidence among studies, grade B evidence exists to support the use of NMES to aid in the recovery of quadriceps strength after knee surgery. Based on the parameters utilized by studies demonstrating optimal treatment effects, it is recommended to implement NMES treatment during the first 2 postoperative weeks at a frequency of ≥50 Hz, at maximum tolerable intensity, with a biphasic current, with large electrodes and a duty cycle ratio of 1:2 to 1:3 (2- to 3-second ramp).

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Section: Resultsmentioning

confidence: 99%

A Comparison of Neuromuscular Electrical Stimulation Parameters for Postoperative Quadriceps Strength in Patients After Knee Surgery: A Systematic Review

Conley

Mattacola

Jochimsen

et al. 2021

Sports Health: A Multidisciplinary Approach

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“…Numerical data of funnel plots were presented in Table E in S3 File . There are two articles[ 40 , 43 ] that are non-pooled in the meta-analysis. One article reported that the number of subjects who had a negative comment on NMES was higher in KFAC than in PC (66.7% vs.…”

Section: Resultsmentioning

confidence: 99%

“…8.3%). [ 40 ] Another article reported that the number of reports of discomfort in each subject was significantly lower in KFAC than in PC (7 vs. 15).…”

Section: Resultsmentioning

confidence: 99%

“…These search strategies provide a more comprehensive assessment of relevant articles by adding new findings to the previous review. Indeed, the current meta-analysis added 8 articles[ 9 , 13 , 14 , 38 – 40 , 42 , 43 ] that were not included in the previous meta-analysis which demonstrated a similar effect of KFAC and PC on quadriceps-evoked torque and discomfort in healthy adults. [ 8 ] It should be noted that the mean age of subjects in all the included studies is quite young (26.4 years); thus, our findings may not be applicable to the elderly population, because the elderly have a different force-frequency relationship of quadriceps from healthy adults.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the effects of kilohertz- and low-frequency electric stimulations: A systematic review with meta-analysis

et al. 2018

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ObjectiveThis study aimed to determine whether kilohertz-frequency alternating current (KFAC) is superior to low-frequency pulsed current (PC) in increasing muscle-evoked torque and lessening discomfort.Data sourcesThe electronic databases PubMed, PEDro, CINAHL, and CENTRAL were searched for related articles, published before August 2017. Furthermore, citation search was performed on the original record using Web of Science.Review methodsRandomized controlled trials, quasi-experimental studies, and within-subject repeated studies evaluating and comparing KFAC and PC treatments were included. The pooled standardized mean differences (SMDs) of KFAC and PC treatments, with 95% confidence intervals (CIs), were calculated using the random effects model.ResultsIn total, 1148 potentially relevant articles were selected, of which 14 articles with within-subject repeated designs (271 participants, mean age: 26.4 years) met the inclusion criteria. KFAC did not significantly increase muscle-evoked torque, compared to PC (pooled SMD: -0.25; 95% CI: -0.53, 0.06; P = 0.120). KFAC had comparable discomfort compared to that experienced using PC (pooled SMD: -0.06; 95% CI: -0.50, 0.38; P = 0.800). These estimates of the effects had a high risk of bias, as assessed using the Downs and Black scale, and were highly heterogeneous studies.ConclusionsThis meta-analysis does not establish that KFAC is superior to PC in increasing muscle-evoked torque and lessening discomfort level. However, no strong conclusion could be drawn because of a high risk of bias and a large amount of heterogeneity. High quality studies comparing the efficacy between PC and KFAC treatments with consideration of potential confounders is warranted to facilitate the development of effective treatment.

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“…Four publications reported using single blinding and two used double blinding. Within the reported double blinded studies, Dantas et al [21] reported the blinding of both investigator and participant to the treatment being applied, but did not specify how this was achieved and Scot et al [22] reported the blinding of both observer (individual who viewed the treatment effects) and participant to the treatment being applied, but again did not specify how this was achieved. None of the papers identified referred to implementing allocation concealment and assignment.…”

Section: Functional Electrical Stimulation Trial Methodologiesmentioning

confidence: 99%

Design of a Smartphone Application with Integrated Functional Electrical Stimulation (FES) Treatment Randomization and On-The-Fly Stimulus Parameter Adjustment for Streamlining the Clinical Evaluation of FES Protocols

Sweeney¹,

Corley²,

Browne³

et al. 2016

J Health Med Inform

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The clinical application of Functional Electrical Stimulation (FES) has evolved over the last five decades. However, the use of the Randomized Control Trial (RCT) methodology in evaluating the clinical effectiveness of new and existing applications of FES is a demanding process adding time and cost to these trials. Consequently, there has been a low level of RCTs applied to FES studies. Poor quality trials result in poor evidence of FES effectiveness with a consequence that the technique may not be adopted into clinical practice. In this paper some of the key challenges encountered in FES randomised control clinical trials are identified and a solution to address these challenges is presented in the form of a smartphone App and a Bluetooth controlled FES architecture. The design and evaluation of a smartphone application using a User Centred Design approach to provide automatic blind randomization control and facilitating the wireless temporal control of a portable Bluetooth enabled FES device is described.

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Electrically Elicited Muscle Torque: Comparison Between 2500-Hz Burst-Modulated Alternating Current and Monophasic Pulsed Current

Abstract: Neuromuscular stimulation using MPC may be more efficacious than using BMAC to achieve a high torque output in patients with quadriceps weakness.

Cited by 13 publications

References 26 publications

A Comparison of Neuromuscular Electrical Stimulation Parameters for Postoperative Quadriceps Strength in Patients After Knee Surgery: A Systematic Review

A Comparison of Neuromuscular Electrical Stimulation Parameters for Postoperative Quadriceps Strength in Patients After Knee Surgery: A Systematic Review

Comparison of the effects of kilohertz- and low-frequency electric stimulations: A systematic review with meta-analysis

Design of a Smartphone Application with Integrated Functional Electrical Stimulation (FES) Treatment Randomization and On-The-Fly Stimulus Parameter Adjustment for Streamlining the Clinical Evaluation of FES Protocols

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