Interleaved neuromuscular electrical stimulation: Motor unit recruitment overlap

Wiest, Matheus Joner; Bergquist, Austin J.; Schimidt, Helen Lidiane; Jones, Kelvin E.; Collins, David F.

doi:10.1002/mus.25249

Cited by 11 publications

(10 citation statements)

References 33 publications

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“…First, the relative difference in stimulation frequencies used here for interleaved vs. synchronous stimulation (17.5 Hz) was modest compared to that in other studies (30 – 45 Hz) (Yoshida and Horch, 1993; McDonnall et al 2004; Nguyen et al 2011). And second, as pointed out by Yoshida and Horch (1993) and Wiest et al (2017), the benefits in terms of fatigue resistance using interleaved multi-electrode stimulation diminishes as the degree of overlap in muscle fibers activated by the electrodes increases. Here the degree of overlap may have been substantial in comparison to the previous investigations.…”

Section: Discussionmentioning

confidence: 97%

“…Therefore, the aim of this study was to determine whether stimulating a muscle using intramuscular electrodes but with more than one source of current could boost force above that achievable with a single source. An additional potential benefit of such distributed stimulation is that some degree of load sharing among the muscle fibers activated by different electrodes might help minimize fatigue during prolonged activity (Mortimer 1981; Yoshida and Horch 1993; Wise et al 2001; McDonnall et al 2004; Nguyen et al 2011; Sayenko et al 2014; Lou et al 2017; Wiest et al 2017). Because of the relatively prolonged force response to each stimulus pulse, it seems feasible that a target force could be maintained by alternating stimuli among the electrodes using lower rates than would be needed by a single electrode.…”

Section: Introductionmentioning

confidence: 99%

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Distributed stimulation increases force elicited with functional electrical stimulation

Buckmire¹,

Lockwood²,

Doane³

et al. 2018

J. Neural Eng.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Distributed stimulation increases force elicited with functional electrical stimulation

Buckmire¹,

Lockwood²,

Doane³

et al. 2018

J. Neural Eng.

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“…Crema et al has also demonstrated flexible activation of multiple fingers using a multi-electrode array across the forearm and hand (16). Other approaches to NMES involve stimulation of the nerve bundle prior to branching and innervating a muscle, which has shown to allow for a larger area of muscle activation and potentially reduce long-term fatigue effects (17–19).…”

Section: Introductionmentioning

confidence: 99%

Variation of Finger Activation Patterns Post-stroke Through Non-invasive Nerve Stimulation

Shin

Yang

2018

Front. Neurol.

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Purpose: A transcutaneous proximal nerve stimulation technique utilizing an electrode grid along the nerve bundles has previously shown flexible activation of multiple fingers. This case study aimed to further demonstrate the ability of this novel stimulation technique to induce various finger grasp patterns in a stroke survivor.Methods: An individual with chronic hemiplegia and severe hand impairment was recruited. Electrical stimulation was delivered to different pairs of an electrode grid along the ulnar and median nerves to selectively activate different finger flexor muscles, with an automated electrode switching method. The resultant individual isometric flexion forces and forearm flexor high-density electromyography (HDEMG) were acquired to evaluate the finger activation patterns. A medium and low level of overall activation were chosen to gauge the available finger patterns for both the contralateral and paretic hands. All the flexion forces were then clustered to categorize the different types of grasp patterns.Results: Both the contralateral and paretic sides demonstrated various force clusters including single and multi-finger activation patterns. The contralateral hand showed finger activation patterns mainly centered on median nerve activation of the index, middle, and ring fingers. The paretic hand exhibited fewer total activation patterns, but still showed activation of all four fingers in some combination.Conclusion: Our results show that electrical stimulation at multiple positions along the proximal nerve bundles can elicit a select variety of finger activation patterns even in a stroke survivor with minimal hand function. This system could be further implemented for better rehabilitative training to help induce functional grasp patterns or to help regain muscle mass.

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“…In our case, the higher current density during SDSS generated higher discomfort, limiting MTT compared to SES. The MTT of SDSS can also be limited by 1) the asynchronous activation of different portions of the muscle compared to the synchronous activation during SES; and 2) the potential overlap of motor unit recruitment between different channels [46].…”

Section: B Maximal-tolerated Torquementioning

confidence: 99%

Fatigue and Discomfort During Spatially Distributed Sequential Stimulation of Tibialis Anterior

Wiest

Bergquist

Heffernan

et al. 2019

IEEE Trans. Neural Syst. Rehabil. Eng.

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Neuromuscular electrical stimulation is conventionally applied through a single pair of electrodes over the muscle belly, denominated single electrode stimulation (SES). SES is limited by discomfort and incomplete motor-unit recruitment, restricting electrically-evoked torque and promoting premature fatigue-induced torquedecline. Sequential stimulation involving rotation of pulses between multiple pairs of electrodes has been proposed as an alternative, denominated spatially distributed sequential stimulation (SDSS). The present aim was to compare discomfort, maximal-tolerated torque, and fatigue-related outcomes between SES and SDSS of tibialis anterior. Ten healthy participants completed two experimental sessions. The self-reported discomfort at sub-maximal torque, the maximal-tolerated torque, fatigue-induced torque-decline during, and doublet-twitch torque at 10-and 100-Hz before and after, 300 intermittent (0.6-sON -0.6-s-OFF) isokinetic contractions were compared between SES and SDSS. SDSS stimulation improved fatigue-related outcomes, whereas increased discomfort and reduced maximal-tolerated torque. SDSS holds promise for reducing fatigue. However, limited torque production and associated discomfort may limit its utility for rehabilitation/training.

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Interleaved neuromuscular electrical stimulation: Motor unit recruitment overlap

Abstract: Low intensity iNMES leads to low overlap and produces torque that is functionally relevant to evoke dorsiflexion during walking. Muscle Nerve 55: 490-499, 2017.

Cited by 11 publications

References 33 publications

Distributed stimulation increases force elicited with functional electrical stimulation

Distributed stimulation increases force elicited with functional electrical stimulation

Variation of Finger Activation Patterns Post-stroke Through Non-invasive Nerve Stimulation

Fatigue and Discomfort During Spatially Distributed Sequential Stimulation of Tibialis Anterior

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