Effects of Neuromuscular Electrical Stimulation Parameters on Torque, Fatigue, and Oxygen Extraction

NCT05061056 | Completed DMC

• 1 other identifier: 47989121.6.0000.8093
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

Neuromuscular Electrical Stimulation (NMES) can minimize muscle atrophy, complications related to muscle disuse and improved neuromuscular performance. However, it is still unclear the influence of specific physical parameters, including carrier frequency, burst duration, and duty cycle regarding the greater generation of evoked torque, sensory discomfort, muscle fatigue, and peripheral oxygen extraction. Thus, the aim of this study is to compare the effects of different NMES protocols applied to the triceps surae muscle for evoked torque, muscle fatigue, sensory discomfort, and peripheral oxygen extraction in healthy individuals. This is a crossover, experimental, randomized, double-blind trial composed of apparently healthy participants. All NMES protocols will be tested on the same individual with randomization of the sequence of intervention protocols. There will be a total of 6 encounters with seven days between them. Session 1 will evaluate the anthropometric measures, the maximum intensity for each intervention protocol, and the sequence of intervention protocols for each individual will be randomized. Sessions 2, 3, 4, and 5 will be composed equally with the assessment of the maximum voluntary and evoked joint torque of the triceps surae muscle through the isokinetic dynamometer, evaluation of muscle fatigue through the H-reflex, M-wave, fatigue index, time-torque-integral, and recruitment curve, evaluation of peripheral oxygen extraction through NIRS (Near Infrared Spectroscopy), electromyographic signals to assessed the RMS (root mean square) and the median frequency, evaluation of the level of sensory discomfort through the Visual Analog Pain Scale and finally by the NMES protocol. The 6th session will be the replication of the 2nd session of each individual. The EENM protocols will be as follows: CR10% (Russian Current with 2500 Hz, modulated in bursts of 50 Hz, 200 µs and 10% duty cycle - 2 ms bursts and 18 ms interbusrts), CR20% (Russian Current with 2500 Hz, modulated in bursts of 50 Hz, 200 µs and 20% of duty cycle - 4 ms bursts and 16 ms interbusrts), CA10% (Aussie current with 1000 Hz, modulated in bursts of 50 Hz, 500 µs and 10% duty cycle - 2 ms of bursts and 18 ms interbusrts), CA20% (Aussie current with 1000 Hz, modulated in bursts of 50 Hz, 500 µs and 20% of duty cycle - 4 ms of bursts and 16 ms interbusrts) all protocols will be performed on the triceps surae muscle.

Conditions

Fatigue

Keywords

Healthy Young; Electric Stimulation Therapy; Evoked torque; Sensory discomfort; Peripheral oxygen extraction

Outcome Measures

Primary Outcomes (9)

• Submaximal voluntary isometric contraction of the triceps surae

  Expressed in muscle strength, assessed using an isokinetic dynamometer

  2 minutes

• Maximum voluntary isometric contraction of the triceps surae

  Expressed in muscle strength, assessed using an isokinetic dynamometer

  5 minutes

• Maximum evoked torque

  Expressed by the description of muscle strength generated by electrical stimulation assessed by the isokinetic dynamometer

  5 minutes

• Torque evoked during the fatigue protocol

  Expressed by the description of muscle strength generated by electrical stimulation assessed by the isokinetic dynamometer

  20 minutes

• Peripheral oxygen extraction

  Expressed by peripheral oxygen consumption assessed by near-infrared spectroscopy from the beginning to the end of the sessions

  40 minutes

• Muscle fatigue assessment before the muscle fatigue protocol

  Expressed by mechanical properties of plantar flexors and central activation relationship using the contraction interpolation technique

  10 minutes

• Assessment of muscle fatigue during the muscle fatigue protocol

  Expressed by the muscle fatigue index through the decline in torque evoked from the beginning to the end of the protocol

  20 minutes

• Muscle fatigue assessment during the muscle fatigue protocol

  Expressed by the decline in torque-time-integral from the beginning to the end of the protocol

  20 minutes

• Electromyographic signals

  Expressed by the raw values of RMS and Median Frequency within a range of 500 ms throughout the entire session

  40 minutes

Secondary Outcomes (2)

• Sensory discomfort during maximum evoked torques

  10 seconds

• Sensory discomfort during fatigue protocol

  10 seconds

Study Arms (4)

Russian current 10%

EXPERIMENTAL

Subjects will receive a interventions (Russian Current at 10% duty cycle). Evoked torque, muscle fatigue, sensory discomfort, and peripheral oxygen extraction will be evaluated.

Other: Russian current 10%

Russian current 20%

EXPERIMENTAL

Subjects will receive a interventions (Russian Current at 20% duty cycle). Evoked torque, muscle fatigue, sensory discomfort, and peripheral oxygen extraction will be evaluated.

Other: Russian current 20%

Aussie current 10%

EXPERIMENTAL

Subjects will receive a interventions (Aussie Current at 10% duty cycle). Evoked torque, muscle fatigue, sensory discomfort, and peripheral oxygen extraction will be evaluated.

Other: Aussie current 10%

Aussie current 20%

EXPERIMENTAL

Subjects will receive a interventions (Aussie Current at 20% duty cycle). Evoked torque, muscle fatigue, sensory discomfort, and peripheral oxygen extraction will be evaluated.

Other: Aussie current 20%

Interventions

Russian current 10% OTHER

Russian current with 2500 Hz, modulated in bursts of 50 Hz, 200 µs and 10% duty cycle - 2 ms bursts and 18 ms interbusrts

Russian current 10%

Russian current 20% OTHER

Russian current with 2500 Hz, modulated in bursts of 50 Hz, 200 µs and 20% duty cycle - 4 ms bursts and 16 ms interbusrts

Russian current 20%

Aussie current 10% OTHER

Aussie current with 1000 Hz, modulated in bursts of 50 Hz, 500 µs and 10% duty cycle - 2 ms bursts and 18 ms interbusrts

Aussie current 10%

Aussie current 20% OTHER

Aussie current with 1000 Hz, modulated in bursts of 50 Hz, 500 µs and 20% duty cycle - 4 ms bursts and 16 ms interbusrts

Aussie current 20%

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Female and male, aged between 18-40 years,
• Be classified as physically active according to the International Physical Activity Questionnaire (IPAQ),
• The practice of just recreational physical activity,
• Achieve a minimum torque of 20% of the MVIC during the NMES
• Be at least three months without strength training

You may not qualify if:

• Present musculoskeletal dysfunction that may interfere with the tests, present intolerance to NMES in the triceps surae muscle,
• Use analgesics, antidepressants, tranquilizers, or other centrally acting agents
• Present cardiovascular or peripheral vascular problems, chronic diseases, neurological or muscle disorders that may impair the complete execution of the study design by the volunteer

Sponsors & Collaborators

• University of Brasilia: lead

Study Sites (1)

João Luiz Q. Durigan

Brasília, Brasil, 72220900, Brazil

Location

Related Publications (10)

• Baldi JC, Jackson RD, Moraille R, Mysiw WJ. Muscle atrophy is prevented in patients with acute spinal cord injury using functional electrical stimulation. Spinal Cord. 1998 Jul;36(7):463-9. doi: 10.1038/sj.sc.3100679.

  PMID: 9670381 RESULT

• Vaz MA, Baroni BM, Geremia JM, Lanferdini FJ, Mayer A, Arampatzis A, Herzog W. Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. J Orthop Res. 2013 Apr;31(4):511-6. doi: 10.1002/jor.22264. Epub 2012 Nov 8.

  PMID: 23138532 RESULT

• Delitto A, Strube MJ, Shulman AD, Minor SD. A study of discomfort with electrical stimulation. Phys Ther. 1992 Jun;72(6):410-21; discussion on 421-4. doi: 10.1093/ptj/72.6.410.

  PMID: 1589461 RESULT

• Dantas LO, Vieira A, Siqueira AL Jr, Salvini TF, Durigan JL. Comparison between the effects of 4 different electrical stimulation current waveforms on isometric knee extension torque and perceived discomfort in healthy women. Muscle Nerve. 2015 Jan;51(1):76-82. doi: 10.1002/mus.24280.

  PMID: 24809656 RESULT

• McLoda TA, Carmack JA. Optimal burst duration during a facilitated quadriceps femoris contraction. J Athl Train. 2000 Apr;35(2):145-50.

  PMID: 16558623 RESULT

• Liebano RE, Waszczuk S Jr, Correa JB. The effect of burst-duty-cycle parameters of medium-frequency alternating current on maximum electrically induced torque of the quadriceps femoris, discomfort, and tolerated current amplitude in professional soccer players. J Orthop Sports Phys Ther. 2013 Dec;43(12):920-6. doi: 10.2519/jospt.2013.4656. Epub 2013 Oct 30.

  PMID: 24175604 RESULT

• Vanderthommen M, Duteil S, Wary C, Raynaud JS, Leroy-Willig A, Crielaard JM, Carlier PG. A comparison of voluntary and electrically induced contractions by interleaved 1H- and 31P-NMRS in humans. J Appl Physiol (1985). 2003 Mar;94(3):1012-24. doi: 10.1152/japplphysiol.00887.2001. Epub 2002 Nov 27.

  PMID: 12571132 RESULT

• Paz IA, Rigo GT, Sgarioni A, Baroni BM, Frasson VB, Vaz MA. Alternating Current Is More Fatigable Than Pulsed Current in People Who Are Healthy: A Double-Blind, Randomized Crossover Trial. Phys Ther. 2021 Jun 1;101(6):pzab056. doi: 10.1093/ptj/pzab056.

  PMID: 33561279 RESULT

• Arpin DJ, Forrest G, Harkema SJ, Rejc E. Submaximal Marker for Investigating Peak Muscle Torque Using Neuromuscular Electrical Stimulation after Paralysis. J Neurotrauma. 2019 Mar 19;36(6):930-936. doi: 10.1089/neu.2018.5848. Epub 2018 Nov 16.

  PMID: 30226407 RESULT

• Botter A, Oprandi G, Lanfranco F, Allasia S, Maffiuletti NA, Minetto MA. Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning. Eur J Appl Physiol. 2011 Oct;111(10):2461-71. doi: 10.1007/s00421-011-2093-y. Epub 2011 Jul 28.

  PMID: 21796408 RESULT

MeSH Terms

Conditions

Fatigue

Condition Hierarchy (Ancestors)

Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• João Durigan, PhD

  University of Brasilia

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate professor

Study Record Dates

• First Submitted: September 9, 2021
• First Posted: September 29, 2021
• Study Start: November 2, 2021
• Primary Completion: May 22, 2022
• Study Completion: May 22, 2022
• Last Updated: May 24, 2023

Record last verified: 2023-05

Data Sharing

• IPD Sharing: Will not share

Locations

BR (1)