Influence of Electrode Positioning and Current Type on Fatigue, Force and Discomfort
NCT ID: NCT04200677
Last Updated: 2023-05-24
Study Results
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Basic Information
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COMPLETED
NA
30 participants
INTERVENTIONAL
2020-01-10
2023-05-01
Brief Summary
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Objectives:
To compare the effects of NMES with narrow and wide pulse widths associated with monophasic and biphasic currents, applied over a tibial nerve and triceps surae muscles in healthy individuals in terms of muscle fatigue, central and peripheral contribution, voluntary and evoked force and sensory discomfort.
Methods:
A crossover, experimental controlled and randomized study will be developed with healthy male and female (age: 18-45 years). The following dependent variables will be: amplitude of H-reflex and M-wave (single and double pulses), voluntary and evoked triceps surae muscles torque, fatigability (force time integral), perceived discomfort and neuromuscular adaptations. The independent variables will be related to current phase, pulse width and location of electrical stimulation electrodes. There will be a familiarization session followed by 9 sessions with 7 rest days between them (10 weeks). Data will be reported as mean and standard deviation (± SD). Parametric tests will be used for the normally distributed data (Shapiro-Wilk test) that show homogeneous variations (Levene test). A repeated measure mixed-model ANOVA will be performed and, in the case of major effects or significant interactions, the Tukey post-hoc test will be applied. In addition, the power and size of the effect (reported as partial eta square, partial η2) will be calculated. The significance threshold will be set at p \<0.05 for all procedures.
Expected results: Biphasic currents will be more comfortable and will generate less muscle fatigue when compared to monophasic currents. There will be less fatigue and greater central contribution when wider pulse currents will be applied over a nerve trunk concerning the application with a wide pulse over a muscle belly.
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Detailed Description
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The following visit in the lab will be:
* Familiarization session.
* Monophasic Current (100 Hz) with 1ms pulse width applied to the Tibial Nerve;
* Biphasic current (100 Hz) with pulse width 0.5ms applied to the Tibial Nerve;
* Biphasic current (100 Hz) with 1ms pulse width applied to the Tibial Nerve;
* Biphasic current (100 Hz) with 2ms pulse width applied to the Tibial Nerve;
* Monophasic (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly;
* Biphasic current (100 Hz) with pulse width 0.5ms applied to the Triceps Surae muscle Belly;
* Biphasic current (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly;
* Biphasic current (100 Hz) with 2ms pulse width applied to the Triceps Surae Muscle Belly;
* Biphasic current (25 Hz) with 0.5ms pulse width applied to the Triceps Surae Muscle Belly.
The dependent variables will be:
* Muscle fatigability;
* Central and peripheral contribution (with H-reflex and M-wave amplitude analysis);
* Maximum voluntary isometric contraction;
* Force production for plantar flexion evoked by NMES;
* Perceived discomfort.
Conditions
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Study Design
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RANDOMIZED
CROSSOVER
OTHER
TRIPLE
Study Groups
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MCN1
Monophasic Current (100 Hz) with 1ms pulse width applied to the Tibial Nerve
Monophasic Current (100 Hz) with 1ms pulse width applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following NMES parameters: (Monophasic Current, 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
BCN05
Biphasic current (100 Hz) with pulse width 0.5ms applied to the Tibial Nerve
Biphasic current (100 Hz) with pulse width 0.5ms applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 0.5 ms, Ton: 6 s, Toff: 18 s)
BCN1
Biphasic current (100 Hz) with 1ms pulse width applied to the Tibial Nerve
Biphasic current (100 Hz) with 1ms pulse width applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
BCN2
Biphasic current (100 Hz) with 2ms pulse width applied to the Tibial Nerve
Biphasic current (100 Hz) with 2ms pulse width applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 2 ms, Ton: 6 s, Toff: 18 s)
MCM1
Monophasic current (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly
Monophasic current (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Monophasic current, 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
BCM05
Biphasic current (100 Hz) with pulse width 0.5ms applied to the Triceps Surae muscle Belly
Biphasic current (100 Hz) with pulse width 0.5ms applied to the Triceps Surae muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 0.5 ms, Ton: 6 s, Toff: 18 s)
BCM1
Biphasic current (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly
Biphasic current (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current , 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
BCM2
Biphasic current (100 Hz) with 2ms pulse width applied to the Triceps Surae Muscle Belly
Biphasic current (100 Hz) with 2ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current , 100 Hz, pulse duration 2 ms, Ton: 6 s, Toff: 18 s)
BC25
Biphasic current (25 Hz) with 0.5ms pulse width applied to the Triceps Surae Muscle Belly
Biphasic current (25 Hz) with 0.5ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 25 Hz, pulse duration 0.5 ms, Ton: 6 s, Toff: 18 s)
Interventions
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Monophasic Current (100 Hz) with 1ms pulse width applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following NMES parameters: (Monophasic Current, 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
Biphasic current (100 Hz) with pulse width 0.5ms applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 0.5 ms, Ton: 6 s, Toff: 18 s)
Biphasic current (100 Hz) with 1ms pulse width applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
Biphasic current (100 Hz) with 2ms pulse width applied to the Tibial Nerve
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 2 ms, Ton: 6 s, Toff: 18 s)
Monophasic current (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Monophasic current, 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
Biphasic current (100 Hz) with pulse width 0.5ms applied to the Triceps Surae muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 100 Hz, pulse duration 0.5 ms, Ton: 6 s, Toff: 18 s)
Biphasic current (100 Hz) with 1ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current , 100 Hz, pulse duration 1 ms, Ton: 6 s, Toff: 18 s)
Biphasic current (100 Hz) with 2ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current , 100 Hz, pulse duration 2 ms, Ton: 6 s, Toff: 18 s)
Biphasic current (25 Hz) with 0.5ms pulse width applied to the Triceps Surae Muscle Belly
The participants will perform 36 contractions evoked by neuromuscular electrical stimulation with the following current parameters: (Biphasic current, 25 Hz, pulse duration 0.5 ms, Ton: 6 s, Toff: 18 s)
Eligibility Criteria
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Inclusion Criteria
* To practice only recreational physical activity;
* Be at least 3 months without practicing strength training.
Exclusion Criteria
* NMES intolerance in the triceps surae muscle belly or tibial nerve;
* Use of analgesics, antidepressants, tranquilizers or other centrally acting agents;
* Cardiovascular or peripheral vascular problems, chronic diseases, neurological or muscular disorders that may hinder the complete execution of the study design by the volunteer.
18 Years
45 Years
ALL
Yes
Sponsors
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University of Brasilia
OTHER
Responsible Party
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João Luiz Q. Durigan
Physical Therapist, Assistant Professor
Locations
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University of Brasília
Brasília, Federal District, Brazil
Faculty of Physical Education
Brasília, Federal District, Brazil
Countries
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References
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Ward AR, Robertson VJ. The variation in fatigue rate with frequency using kHz frequency alternating current. Med Eng Phys. 2000 Nov;22(9):637-46. doi: 10.1016/s1350-4533(00)00085-0.
Aldayel A, Jubeau M, McGuigan M, Nosaka K. Comparison between alternating and pulsed current electrical muscle stimulation for muscle and systemic acute responses. J Appl Physiol (1985). 2010 Sep;109(3):735-44. doi: 10.1152/japplphysiol.00189.2010. Epub 2010 Jul 1.
Ward AR, Lucas-Toumbourou S, McCarthy B. A comparison of the analgesic efficacy of medium-frequency alternating current and TENS. Physiotherapy. 2009 Dec;95(4):280-8. doi: 10.1016/j.physio.2009.06.005. Epub 2009 Sep 2.
Selkowitz DM, Rossman EG, Fitzpatrick S. Effect of burst-modulated alternating current carrier frequency on current amplitude required to produce maximally tolerated electrically stimulated quadriceps femoris knee extension torque. Am J Phys Med Rehabil. 2009 Dec;88(12):973-8. doi: 10.1097/PHM.0b013e3181c1eda5.
Ward AR, Shkuratova N. Russian electrical stimulation: the early experiments. Phys Ther. 2002 Oct;82(10):1019-30.
Bergquist AJ, Clair JM, Collins DF. Motor unit recruitment when neuromuscular electrical stimulation is applied over a nerve trunk compared with a muscle belly: triceps surae. J Appl Physiol (1985). 2011 Mar;110(3):627-37. doi: 10.1152/japplphysiol.01103.2010. Epub 2010 Dec 23.
Collins DF. Central contributions to contractions evoked by tetanic neuromuscular electrical stimulation. Exerc Sport Sci Rev. 2007 Jul;35(3):102-9. doi: 10.1097/jes.0b013e3180a0321b.
Martin A, Grospretre S, Vilmen C, Guye M, Mattei JP, LE Fur Y, Bendahan D, Gondin J. The Etiology of Muscle Fatigue Differs between Two Electrical Stimulation Protocols. Med Sci Sports Exerc. 2016 Aug;48(8):1474-84. doi: 10.1249/MSS.0000000000000930.
Neyroud D, Dodd D, Gondin J, Maffiuletti NA, Kayser B, Place N. Wide-pulse-high-frequency neuromuscular stimulation of triceps surae induces greater muscle fatigue compared with conventional stimulation. J Appl Physiol (1985). 2014 May 15;116(10):1281-9. doi: 10.1152/japplphysiol.01015.2013. Epub 2014 Mar 27.
Regina Dias Da Silva S, Neyroud D, Maffiuletti NA, Gondin J, Place N. Twitch potentiation induced by two different modalities of neuromuscular electrical stimulation: implications for motor unit recruitment. Muscle Nerve. 2015 Mar;51(3):412-8. doi: 10.1002/mus.24315. Epub 2015 Jan 5.
Wegrzyk J, Foure A, Le Fur Y, Maffiuletti NA, Vilmen C, Guye M, Mattei JP, Place N, Bendahan D, Gondin J. Responders to Wide-Pulse, High-Frequency Neuromuscular Electrical Stimulation Show Reduced Metabolic Demand: A 31P-MRS Study in Humans. PLoS One. 2015 Nov 30;10(11):e0143972. doi: 10.1371/journal.pone.0143972. eCollection 2015.
Wegrzyk J, Foure A, Vilmen C, Ghattas B, Maffiuletti NA, Mattei JP, Place N, Bendahan D, Gondin J. Extra Forces induced by wide-pulse, high-frequency electrical stimulation: Occurrence, magnitude, variability and underlying mechanisms. Clin Neurophysiol. 2015 Jul;126(7):1400-12. doi: 10.1016/j.clinph.2014.10.001. Epub 2014 Oct 13.
Kiernan MC, Lin CS, Burke D. Differences in activity-dependent hyperpolarization in human sensory and motor axons. J Physiol. 2004 Jul 1;558(Pt 1):341-9. doi: 10.1113/jphysiol.2004.063966. Epub 2004 May 14.
Kiernan MC, Mogyoros I, Burke D. Differences in the recovery of excitability in sensory and motor axons of human median nerve. Brain. 1996 Aug;119 ( Pt 4):1099-105. doi: 10.1093/brain/119.4.1099.
Alexandre F, Derosiere G, Papaiordanidou M, Billot M, Varray A. Cortical motor output decreases after neuromuscular fatigue induced by electrical stimulation of the plantar flexor muscles. Acta Physiol (Oxf). 2015 May;214(1):124-34. doi: 10.1111/apha.12478. Epub 2015 Mar 18.
Dreibati B, Lavet C, Pinti A, Poumarat G. Influence of electrical stimulation frequency on skeletal muscle force and fatigue. Ann Phys Rehabil Med. 2010 May;53(4):266-71, 271-7. doi: 10.1016/j.rehab.2010.03.004. Epub 2010 Apr 1. English, French.
Jubeau M, Zory R, Gondin J, Martin A, Maffiuletti NA. Effect of electrostimulation training-detraining on neuromuscular fatigue mechanisms. Neurosci Lett. 2007 Aug 31;424(1):41-6. doi: 10.1016/j.neulet.2007.07.018. Epub 2007 Aug 1.
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Foure A, Nosaka K, Wegrzyk J, Duhamel G, Le Troter A, Boudinet H, Mattei JP, Vilmen C, Jubeau M, Bendahan D, Gondin J. Time course of central and peripheral alterations after isometric neuromuscular electrical stimulation-induced muscle damage. PLoS One. 2014 Sep 12;9(9):e107298. doi: 10.1371/journal.pone.0107298. eCollection 2014.
Other Identifiers
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CAAE: 14734619.3.0000.8093
Identifier Type: -
Identifier Source: org_study_id
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