Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 5 , Pages 856-864 , May 2008

The Effectiveness of Progressively Increasing Stimulation Frequency and Intensity to Maintain Paralyzed Muscle Force During Repetitive Activation in Persons With Spinal Cord Injury

  • Li-Wei Chou, PhD

      Affiliations

    • Biomechanics and Movement Science Program, University of Delaware, Newark, DE
  • ,
  • Samuel C. Lee, PhD

      Affiliations

    • Department of Physical Therapy, University of Delaware, Newark, DE
    • Research Department, Shriners Hospitals for Children, Philadelphia, PA.
  • ,
  • Therese E. Johnston, PhD

      Affiliations

    • Research Department, Shriners Hospitals for Children, Philadelphia, PA.
  • ,
  • Stuart A. Binder-Macleod, PT, PhD

      Affiliations

    • Biomechanics and Movement Science Program, University of Delaware, Newark, DE
    • Department of Physical Therapy, University of Delaware, Newark, DE
    • Corresponding Author InformationReprint requests to Stuart A. Binder-Macleod, PT, PhD, Dept of Physical Therapy, University of Delaware, 301 McKinly Laboratory, Newark, DE 19716

References 

  1. Liberson WT, Holmquest HJ, Scot D, Dow M. Functional electrotherapy: stimulation of the peroneal nerve synchronized with the swing phase of the gait of hemiplegic patients. Arch Phys Med Rehabil. 1961;42:101–105
  2. Wilder RP, Wind TC, Jones EV, Crider BE, Edlich RF. Functional electrical stimulation for a dropped foot. J Long Term Eff Med Implants. 2002;12:149–159
  3. van der Aa HE, Bultstra G, Verloop AJ, et al. Application of a dual channel peroneal nerve stimulator in a patient with a “central” drop foot. Acta Neurochir Suppl. 2002;79:105–107
  4. Agarwal S, Kobetic R, Nandurkar S, Marsolais EB. Functional electrical stimulation for walking in paraplegia: 17-year follow-up of 2 cases. J Spinal Cord Med. 2003;26:86–91
  5. Saigal R, Renzi C, Mushahwar VK. Intraspinal microstimulation generates functional movements after spinal-cord injury. IEEE Trans Neural Syst Rehabil Eng. 2004;12:430–440
  6. Creasey GH, Ho CH, Triolo RJ, et al. Clinical applications of electrical stimulation after spinal cord injury. J Spinal Cord Med. 2004;27:365–375
  7. Kim CM, Eng JJ, Whittaker MW. Effects of a simple functional electric system and/or a hinged ankle-foot orthosis on walking in persons with incomplete spinal cord injury. Arch Phys Med Rehabil. 2004;85:1718–1723
  8. Mihelj M, Munih M. Unsupported standing with minimized ankle muscle fatigue. IEEE Trans Biomed Eng. 2004;51:1330–1340
  9. Pierce SR, Laughton CA, Smith BT, Orlin MN, Johnston TE, McCarthy JJ. Direct effect of percutaneous electric stimulation during gait in children with hemiplegic cerebral palsy: a report of 2 cases. Arch Phys Med Rehabil. 2004;85:339–343
  10. Stein RB. Functional electrical stimulation after spinal cord injury. J Neurotrauma. 1999;16:713–717
  11. Thrasher TA, Flett HM, Popovic MR. Gait training regimen for incomplete spinal cord injury using functional electrical stimulation. Spinal Cord. 2006;44:357–361
  12. Isakov E, Mizrahi J, Najenson T. Biomechanical and physiological evaluation of FES-activated paraplegic patients. J Rehabil Res Dev. 1986;23:9–19
  13. Peckham PH, Knutson JS. Functional electrical stimulation for neuromuscular applications. Annu Rev Biomed Eng. 2005;7:327–360
  14. Popovic MR, Curt A, Keller T, Dietz V. Functional electrical stimulation for grasping and walking: indications and limitations. Spinal Cord. 2001;39:403–412
  15. Adams GR, Harris RT, Woodard D, Dudley GA. Mapping of electrical muscle stimulation using MRI. J Appl Physiol. 1993;74:532–537
  16. Blair EA, Erlanger J. A comparison of the characteristics of axons through their individual electrical responses. Am J Physiol. 1933;106:524–564
  17. Heyters M, Carpentier A, Duchateau J, Hainaut K. Twitch analysis as an approach to motor unit activation during electrical stimulation. Can J Appl Physiol. 1994;19:451–461
  18. Trimble MH, Enoka RM. Mechanisms underlying the training effects associated with neuromuscular electrical stimulation. Phys Ther. 1991;71:273–280discussion 280-2
  19. Sinacore DR, Delitto A, King DS, Rose SJ. Type II fiber activation with electrical stimulation: a preliminary report. Phys Ther. 1990;70:416–422
  20. Burnham R, Martin T, Stein R, Bell G, MacLean I, Steadward R. Skeletal muscle fibre type transformation following spinal cord injury. Spinal Cord. 1997;35:86–91
  21. Castro MJ, Apple DF, Staron RS, Campos GE, Dudley GA. Influence of complete spinal cord injury on skeletal muscle within 6 mo of injury. J Appl Physiol. 1999;86:350–358
  22. Round JM, Barr FM, Moffat B, Jones DA. Fibre areas and histochemical fibre types in the quadriceps muscle of paraplegic subjects. J Neurol Sci. 1993;116:207–211
  23. Scott WB, Lee SC, Johnston TE, Binkley J, Binder-Macleod SA. Contractile properties and the force-frequency relationship of the paralyzed human quadriceps femoris muscle. Phys Ther. 2006;86:788–799
  24. Shields RK. Fatigability, relaxation properties, and electromyographic responses of the human paralyzed soleus muscle. J Neurophysiol. 1995;73:2195–2206
  25. Thomas CK. Fatigue in human thenar muscles paralysed by spinal cord injury. J Electromyogr Kinesiol. 1997;7:15–26
  26. Person RS, Kudina LP. Discharge frequency and discharge pattern of human motor units during voluntary contraction of muscle. Electroencephalogr Clin Neurophysiol. 1972;32:471–483
  27. Thomas CK, del Valle A. The role of motor unit rate modulation versus recruitment in repeated submaximal voluntary contractions performed by control and spinal cord injured subjects. J Electromyogr Kinesiol. 2001;11:217–229
  28. Lyons GM, Wilcox DJ, Lyons DJ, Hilton D. Evaluation of a drop foot stimulator FES intensity envelope matched to tibialis anterior muscle activity during walking. In: Proceedings of the 5th Annual IFESS Conference. 2000;p. 448–451Jun 18-21; Aalborg (Sweden)
  29. Mourselas N, Granat MH. Correction of foot drop using a fuzzy logic controlled miniature stimulator. In: Proceedings of 5th Annual IFESS Conference. 2000;p. 456–457Jun 18-20; Aalborg (Denmark)
  30. Prochazka A, Wiles CM. Electrical stimulation of paretic leg muscle in man, allowing feedback controlled movements to be generated from the wrist. J Physiol. 1983;343:20–21
  31. Stanić U, Trnkoczy A, Aćimović R, Gros N. Effect of gradually modulated electrical stimulation on the plasticity of artificial evoked movements. Med Biol Eng Comput. 1977;15:62–66
  32. Kebaetse MB, Binder-Macleod SA. Strategies that improve human skeletal muscle performance during repetitive, non-isometric contractions. Pflugers Arch. 2004;448:525–532
  33. Kebaetse MB, Lee SC, Johnston TE, Binder-Macleod SA. Strategies that improve paralyzed human quadriceps femoris muscle performance during repetitive, nonisometric contractions. Arch Phys Med Rehabil. 2005;86:2157–2164
  34. Chou LW. New strategies to maintain paralyzed muscle force output during repetitive electrical stimulation. [dissertation] Newark: Univ Delaware; 2006;
  35. Crago PE, Peckham PH, Mortimer JT, Van der Meulen JP. The choice of pulse duration for chronic electrical stimulation via surface, nerve, and intramuscular electrodes. Ann Biomed Eng. 1974;2:252–264
  36. Barnett S, Cooney K, Johnston R. Electrically elicited quadriceps femoris muscle torque as a function of various electrode placements. J Clin Electrophysiol. 1991;3:3–8
  37. Gerrits HL, De Haan A, Hopman MT, van der Woude LH, Jones DA, Sargeant AJ. Contractile properties of the quadriceps muscle in individuals with spinal cord injury. Muscle Nerve. 1999;22:1249–1256
  38. Kernell D, Sjoholm H. Recruitment and firing rate modulation of motor unit tension in a small muscle of the cat's foot. Brain Res. 1975;98:57–72
  39. Botterman BR, Iwamoto GA, Gonyea WJ. Gradation of isometric tension by different activation rates in motor units of cat flexor carpi radialis muscle. J Neurophysiol. 1986;56:494–506
  40. Kesar T, Chou LW, Binder-Macleod SA. Effects of stimulation frequency versus pulse duration modulation on muscle fatigue. J Electromyogr Kinesiol. In press.
  41. Jones DA. High-and low-frequency fatigue revisited. Acta Physiol Scand. 1996;156:265–270
  42. Jones DA, Bigland-Ritchie B, Edwards RH. Excitation frequency and muscle fatigue: mechanical responses during voluntary and stimulated contractions. Exp Neurol. 1979;64:401–413
  43. Marsden CD, Meadows JC, Merton PA. “Muscular wisdom” that minimizes fatigue during prolonged effort in man: peak rates of motoneuron discharge and slowing of discharge during fatigue. Adv Neurol. 1983;39:169–211
  44. Thomas CK. Contractile properties of human thenar muscles paralyzed by spinal cord injury. Muscle Nerve. 1997;20:788–799
  45. Binder-Macleod SA, McDermond LR. Changes in the force-frequency relationship of the human quadriceps femoris muscle following electrically and voluntarily induced fatigue. Phys Ther. 1992;72:95–104
  46. Binder-Macleod SA, Lee SC, Fritz AD, Kucharski LJ. New look at force-frequency relationship of human skeletal muscle: effects of fatigue. J Neurophysiol. 1998;79:1858–1868

 Supported by the National Institutes of Health (grant no. HD-36379).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(08)00111-1

doi: 10.1016/j.apmr.2007.10.027

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 5 , Pages 856-864 , May 2008