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Alternating stimulation of synergistic muscles during functional electrical stimulation cycling improves endurance in persons with spinal cord injury
Authors:MJ Decker  L Griffin  LD Abraham  L Brandt
Institution:1. Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia;2. Department of Biomedical Engineering, Faculty of Engineering and Technology, University of Ilorin, P. M. B. 1515 Ilorin, Nigeria;3. Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;4. Clinical Exercise and Rehabilitation Unit, Discipline of Exercise and Sports Sciences, Faculty of Health Sciences, The University of Sydney, Sydney, 2006 NSW, Australia;1. Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia;2. Department of Biomedical Engineering, Faculty of Engineering and Technology, University of Ilorin, P. M. B. 1515 Ilorin, Nigeria;3. Department of Exercise Science, Creighton University, 2500 California Plaza, Kiewit Fitness center 228, Omaha, NE 68178, United States
Abstract:Therapeutic effects of functional electrical stimulation (FES) cycling for persons with spinal cord injury (SCI) are limited by high rates of muscular fatigue. FES-cycling performance limits and surface mechanomyography (MMG) of 12 persons with SCI were compared under two different stimulation protocols of the quadriceps muscles. One strategy used the standard “co-activation” protocol from the manufacturer of the FES cycle which involved intermittent simultaneous activation of the entire quadriceps muscle group for 400 ms. The other strategy was an “alternation” stimulation protocol which involved alternately stimulating the rectus femoris (RF) muscle for 100 ms and the vastus medialis (VM) and vastus lateralis (VL) muscles for 100 ms, with two sets with a 400 ms burst. Thus, during the alternation protocol, each of the muscle groups rested for two 100 ms “off” periods in each 400 ms burst. There was no difference in average cycling cadence (28 RPM) between the two protocols. The alternation stimulation protocol produced longer ride times and longer virtual distances traveled and used lower stimulation intensity levels with no differences in average MMG amplitudes compared to the co-activation protocol. These results demonstrate that FES-cycling performance can be enhanced by a synergistic muscle alternation stimulation strategy.
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