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Lane, Rodney. "Control of upper-limb functional neuromuscular electrical stimulation." Thesis, University of Southampton, 2016. https://eprints.soton.ac.uk/419062/.
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Functional electrical stimulation (FES) is the name given for the use of neuromuscular electrical stimulation to achieve patterns of induced movement which are of functional benefit to the user. System are available that use FES to aid persons who have suffered an insult to the motor control region of the brain and been left with movement impairment. The aim of this research was to investigate methods of providing an FES system that could have a beneficial effect in restoring arm function. The techniques for applying upper-limb stimulation are well established, however the methods of controlling it to provide functional use remain lacking. This is because upper-limb movement can be difficult to measure and quantify as the starting point for any movement may not be well defined. Moreover the movements needed to complete a useful function such as reaching and grasping requires the coordinated control of a number of muscle groups, and that relies on being able to track the position of the limb. Effective control of FES for the arm requires reliable feedback about the position and state of the limb. Electromyograms (EMG) are a measure of the very small electrical signals that are emitted whenever a muscle is ‘fired’ to move. EMG can be used to detect muscle activity and so can be a useful feedback control input. It does however have a number of drawbacks that this research sought to address by combining the method with external motion sensors. The intension had been to use the motion sensors to track the position of the limb and then use the EMG measurements to detect the wearer’s movements. FES could then be used to assist the wearer in making a desired movement. Initial studies were done to separately investigate the motion sensing and the EMG measurement components of the system. However before these could be combined a more interesting observation was made relating to bioimpedance. A study of bioimpedance measurements found a relationship between tissue impedance changes and muscle activity. Different methods for measuring bioimpedance where investigated and the results compared, before a practical technique for capturing measurements was developed and demonstrated. A new set of test equipment was made using these finding. Subsequent results using this equipment were able to demonstrate that bioimpedance measurement could be taken from a limb while FES was being used, and that these measurement could be used as a feedback signal to control the FES to maintain a target limb position. This work forms the basis of a novel approach to the control of FES that uses feedback from the user’s limb to determine the position of the limb in free space without need for additional sensors.
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Kershaw, Robert Andrew. "Retrieved voluntary electromyogram signals for functional electrical stimulation control." Thesis, University of Bristol, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295098.
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Valadao, Jaime Andre. "The effect of neuromuscular electrical stimulation on hamstring prehabilitation." University of the Western Cape, 2018. http://hdl.handle.net/11394/6566.
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Masters of ScienceBACKGROUND: Hamstring injuries remain a growing concern within a large variety of sports from the elite athlete to the weekend warrior. A copious amount of research has been performed in an attempt to reduce these injuries. The aim of this study was to understand the changes in lengthened state eccentric strength of the hamstrings following four separate protocols. METHODS: A quantitative research approach, using a true experimental design, was adopted for this study. A convenience sample of non-sedentary, 35 male participants, between the ages of 18 and 35 within the City of Cape Town was used. Participants were randomly allocated to one of four groups namely; Control group (C), resistance training alone (RT), neuromuscular electrical stimulation alone (NMES), or NMES superimposed with RT (NMES&RT). Participant’s eccentric hamstring strength was tested in a lengthened state, on the Biodex system 4 Pro™ for the pre- and post-test. The intervention spanned over four weeks. SPSS version 25 was used for data analysis. RESULTS: All groups demonstrated a mean increase in relative peak torque. However, a repeated-measures analysis of variance (ANOVA) showed no interaction effect (p = 0.411) between the four groups. Further analysis using Magnitude-based inferences (MBI), to identify the magnitude of changes, showed a small positive effect for both the NMES and NMES&RT group when compared to the C and RT groups. CONCLUSION: Although there are no statistically significant differences between the four groups employed in this study (C, RT, NMES, NMES&RT), NMES and NMES&RT did show small positive effects compared to C and RT with a very low likelihood of negative effects. Thus, using NMES either alone or superimposed with resistance training will be beneficial for trained athletes but it is not a necessity and the use of specific resistance training may be just as effective.
2019-04-30
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Alahmari, Sami Khaloufah M. "Muscle force production and neuromuscular fatigue responses to neuromuscular electrical stimulation and tendon vibration." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/236174/1/Sami_Alahmari_Thesis.pdf.
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Neuromuscular electrical stimulation is an intervention that produces artificial muscle contractions and is used to rehabilitate people with motor impairments. However, a typical problem is the occurrence of rapid fatigue, which limits the training stimulus. This thesis investigated whether the addition of tendon vibration and concurrent activation of upper limb muscles could minimise fatigue and maximise torque produced by the calf muscles during neuromuscular electrical stimulation. The experiments in this thesis showed that superimposition of tendon vibration can increase the amount of torque produced by calf muscles, and that the addition of sustained handgrip contraction could further increase this torque.
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Hamada, Taku. "Neuromuscular and metabolic responses to electrical stimulation of human skeletal muscle." Kyoto University, 2004. http://hdl.handle.net/2433/147700.
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Kyoto University (京都大学)0048
新制・課程博士
博士(人間・環境学)
甲第10941号
人博第228号
15||183(吉田南総合図書館)
新制||人||57(附属図書館)
UT51-2004-G788
京都大学大学院人間・環境学研究科文化・地域環境学専攻
(主査)教授 森谷 敏夫, 教授 津田 謹輔, 助教授 小田 伸午
学位規則第4条第1項該当
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Trimble, Mark Herbert 1958. "EFFECTS OF ELECTRICAL STIMULATION ON THE RECRUITMENT ORDER OF MOTOR UNITS IN MAN: INDIRECT EXAMINATION BY ELECTRICALLY EVOKED MUSCLE RESPONSES." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276555.
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Although the neural mechanisms responsible for the orderly recruitment of motor units have been investigated extensively, the flexibility of the underlying neural circuitry remains unclear. For example, the effects of electrical stimulation on the recruitment order of motor units is not well understood. This project was designed to study the recruitment order of motor units in man during different stimulation protocols. Examination of the compound-twitch characteristics of electrically evoked responses allowed an indirect determination of motor-unit recruitment order. The results demonstrate that the recruitment order of quadriceps femoris and triceps surae motor units differs according to the stimulation protocols used. Analysis of the compound-twitch characteristics indicated that the recruitment order of motor units during Hoffmann reflexes is similar to that of volitional muscle contractions but effectively the reverse of that during direct-motor responses. Moreover, the results suggest that cutaneous-afferent stimulation alters the recruitment thresholds of different motor unit types during the Hoffman reflex.
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Wilson, Ron M. "Effects of neuromuscular electrical stimulation of various frequencies and intensities on energy expenditure." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/MQ33465.pdf.
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Melillo, Julie Ann. "Influence of Muscle Motor Point Identification on Quadriceps Function Following Neuromuscular Electrical Stimulation." University of Toledo / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1556547710451478.
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Griffiths, Leanne. "The role of neuromuscular electrical stimulation in reversing age-related and pathological muscle atrophy." Thesis, Keele University, 2016. http://eprints.keele.ac.uk/2357/.
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An ageing population increases the number of frail, elderly individuals. Physiotherapists are increasingly treating frail individuals due to the associated rate of rapid muscle atrophy. A rapid loss of muscle strength can result in difficulty performing activities of daily living, making individuals more susceptible to other age‐related pathologies. Some frail individuals are unable to contract their muscle sufficiently to complete a rehabilitation programme. This can be exacerbated in a neurological population such as stroke. The aim of this thesis was to prevent muscle atrophy associated with age to allow rehabilitation to commence with a quicker onset. Neuromuscular electrical stimulation (NMES) is a treatment modality capable of producing muscle contraction. Its use is poorly understood, with little guidance surrounding optimal parameters or muscular response to treatment. This thesis has identified optimal stimulation parameters for strength training with NMES, and tested them on a healthy population of varying ages, and in a stroke population. A muscle measurement device was designed and tested to allow accurate measurements of moments about joints. Results indicate that the protocol is effective in inducing hypertrophy, as indicated by advances in pennation angle and maximal isometric force production. The protocol was effective at producing a small decline in force associated with a hypertrophic stimulus. Results indicate that treatment should be administered with the highest available stimulation amplitude to achieve optimal results. NMES appears to be able to advance internal muscle architecture, despite lack of volitional muscle control post stroke. Variability of response was investigated through blood biomarkers (Creatine Kinase) which was demonstrated to increase in line with volitional strength training literature. The exercise status of the individual appears to be correlated with muscle response. It is recommended that NMES could be administered in the acute period of a physiotherapy protocol to prevent muscle atrophy associated with ageing. Further work should focus on developing the strength measurement device used throughout this thesis, and investigating a protocol suitable for other applications to allow a smooth transition into clinical settings.
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Rosie, Juliet. "The immediate effects of EMG-triggered neuromuscular electrical stimulation on cortical excitability and grip control in people with chronic stroke." Click here to access this resource online, 2009. http://hdl.handle.net/10292/731.
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AIM The aim of this study was to identify the immediate effects on cortical excitability and grip control of a short intervention of EMG-triggered neuromuscular electrical stimulation, compared to voluntary activation of the finger flexor muscles, in people with chronic stroke. STUDY DESIGN This experimental study used a within-subject design with experimental and control interventions. PARTICIPANTS Fifteen people with chronic stroke participated in the study. INTERVENTION Participants performed a simple force tracking task with or without EMG-triggered neuromuscular electrical stimulation of the finger flexor muscles. MAIN OUTCOME MEASURES Cortical excitability was measured by single and paired-pulse transcranial magnetic stimulation. Multi-digit grip control accuracy was measured during ramp and sine wave force tracking tasks. Maximal grip strength was measured before and after each intervention to monitor muscle fatigue. RESULTS No significant increases in cortico-motor excitability were found. Intracortical inhibition significantly increased following the EMG-triggered neuromuscular electrical stimulation intervention immediately post-intervention (t = 2.466, p = .036), and at 10 minutes post-intervention (t = 2.45, p = .04). Accuracy during one component of the force tracking tasks significantly improved (F(1, 14) = 4.701, p = .048), following both EMG-triggered neuromuscular electrical stimulation and voluntary activation interventions. Maximal grip strength reduced significantly following both interventions, after the assessment of cortical excitability (F(1, 8) = 9.197, p = .16), and grip control (F(1, 14) = 9.026, p = .009). CONCLUSIONS EMG-triggered neuromuscular electrical stimulation during short duration force tracking training does not increase cortical excitability in participants with chronic stroke. Short duration force tracking training both with and without EMG-triggered neuromuscular electrical stimulation leads to improvements in training-specific aspects of grip control in people with chronic stroke.
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Seger, Jan Y. "Neuromuscular aspects of eccentric knee extensor actions : effects of electrical stimulation, age, gender and training /." Stockholm, 1998. http://diss.kib.ki.se/1998/91-628-3200-X/.
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Church, Catherine Jayne. "Does surface neuromuscular electrical stimulation (sNMES) to the upper limb following acute stroke improve outcome?" Thesis, University of Newcastle Upon Tyne, 2006. http://hdl.handle.net/10443/634.
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Does surface neuromuscular electrical stimulation (sNMES) to the upper limb following acute stroke Improve outcome? Introduction: Upper limb impairment affects 85% of stroke patients, half of whom still experience problems three months later('-3). The literature is unclear about the effectiveness of upper limb rehabilitation strategies, and there is a need to identify interventions that will improve upper limb function and reduce the incidence of shoulder pain. Surface neuromuscular electrical stimulation (sNMES) has been proposed as a safe method of improving outcome after stroke but further research is needed to evaluate the effect of this treatment on upper limb recovery and pain (4.5) Aims: We have undertaken a randornised controlled trial to evaluate a programme of upper limb sNMES following acute stroke. Methods: Patients admitted within 10 days of acute stroke were assessed against the following eligibility criteria: new upper limb impairment (motor and/or sensory and/or neglect); medically stable; no cognitive/language impairments or previous upper limb problem likely to influence assessments; no contraindication to sNIVIES. Participants were randomised via an independent telephone randomisation service to receive a 4-week programme of upper limb sNIVIES (11 hour three times daily) or placebo in addition to stroke unit care. The active stimulator produced a shoulder shrug. Outcome measures were undertaken by a researcher who was blinded to the randomisation group. The primary outcome measure was the Action Research Arm Test (ARAT)(6,7) 3 months after stroke. Secondary outcome measures included upper limb pain, disability and health status. One hundred and sixty eight subjects were required for 80% power to detect a clinically significant difference in ARAT (8 points)(6,7). Results: There were 176 study participants. The groups were well matched at baseline. There was no difference in arm function between groups in terms of the primary outcome measure. The median ARAT (6,7) score at 3 months was 50.0 in the intervention group (n=79) and 55.5 in the control group (n=74) (p=0.068). There were however significant differences in outcomes in favour of the control group when using other measures to assess arm function (the grasp and gross subsections of the ARAT(6. 7 ) , and the Frenchay Arm Test' (FAT)(8)). There was also a significant difference in favour of the control group when assessing impairment using the Arm subsection of the Motricity Index(g). There were no statistically significant differences between the groups at 3 months in terms of prevalence of upper limb pain, disability and global health status. No significant differences were seen between the groups at 4 weeks in any of the outcome measures. Secondary analysis revealed statistically significant differences in favour of the control group in those with more severe initial functional impairment. Subjects received 70% of intended stimulation or placebo with no significant difference between groups. Conclusions: A 4-week programme of sNMES to the shoulder does not improve functional outcome following acute stroke and may worsen arm function in certain stroke patients. 'Routine' use of sNMES to the proximal upper limb after acute stroke cannot be recommended.
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Eddy, Brandon Scott. "The effects of neuromuscular electrical stimulation training on the electromyographic power spectrum of suprahyoid musculature." Thesis, University of Iowa, 2015. https://ir.uiowa.edu/etd/1593.
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The use of neuromuscular electrical stimulation (NMES) for the treatment of swallowing disorders has become increasingly popular, yet little is known about its long-term effects on muscle physiology. This study indirectly assessed suprahyoid muscle physiology using electromyography (EMG) during a jaw-opening task that was completed before training, immediately after training, and two-weeks after training. Comparisons were made in muscle performance between control participants who engaged in effortful swallowing training and participants who received conjunctive NMES during effortful swallow training. All participants completed four weeks of swallowing exercises conducted five days a week (20 sessions) and consisting of 120 swallows each session. Results revealed that participants collectively improved their peak force production following training, but peak force and EMG median frequency did not vary as a function of training method. The observed high variability in median frequency between trials in addition to the documented improvement in function without a measured change in physiology suggests the need to consider alternate electrode placements during EMG or other tools of assessment. These findings suggests that both effortful swallow training and long-term conjunctive NMES with effortful swallowing improves jaw-opening strength of healthy adults, though adding NMES to the treatment was no more effective than training without it. Further research is necessary to determine the effects of long-term NMES training on swallowing physiology in vivo using other indirect measurements, or direct measurements such as muscle biopsy if possible.
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Doeltgen, Sebastian Heinrich. "The Effects of Neuromuscular Electrical Stimulation of the Submental Muscle Group on the Excitability of Corticobulbar Projections." Thesis, University of Canterbury. Communication Disorders, 2009. http://hdl.handle.net/10092/2857.
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Neuromuscular electrical stimulation (NMES) has become an increasingly popular rehabilitative treatment approach for swallowing disorders (dysphagia). However, its precise effects on swallowing biomechanics and measures of swallowing neurophysiology are unclear. Clearly defined NMES treatment protocols that have been corroborated by thorough empirical research are lacking. The primary objective of this research programme was therefore to establish optimal NMES treatment parameters for the anterior hyo-mandibular (submental) musculature, a muscle group that is critically involved in the oral and pharyngeal phases of swallowing. Based on previous research, the primary hypothesis was that various NMES treatment protocols would have differential effects of either enhancing or inhibiting the excitability of corticobulbar projections to this muscle group. The research paradigm used to test this hypothesis was an evaluation of MEP amplitude and onset latency, recorded in the functional context of volitional contraction of the submental musculature (VC) and contraction of this muscle group during the pharyngeal phase of volitional swallowing (VPS, volitional pharyngeal swallow). Outcome measures were recorded before and at several time points after each NMES treatment trial. This methodology is similar to, but improved upon, research paradigms previously reported. Changes in corticobulbar excitability in response to various NMES treatment protocols were recorded in a series of experiments. Ten healthy research participants were recruited into a study that evaluated the effects of event-related NMES, whereas 15 healthy research participants were enrolled in a study that investigated the effects of non-event-related NMES. In a third cohort of 35 healthy research participants, task-dependent differences in corticobulbar excitability were evaluated during three conditions of submental muscle contraction: VC, VPS and submental muscle contraction during the pharyngeal phase of reflexive swallowing (RPS, reflexive pharyngeal swallowing). Event-related NMES induced frequency-depended changes in corticobulbar excitability. NMES administered at 80 Hz facilitated MEP amplitude, whereas NMES at 5 Hz and 20 Hz inhibited MEP amplitude. No changes were observed after NMES at 40 Hz. Maximal excitatory or inhibitory changes occurred 60 min post-treatment. Changes in MEP amplitude in response to event-related NMES were only observed when MEPs were recorded during the VC condition, whereas MEPs recorded during the VPS condition remained unaffected. Non-event-related NMES did not affect MEP amplitude in either of the muscle contraction conditions. Similarly, MEP onset latencies remained unchanged across all comparisons. MEPs were detected most consistently during the VC contraction condition. They were less frequently detected and were smaller in amplitude for the VPS condition and they were infrequently detected during pre-activation by RPS. The documented results indicate that event-related NMES has a more substantial impact on MEP amplitude than non-event-related NMES, producing excitatory and inhibitory effects. Comparison of MEPs recorded during VC, VPS and RPS suggests that different neural networks may govern the motor control of submental muscle activation during these tasks. This research programme is the first to investigate the effects of various NMES treatment protocols on the excitability of submental corticobulbar projections. It provides important new information for the use of NMES in clinical rehabilitation practices and our understanding of the neural networks governing swallowing motor control.
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Carkner, Jonathon. "The role of neuromuscular electrical stimulation in improving peripheral muscle strength in chronically ill bedbound patients." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=104660.
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Chronically ill patients undergoing prolonged bedrest in the intensive care unit and long-term care facilities typically experience a marked loss of muscle mass, particularly in the lower limbs, translating into clinically significant muscular weakness. Both muscle atrophy and weakness can be present following only one week of stay in the ICU. Following discharge from the hospital, functional limitations may persist for years and impede their return to activities of daily living, thus highlighting the importance of developing an effective intervention against disuse-related muscle atrophy and weakness. This thesis aimed to evaluate the feasibility of application of neuromuscular electrical stimulation (NMES) in chronically ill bedridden (CIB) patients and the efficacy of NMES in both improving muscle strength and attenuating lower limb muscle atrophy during their hospitalization. Four CIB patients (76 ± 7 years) underwent 15 NMES sessions of the quadriceps muscle over a period of 3 weeks. In each patient, one leg was randomly designated to receive treatment (TRT) with NMES and usual care and the control (CTL) leg received sham stimulation with usual care from the physiotherapist consisting of mobilization sessions of the upper and lower limbs. Efficacy of NMES was assessed pre and post intervention through determination of maximal quadricep strength and muscle size through ultrasound muscle imaging. The muscle strength response was variable, with 2 of 4 patients demonstrating increases (by 10 and 40%) and the lack of increase in muscle mass in these patients suggests neural adaptation as the underlying mechanism, not hypertrophy in this 3-week NMES protocol. Although the protocol was well tolerated by all patients, overall, feasibility was poor due to recruitment difficulties including the presence of lower limb oedema and neuromuscular disease. We posit that NMES may be effective in improving lower limb strength in bedbound patients, however future multi-center trials are needed to ensure sufficient patient recruitment in order to confirm efficacy of NMES in improving muscle strength in CIB patients.Les patients hospitalisés aux soins intensifs ou dans un centre de soins longue durée avec alitement prolongé démontrent souvent une perte marquée de masse musculaire, notamment au niveau des membres inférieurs, qui se traduit cliniquement en une perte de force musculaire significative . L'atrophie et la perte de force qui l'accompagne peuvent se manifester après seulement une semaine d'alitement. Les limitations fonctionnelles peuvent persister pendant des années après la sortie de l'hôpital et empêcher le retour aux activités quotidiennes, soulignant ainsi l'importance de développer une intervention efficace contre l'atrophie et la faiblesse musculaire liée à la désuétude. Cette thèse avait pour but d'évaluer la faisabilité de la stimulation électrique fonctionnelle (SEF) chez les patients alités de façon chronique, ainsi que l'efficacité de la SEF à augmenter la force musculaire et à diminuer l'atrophie musculaire des membres inférieurs pendant un séjour à l'hôpital. Quatre patients alités (76 ± 7 ans) ont participé à 15 sessions de SEF du quadriceps sur une période de trois semaines. Pour chaque patient, une jambe a été sélectionnée aléatoirement pour recevoir un traitement SEF, tandis que la jambe contrôle a reçu un traitement placebo; les deux jambes ont aussi continué à recevoir un traitement standard de physiothérapie qui consistait de mobilisations des membres inférieurs et supérieurs. L'efficacité du SEF a été évaluée en déterminant la force maximale du quadriceps et la taille du muscle par échographie pré- et post- intervention. La réponse de la force musculaire au traitement a été variable, avec deux de quatre patients démontrant des améliorations (de 10 et 40%). L'absence d'une augmentation de la masse musculaire chez ces patients suggère que l'amélioration est liée à une adaptation neurale plutôt qu'à une hypertrophie du muscle. Bien que le protocole ait été bien toléré par tous les patients évalués, la pauvre faisabilité du protocole a été soulignée par les difficultés rencontrées lors du recrutement, incluant l'œdème dans les membres inférieurs et la présence de maladies neuromusculaires. Nous postulons que la SEF pourrait être efficace pour améliorer la force musculaire des membres inférieurs chez les patients alités, mais des essais multi-centres sont nécessaires afin de permettre un recrutement suffisant pour confirmer cette efficacité.
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Derington, John A. "The Acute Effects of Patterned Electrical Neuromuscular Stimulation on Quadriceps Torque Production and Motor Unit Recruitment." BYU ScholarsArchive, 2014. https://scholarsarchive.byu.edu/etd/4087.
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Electric muscle stimulation (EMS) has been widely used in the rehabilitation of musculoskeletal injuries. Patterned electrical neuromuscular stimulation (PENS), a specific form of EMS, has been developed to better educate muscles to contract properly. The physiological efficacy of PENS has not been quantifiably identified. OBJECTIVES: The aim of this study is to determine the acute effect of one PENS training session (3 sets of 10 1-sec repetitions) on maximal isometric knee extensor (MVIC) torque production and surface EMG (sEMG) in healthy nonathlete college students. DESIGN: A randomized repeated-measures design was used in this study. METHODS: Twenty-two male college students participated in the study. All participants completed two training sessions, one with PENS and one without, in a randomized crossover design. RESULTS: One bout of PENS training significantly increased MVIC (3.1% ± 1.7%, p = 0.03) which was greater than the change in MVIC of the control group (p = 0.03). Control training did not alter MVIC but resulted in significant decrease in average sEMG amplitude (-7.8% ± 1.6%, p ≤ 0.01) and peak sEMG amplitude (-10.4% ± 2.7%, p ≤ 0.01). These reductions in sEMG following control training were significantly different from the PENS group (p = 0.03 and p ≤ 0.01). CONCLUSIONS: The findings suggest that strength training in conjunction with PENS can enhance torque production after just one bout of training. The increase in torque with no change in sEMG amplitude can be explained by increased motor unit synchronization or decreased cocontraction of antagonist muscles.
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Euler, Luisa. "Impedance and Stimulation Comfort of Knitted Electrodes for Neuromuscular Electrical Stimulation (NMES) : Influence of electrode construction and pressure application to the electrode." Thesis, Högskolan i Borås, Akademin för textil, teknik och ekonomi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-23896.
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Neuromuscular electrical stimulation (NMES) is a modality of electrotherapy which is aiming to restore and improve muscle function by injecting small levels of current into the muscle using different types of electrodes. Advantages are seen in using textile electrodes which can be integrated into wearables. Previous research has been done for the development of textile stimulation electrodes. However, the focus has not been on the electrode construction itself. Therefore, the influence of electrode construction parameters of knitted electrodes as well as of the electrode condition, i.e. wet or dry, on the skin-electrode impedance and on the perceived stimulation comfort were analysed. Further, the application of pressure to the electrode was investigated. It was found that the electrode condition is the most important parameter for the electrode performance as a wet electrode showed a lower impedance and an improved stimulation comfort with a better skin contact. Followed by this, the pressure was the second most important factor, especially for dry electrodes. A higher pressure reduced the skin-electrode impedance and improved the skin contact in dry condition. Nevertheless, dry electrodes with a high applied pressure still performed worse than wet electrodes. Regarding the electrode design, the most important factor was the electrode size. A bigger size reduced the impedance. Nevertheless, for the application in NMES, a smaller electrode size is to be preferred as it improved the stimulation selectivity and thus, a lower NMES level was required to induce a plantarflexion without affecting the stimulation comfort. The other investigated construction parameters (binding, yarn density, shape) only showed minor influences on the electrode performance. Therefore, the possibilities of applying pressure to the electrode to improve the performance of dry textile electrodes should be further investigated.
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Wilkenfeld, Ari (Ari Jacob) 1974. "Computer simulation of the neuromuscular reaction to electrical stimulation of the spinal cord of a spinalized frog." Thesis, Massachusetts Institute of Technology, 1997. http://hdl.handle.net/1721.1/42812.
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Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1997.Includes bibliographical references (leaves 51-52).
submitted by Ari Wilkenfeld.
S.M.
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McClurg, Doreen Elizabeth. "Urinary dysfunction in multiple sclerosis : effect of pelvic floor muscle training, electromyography biofeedback and neuromuscular electrical stimulation." Thesis, University of Ulster, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.433932.
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Arcolezi, Héber Hwang. "A novel robust and intelligent control based approach for human lower limb rehabilitation via neuromuscular electrical stimulation /." Ilha Solteira, 2019. http://hdl.handle.net/11449/190755.
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Orientador: Aparecido Augusto de CarvalhoAbstract: In the last few years, several studies have been carried out showing that neuromuscular electrical stimulation (NMES) can produce good therapeutic results in patients with spinal cord injury (SCI). This research introduces a new robust and intelligent control-based methodology for human lower limb rehabilitation via NMES using a continuous-time control technique named robust integral of the sign of the error (RISE). Although in the literature the RISE controller has shown good results without any fine-tuning method, a trial and error approach would quickly lead to muscle fatigue in SCI patients. Therefore, it was shown in this study that the control performance for robustly tracking a reference signal can be improved through the proposed approach by providing an intelligent tuning for each voluntary. Simulation results with a mathematical model and eight identified subjects from the literature are provided, and real experiments are performed with seven healthy and two paraplegic subjects. Besides, this research introduces the application of deep and dynamic neural networks namely the multilayer perceptron, a simple recurrent neural network, and the Long Short-Term memory architecture, to identify the nonlinear and time-varying relationship between the supplied NMES and achieved angular position. Identification results indicate good fitting to data and very low mean square error using few data for training, proving to be very prospective methods for proposing control-oriented ... (Complete abstract click electronic access below)
Resumo: Nos últimos anos, vários estudos foram realizados mostrando que a estimulação elétrica neuromuscular (EENM) pode produzir bons resultados terapêuticos em pacientes com lesão medular (LM). Esta pesquisa introduz uma nova metodologia robusta e inteligente baseada em controle para a reabilitação de membros inferiores humanos via EENM usando uma técnica de controle de tempo contínuo chamada robust integral of the sign of the error (RISE). Embora na literatura o controlador RISE tem demonstrado bons resultados sem qualquer método de ajuste fino, uma abordagem de tentativa e erro poderia levar rapidamente à fadiga muscular em pacientes com LM. Portanto, foi mostrado nesse estudo que o desempenho do controle para rastrear com robustez um sinal de referência pode ser melhorado através da abordagem proposta, fornecendo um ajuste inteligente para cada voluntário. Resultados de simulação com um modelo matemático e oito sujeitos identificados da literatura são fornecidos, e experimentos reais são feitos com sete indivíduos saudáveis e dois paraplégicos. Além disso, esta pesquisa introduz a aplicação de redes neurais profundas e dinâmicas, especificamente o perceptron multicamadas, uma rede neural recorrente simples e a arquitetura Long Short-Term Memory, para identificar a relação não-linear e variante no tempo entre a EENM fornecida e a posição angular alcançada. Os resultados de identificação indicam boa adaptação aos dados e erro quadrático médio muito baixo usando poucos dados para... (Resumo completo, clicar acesso eletrônico abaixo)
Mestre
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Mercadal, Cavaller Borja. "Electroporation and peripheral nerve stimulation." Doctoral thesis, Universitat Pompeu Fabra, 2019. http://hdl.handle.net/10803/667854.
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This thesis aimed at addressing questions within the fields of electroporation and peripheral nerve stimulation and, in particular, those that arise from the interaction between the two phenomenona. On the one hand, electroporation can have various direct and indirect effects in the neuronal functions. This thesis investigates the possible role of electroporation in pulsed radiofrequency treatments for chronic pain. On the other hand, during electroporation based treatments, electrical stimulation of peripheral nerves appears as an unwanted effect causing muscle contractions and acute pain. This thesis analyzes the rationale behind the use of bipolar pulses to mitigate this effect and the implications of such approach in irreversible electroporation treatments. In addition, this thesis provides a theoretical framework to explain a series of results that were in apparent contradiction with the common knowledge of the electroporation phenomenon. Finally, this thesis presents a neuromuscular model to study the recruitment patterns in intramuscular electrical stimulation.Aquesta tesi té com a objectiu resoldre qüestions en els camps de l’electroporació i l’estimulació dels nervis perifèrics, i sobretot, aquelles que es deriven de l’interacció entre els dos fenòmens. L’electroporació pot tenir diversos efectes directes o indirectes en les funcions neuronals. En aquesta tesi s’investiga el possible paper de l’electroporació en els tractaments de radiofreqüència polsada. D’altra banda, durant els tractaments basats en l’electroporació, l’estimulació elèctrica dels nervis perifèrics apareix com a efecte secundari causant contraccions musculars i dolor. En aquesta tesi s’analitza com l’ús de polsos bipolar pot mitigar aquests efectes i quines implicacions té aquesta estratègia en els tractaments d’electroporació irreversible. En aquesta tesi també es presenta un marc teòric per explicar una sèrie de resultats que entren en aparent contradicció amb els nostres coneixements sobre l’electroporació. Finalment, es presenta un model neuromuscular que permet estudiar la resposta d’un múscul quan és estimulat mitjançant elèctrodes intramusculars.
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Gelfer, Yael. "The effect of Neuromuscular Electrical Stimulation on children with Congenital Talipes Equinovarus following treatment with the Ponseti method." Thesis, University of Surrey, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.505100.
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Congenital Talipes Equinovarus (CTEV) or clubfoot is the commonest congenital orthopaedic condition with an incidence of 1.5 per 1000 in the UK. The usual treatment for CTEV is the Ponseti method, consisting ofserial manipulation and casting followed by immobilisation in a foot brace. Two main factors have an effect on treatment result: deformity relapse due to muscle imbalance, creating the need for surgery, and smaller ankle range ofmotion (ROM) and calf circumference (CC).This study investigated the practicality ofsurface neuromuscular electrical stimulation (NMES) as an 'active' intervention in infants with CTEV. The primary outcome measure was the potential to reduce relapse measured by the Pirani score and secondary outcome measures were increase ROM and calf circumference. An AlBA2 approach (Astimulation, B-non-stimulation), six weeks each phase, was used in a study and a control group each with eight feet. At each session evertor muscle activity, Pirani severity score and static measures were assessed. Usage and parent perception was assessed using a questionnaire. The compliance with the stimulation and the brace were monitored by diary cards. A separate study with normally developing feet (n=26) and clubfeet (n=14) was also undertaken to determine the repeatability ofthe static measures.
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Musi, Wennergren Alexander. "Neuromuscular electrical stimulation after anterior cruciate ligament reconstruction surgery : Effects on rate of torque development and electromechanical delay." Thesis, Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-3773.
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Abstract Aim: The main objective of this study was to compare electro mechanical delay (EMD) and rate of torque development (RTD) of the knee extensors 6 weeks after rehabilitation of anterior cruciate ligament reconstruction (ACLR) with or without neuromuscular electrical stimulation (NMES). Further the feasibility of the study was examined. Method: 10 participants were randomized into two groups, one neuromuscular electrical stimulation group (NMESG) and one training group (TG). The NMESG used a NMES-device as a complement to the ordinary rehabilitation protocol. Regular meetings with a physiotherapist were scheduled during the rehabilitation. Measurements of RTD and EMD during knee extension were made in an isokinetic dynamometer with electromyography recordings (EMG) from the knee extensors 6 weeks after surgery. Results: All participants completed the study. The NMESG went to see the physiotherapist 6.7 ± 2.5 times and the TG 6.8 ± 1.8 times. The participants in the NMESG used the NMES-apparatus 28 ± 1.7 times. Total number of training days for the NMESG was 25 ± 4 and for the TG 35 ± 1. RTD did not significantly differ between the groups. For the TG, RDT was 901.1, 941.2 and 531.0 Nm/s, over the first 50, 100 and 200 ms, respectively. For NMESG: RTD was 824.3, 966.2 and 529.0 Nm/s, over the first 50, 100 and 200 ms, respectively. No significant difference between the groups or interaction between group and muscle was found in EMD. For both groups EMD was significantly larger for vastus medialis as compared to the vastus lateralis and rectus femoris. Conclusions: The study was feasible to perform, and despite fewer training days for the NMESG, no significant group differences were found in RTD or EMD. A larger study population is needed to evaluate the efficacy of the intervention.Abstrakt Syfte: Huvudsyftet med denna studie var att jämföra elektromekaniska fördröjning (EMD) och vridmoment utveckling (RTD) för knäextensorerna 6 veckor efter rehabilitering av främre korsbandsrekonstruktion (ACLR) med eller utan neuromuskulär elektrisk stimulering (NMES). Vidare undersöktes genomförbarheten av studien. Metod: 10 deltagare randomiseras in i två grupper, en neuromuskulär elektrisk stimulerings grupp (NMESG) och en träningsgrupp (TG). NMESG använde en NMES - enhet som ett komplement till ordinarie rehabiliteringsprotokoll. Regelbundna möten med sjukgymnast var inplanerad under rehabiliteringen. Mätningar av RTD och EMD under knäets extension gjordes i en isokinetisk dynamometer med elektromyografi inspelningar (EMG) från knäextensorerna 6 veckor efter operationen. Resultat: Alla deltagare fullföljde studien. NMESG träffade sjukgymnasten 6,7 ± 2,5 gånger och TG 6,8 ± 1,8 gånger. Deltagarna i NMESG använde NMES - apparaten 28 ± 1,7 gånger. Totalt antal träningsdagar för NMESG var 25 ± 4 och för TG 35 ± 1. RTD skiljde sig inte signifikant mellan grupperna. För TG var RDT 901,1, 941,2 och 531,0 Nm/s, under de respektive första 50, 100 och 200 ms. För NMESG var RTD 824,3, 966,2 och 529,0 Nm/s, under de respektive första 50, 100 och 200 ms. Inga signifikanta skillnader mellan grupperna eller samspel mellan grupp och muskler hittades i EMD. För båda grupperna var EMD signifikant större för vastus medialis jämfört vastus lateralis och rectus femoris. Slutsats: Studien var möjligt att utföra, och trots färre träningsdagar för NMESG sågs inga signifikanta skillnader mellan grupperna i RTD eller EMD. Det behövs en större studiepopulation för att utvärdera effekten av interventionen.
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Aldayel, Abdulaziz A. "Comparison of acute physiological effects between alternating current and pulsed current electrical muscle stimulation." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2010. https://ro.ecu.edu.au/theses/131.
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Electrical muscle stimulation (EMS) is widely used in rehabilitation and sport training, and alternating current and pulsed current EMS are commonly used. However, no systematic comparison between alternating and pulsed current EMS has been made in the previous studies. The main aim of this research was to compare acute physiological responses between the alternating and pulsed current EMS. The secondary purpose of the research was to investigate further muscle damage induced by EMS-evoked isometric contractions. Three experimental studies were conducted in the thesis project together with literature review about EMS.
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Whale, Conley Caitlin E. "EFFECT OF A 12-WEEK HOME-BASED NEUROMUSCULAR ELECTRICAL STIMULATION TREATMENT ON CLINICAL OUTCOMES FOLLOWING ARTICULAR CARTILAGE KNEE SURGERY." UKnowledge, 2017. http://uknowledge.uky.edu/rehabsci_etds/40.
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Articular cartilage defects in the knee are common, and can result in pain, decreased function and decreased quality of life. Untreated defects are considered to be a risk factor for developing osteoarthritis, a progressive degenerative joint disease with minimal treatment options. To address these issues, various surgical procedures are available to treat articular cartilage defects in the knee. While these procedures overall have positive results, after surgery patients experience large and persistent deficits in quadriceps strength. A contributing factor to this post-surgical weakness is believed to be the extended post-operative non-weight bearing period, with full weight bearing not initiated until approximately 4 – 6 weeks after surgery. During this non-weight bearing period a minimal amount of demand is placed upon the muscle. Subsequently, the quadriceps muscle undergoes a large degree of atrophy with a significant decrease in muscle strength. Muscular strength deficits reduce the knee joint stability, also increasing the risk of osteoarthritis development. Interventions that can be used to facilitate quadriceps strength while protecting the articular cartilage repair are needed. Neuromuscular electrical stimulation (NMES) is an effective post-knee surgery rehabilitation technique to regain quadriceps musculature. In recent years manufactures have been developing knee sleeve garments integrated with NMES allowing for portability of the NMES treatment.
The primary aim of this study was to evaluate the effectiveness of a 12-week home-based neuromuscular electrical stimulation treatment on post-surgical clinical outcomes (quadriceps strength, lower extremity function, and patient reported outcomes) after articular cartilage knee surgery. Patients were randomized between a standard of care home-treatment group and a NMES home-treatment group. Patients completed isometric quadriceps strength testing, the Y-balance test, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) before surgery and at 3-months after surgery. The secondary aims of this study were to determine the most effective NMES parameters for post-surgical quadriceps strength; and to develop a framework to identify factors that may influence a patient’s adherence to a prescribed therapy program.
From our results we can make several conclusions. First, we found only a small number of studies utilize similar parameters for post-surgical quadriceps strength treatments. The majority of the parameters reported in the literature were highly variable between studies. Second, clinicians can utilize the expanded Health Belief Model to identify situational and personal factors unique to a patient that may impact adherence to a prescribed treatment. Clinicians can then implement the proposed interventional strategies to address the identified situational and personal factors. Finally, there was no difference in quadriceps strength, lower extremity function, or self-reported scores at 3-month between a home-based NMES treatment and a standard of care home-based treatment. Patients’ adherence to the treatment protocols may have been a major factor contributing to these results. Utilizing a model, such as the proposed expanded Health Belief Model, may assist clinicians in improving a patients’ adherence to future prescribed home-treatment programs.
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Magdalon, Eliane Cristina. "Facilitação neuromuscular proprioceptiva : tratamento isolado em comparação com a associação da estimulação eletrica neuromuscular em membro superior de pacientes hemipareticos pos-AVC." [s.n.], 2004. http://repositorio.unicamp.br/jspui/handle/REPOSIP/261711.
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Orientador: Antonio Augusto Fasolo QuevedoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Eletrica e de Computação
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Resumo: Objetivo: verificar o efeito da adição da Estimulação Elétrica Neuromuscular (NMES) ao treinamento do padrão de Facilitação Neuromuscular Proprioceptiva (FNP) em membro superior de pacientes hemiparéticos pós-AVC. Metodologia: foram selecionados 10 pacientes, divididos igualmente em dois grupos. Ambos receberam o treinamento com os padrões de FNP, entretanto o grupo 2 recebeu a adição da NMES. As avaliações dos membros superiores foram realizadas pré-tratamento (iniciais), pós-tratamento (finais) e após 7 a 8 semanas do término das sessões de tratamento (tardias). Para a avaliação utilizou-se a Escala de Fugl-Meyer, o índice de Barthel Modificado (IBM) e Escala de Ashworth. Resultados: Análises não-paramétricas revelaram aumentos estatisticamente significativos na pontuação motora total do MS em todos os estágios da avaliação de Fugl-Meyer para o grupo 1. O grupo 2 somente mostrou aumento estatisticamente significativo para o estágio I x F (p-valor=O,O30), sendo para os demais estágios o p-valor>O,O5. Na escala de Ashworth encontrou-se diferença significativa somente entre a comparação dedo I dedo F do grupo 1 (p-valor=O,O30). No grupo 1, encontraram-se diferenças significativas (pvalor=O,O30) na goniometria ativa e passiva da flexão de ombro e de cotovelo I x F e I x T, e também houve diferença significativa na flexão de punho passiva F x T e extensão de punho passiva I x T. Não houve diferença estatisticamente significativa no IBM para ambos os grupos. Conclusões: analisando-se isoladamente cada grupo, o protocolo utilizado para o grupo de FNP foi suficiente para aumentar a pontuação motora do MS na Escala de Fugl-Meyer, apresentando retenção do tratamento. Entretanto a adição da NMES não foi suficiente para garantir a retenção do tratamento e alterar o IBM e Escala de Ashworth
Abstract: Objectives: The aim of this study was to evaluate the efficacy of Neuromuscular Electrical stimulation (NMES) added to Proprioceptive Neuromuscular Facilitation (PNF) patterns in upper limbs of hemiparetic patients after stroke. Methods: Ten hemiparetic subjects were divided into two groups, both receiving PNF patterns. Group 2 received, in addition, NMES. Upper limb was evaluated pre-treatment (initial - I), post-treatment (final - F) and after 7 or 8 weeks after the end of the sessions (Iate - L). Motor function was assessed with the upper extremity motor subscore of the Fugl-Meyer Assessment (FMA), the Modified Barthel lndex (MBI), and Ashworth Scale for muscular tonus. Results: Non-parametric analyses revealed statistically significant gains in Fugl-Meyer Scores between I x F, I x L and F x L (p=O,O30) in group 1. Group 2 only showed statistically significant gains for I x F, for the other combinations p>O,O5. Ashworth Score presented significant differences only for fingers I x F in group 1 (p=O,OO3). For group 1, there were significant differences (p=O,OO3) in active and passive goniometry for shoulder flexion I x F and I x L, elbow flexion I x F and Initial x L, and there were also significant differences in passive wrist flexion F x L and passive wrist extension I x L. There were not statistically significant differences in MBI for both groups. Conclusion: The methodology was able to increase the motor score of upper extremity by Fugl-Meyer Score and increasing amplitude of the passive and active movement. Meanwhile, the addition of FES was not enough to change with statistical significance the data of the Fugl-Meyer Assessment, MBI and Ashworth Scale
Mestrado
Engenharia Biomedica
Mestre em Engenharia Elétrica
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Souza, Soraia Figueiredo de. "ESTIMULAÇÃO ELÉTRICA NEUROMUSCULAR EM CÃES SUBMETIDOS À IMOBILIZAÇÃO RÍGIDA, TEMPORÁRIA DA ARTICULAÇÃO FEMORO-TÍBIOPATELAR." Universidade Federal de Santa Maria, 2006. http://repositorio.ufsm.br/handle/1/10219.
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The objective of this study was to evaluate the effects of neuromuscular electrical stimulation (NMES) of low frequency on the vastus lateralis muscle. Eleven, male and female, dogs of variable age were randomly placed in 3 groups: I (control), II (NMES post immobilization), and III (NMES before and post immobilization). The right femoral-tibial-patellar joint of the animals in groups I, II, and III was immobilized for 30 days by the percutaneous transfixation type II method. The dogs from group II were placed on eletrotherapy 3 times weekly for 90 days, during (30 days) and post immobilization (60 days). The dogs from group II were initiated on NMES post-removal of the temporary rigid immobilization. The parameters evaluated consisted of: measurement of thigh circumference, joint motion using a goniometer, gait analysis, creatine kinase (CK) and aspartate aminotransferase (AST) levels and morphometry of the longitudinal muscle fibers collected by vastus lateralis muscle biopsy. The gait analysis was performed daily by the same observer for 90 days. The circumference of the thigh, joint motion, and muscle biopsy were performed on days 0, 30, 60 and 90 post-surgery. The blood samples for CK and AST were collected before and immediately after 6, 24 and 48 hours post-NMES on days 0,1,7,30,45,60,75 and 90. The NMES was employed on the femoral quadriceps muscle group with a frequency of 50Hz post-duration of 300msec on an off-time/on-time ratio of 1:2. There was no significant difference on the gait analysis, thigh circumference, joint motion, and CK and AST values. In terms of morphometry of muscle fibers, the greatest hypertrophy change was observed on longitudinal fibers of the dogs from group II (p=0.0005), followed by the dogs from group III. It can be concluded that NMES of low frequency does not avoid the muscular atrophy of vastus lateralis muscle during rigid temporary immobilization of the stifle joint, but causes muscular gain after this period, recommending its useCom o objetivo de avaliar o efeito da estimulação elétrica neuromuscular (EENM) de baixa freqüência no músculo vasto lateral foram utilizados 11 cães, machos e fêmeas, sem raça definida, de idades variadas e agrupados aleatoriamente em três grupos denominados de I ou controle, II (EENM após imobilização) e III (EENM durante e após imobilização). A articulação femoro-tíbio-patelar direita dos animais dos grupos I, II e III foi imobilizada por 30 dias pelo método de transfixação percutânea tipo II. Os cães do grupo III iniciaram as sessões de eletroterapia, três vezes por semana, por 90 dias, ou seja, durante (30 dias) e após a imobilização (60 dias). Os cães dos grupos II tiveram início da EENM após a remoção da imobilização rígida temporária. Os parâmetros avaliados foram a mensuração da circunferência da coxa, goniometria do joelho, graus de claudicação, enzimas creatina-quinase (CK) e aspartato-amino-transferase (AST) e morfometria das fibras musculares longitudinais obtidas por biópsia muscular do vasto lateral. A análise dos graus de claudicação foi realizada diariamente por um mesmo observador por 90 dias. A circunferência de coxa, goniometria e biópsia do músculo vasto lateral foram realizadas nos tempos zero, 30, 60 e 90 dias de pós-operatório. As amostras de sangue para avaliação da CK e AST foram coletadas antes, imediatamente depois, aos 6, 24 e 48 horas após a EENM, nos dias zero, um, sete, 30, 45, 60, 75 e 90. A EENM foi empregada no músculo quadríceps femoral numa freqüência de 50Hz, duração de pulso de 300 milisegundos e relação on time/off time de 1:2. Não houve diferença significativa nos graus de claudicação, valores de circunferência da coxa, goniometria e comportamento das enzimas CK e AST entre os grupos I, II e III. Quanto à morfometria das fibras musculares, foi observada uma maior hipertrofia das fibras musculares longitudinais nos cães do grupo II (p=0,0005), seguida pelos cães do grupo III. Podese concluir que a EENM de baixa freqüência não evita a atrofia do músculo vasto lateral durante a imobilização rígida temporária do joelho, mas ocasiona ganho de massa muscular após esse período, recomendando-se o seu uso
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Vitry, Florian. "Effets aigus et chroniques de l’électrostimulation appliquée au niveau du nerf moteur : importance du retour afférent." Thesis, Bourgogne Franche-Comté, 2019. http://www.theses.fr/2019UBFCK087.
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L'objectif de cette thèse était d’étudier l'impact de protocoles d’électrostimulation favorisant un recrutement indirect des unités motrices (UM) via les afférences sensorielles et induisant le développement d’extra force, sur le système neuromusculaire. Ces protocoles associent une grande largeur d’impulsion, une faible intensité de stimulation, des hautes et basses fréquences et sont appliqués sur le nerf moteur. L’étude des effets de ces protocoles sur la fatigue neuromusculaire lors d’une application aiguë a fait l’objet de la première étude qui a montré que pour un impact équivalent sur la capacité maximale de production de force, les basses fréquences de stimulation limitaient la diminution de force au cours d’une session d’électrostimulation comparativement aux hautes fréquences. L’application de manière chronique de ces protocoles lors d’un entraînement a fait l’objet de la deuxième étude. Les résultats ont montré des gains de force importants malgré les faibles intensités de stimulation et des adaptations nerveuses qui étaient dépendantes de la fréquence de stimulation. Les résultats de ces deux études ont aussi permis de mettre en évidence l’importance du phénomène d’extra force sur les adaptations induites. Ainsi, l’étude de ce dernier phénomène a fait l’objet de la troisième étude. Les résultats ont montré que lorsque le recrutement initial des UM était indirect, l’extra force était présente pour toutes les fréquences de stimulation. De plus, le développement de l'extra force a induit une diminution de l’excitabilité spinale après les basses fréquences de stimulation et une augmentation après les hautes fréquences. La dernière étude de ce travail s’est intéressée aux mécanismes expliquant ces modulations spinales. Les résultats ont montré que le mécanisme de dépression post-activation pourrait expliquer la diminution observée après les basses fréquences, tandis que ce mécanisme serait compensé par la présence de courants entrants persistants, entraînant une augmentation de l’excitabilité des motoneurones après les hautes fréquences de stimulation. L’ensemble de ces résultats souligne l’importance du retour afférent aux adaptations neuromusculaires induites après une application aiguë et chronique de l’électrostimulationThe aim of this thesis was to investigate the effects of electrical stimulation protocols favouring an indirect motor units’ (MU) recruitment via sensory axons activation and giving rise to extra force development, on the neuromuscular system. These protocols use wide pulse duration, low stimulation intensity, low and high stimulation frequencies and are applied over the motor nerve. The aim of the first study was to examine the effects of these protocols on the extent and origin of neuromuscular fatigue during an acute application. Results showed that for a similar impact on maximal force generating capacity, low stimulation frequencies limit force decreases during the stimulation trains as compared to high stimulation frequencies. The aim of the second study was to investigate the effects of chronic application of these protocols. Results showed important torque gains after the training period despite the low stimulation intensity used, while the induced neural adaptations were frequency-dependent. Results of these two studies also highlighted the importance of the phenomenon of extra torque on induced adaptations. Thus, the aim of the third study was to determine the conditions permitting the occurrence of extra torque, by modulating the frequency and intensity of stimulation. Main results showed that when the initial MU recruitment was mostly indirect, the developed torque was higher than the one expected for the given stimulation parameters, independently of the stimulation frequency, suggesting that the indirect MU recruitment plays a preponderant role in the occurrence of extra torque. Moreover, a frequency-dependent impact on spinal excitability was observed, resulting in a decrease after the low stimulation frequency and an increase after the high frequency. Consequently, the last study investigated the mechanisms responsible for the distinct modulation of spinal excitability. Results showed that the decrease in spinal excitability observed after the low stimulation frequency could be attributed to increased homosynaptic post-activation depression, while this latter mechanism could have been compensated by an enhanced motoneuron excitability as a result of persistent inward currents after the high stimulation frequency. All these results underline the importance of the afferent volley to the induced neuromuscular adaptations after acute and chronic electrical stimulation application
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Sene, Marcela de Oliveira. "Efeitos da estimulação elétrica neuromuscular sobre o gasto energético de lesados medulares." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/82/82131/tde-01092003-110729/.
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Lesões na medula espinhal atingem um grande número de pessoas, devido a traumas, doenças congênitas ou adquiridas. Para estes tipos de lesões não há cura e os indivíduos lesados medulares dependem de tratamento através de fisioterapia ou órteses que auxiliem na recuperação de possíveis funções perdidas. A Estimulação Elétrica Neuromuscular (EENM) tem sido pesquisada com essa proposta: reabilitar pessoas portadoras de lesão medular ou disfunções do aparelho locomotor. Muitos estudos já foram desenvolvidos na área de estimulação elétrica neuromuscular, avaliando a marcha, o ato de levantar-se ou outros movimentos. Um ponto em comum entre estes estudos é a preocupação com os efeitos fisiológicos da EENM, como por exemplo o gasto energético. Diante disto, o objetivo deste projeto foi avaliar os efeitos da EENM sobre o gasto energético de lesados medulares. Foi observado o consumo de oxigênio durante o repouso, a marcha e a recuperação. A avaliação proposta foi realizada por método indireto e as análises estatísticas foram realizadas através do teste ANOVA ONE WAY. Os resultados sugerem os voluntários tiveram recuperação fisiológica. Entretanto novas pesquisas são necessárias, com outras variáveis sendo avaliadas.Lesions in the spinal cord affect a great number of individuals, either due to traumas or to congenital or acquired diseases. Such lesions are incurable, and the injured patients depend on physiotherapy or orthosis to aid in the recovery of lost functions. The Neuromuscular Electrical Stimulation (NMES) has been researched with this purpose: rehabilitating spinal cord injured patients, or those with motor system dysfunction. Several studies have already been developed in the field of neuromuscular electrical stimulation, assessing gait, the act of getting up or other everyday movements. All these studies bear something in common: the concern with the physiologic effects of NMES, such as the energy consumption. Hence, the objective of this project was to evaluate the effects of NMES on the energy cost of spinal injured patients. The consumption of oxygen was assessed during rest, gait and the recovery period. The proposed evaluation was made through indirect method, and the statistical analyses through the ANOVA ONE WAY test. The results to suggest that the volunteers had phisyological recovery. However, news reserchs there are needs, with others variable to be estimated.
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Macht, Jordon W. "THE EFFECT OF β-HYDROXY-β-METHYLBUTYRATE (HMB) SUPPLEMENTATION ON NEUROMUSCULAR PERFORMANCE FOLLOWING FATIGUING EXERCISE IN HEALTHY SUBJECTS." UKnowledge, 2015. http://uknowledge.uky.edu/khp_etds/23.
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Supporters of a nutritional supplement, β-Hydroxy-β-Methylbutyrate (HMB) supplementation, claim that it will increase the muscular strength gains and lean muscle mass gains seen during a resistance training program. It has been suggested that HMB supplementation does this by preventing muscle damage or by regenerating damaged muscle cell membranes. However, no research has evaluated the effect of HMB supplementation on low frequency fatigue. Therefore, the purpose of this study was to determine if three weeks of HMB supplementation could attenuate the effects of low frequency fatigue caused by eccentric muscle contractions of the tibialis anterior muscle. A total of 33 healthy recreationally active subjects (18 males, 15 females; 23.2 ± 4.3 yr) were recruited for this study. All subjects preformed 4 sets of 25 eccentric contractions of the tibialis anterior muscle through a range of motion of 30 degrees. Recovery measures were taken for 20 minutes after the fatigue protocol and at 48 and 96 hours of recovery. The recovery measures included: Maximum voluntary contraction peak torque, 10 Hz peak torque, 50 Hz peak torque, 10/50 Hz peak torque ratio, and EMG measurements. Each subject served as their own control and limbs were randomly assigned to pre-supplement or post-supplement limbs. Following the pre-supplement fatigue protocol and recovery measures each subject completed three weeks of 3g/day HMB supplementation. After the supplementation period the post-supplement fatigue protocol was completed and recovery measures were taken. The 10 Hz peak torque and the 10/50 Hz torque ratio in the pre-supplement limb was still significantly reduced at the 96-hour recovery measurement time, indicating that it was still showing low frequency muscle fatigue at this time. Furthermore, the post-supplement limb, recovered from the fatigue protocol faster, and did not show any signs of low frequency muscle fatigue at the 48-hour recovery measurement time. In addition the pre-supplement limb had significant maximum voluntary contraction torque deficit at the 48-hour recovery measurement time and the post-supplement limb showed no significant deficits. The main findings of this study were that three weeks of HMB supplementation attenuated low frequency fatigue and maximum voluntary contraction torque reduction after an eccentric fatigue protocol.
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Prado, Thiago Alexandre [UNESP]. "Implementação de um controlador PID embarcado para o controle em malha fechada de um estimulador neuromuscular funcional." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/87062.
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Por décadas, a aplicação de Estimulação Elétrica Neuromuscular (EENM) em pacientes paraplégicos e hemiplégicos tem melhorado significativamente sua qualidade de vida. Entretanto, comercialmente, essa técnica é aplicada sem o uso de uma lei de controle em malha fechada, o que limita sua eficiência. Assim, neste trabalho, projetou-se e implementouse um controlador PID embarcado para o uso com estimuladores elétricos neuromusculares. O projeto desse controlador se baseou em um modelo matemático linear de segunda ordem, que representa o comportamento da força muscular devido a um estímulo elétrico. Posteriormente, desenvolveram-se algoritmos na linguagem de programação Python que possibilitam o projeto automático de controladores PID com diferentes especificações para diferentes pacientes. Dessa forma, o usuário informa os parâmetros do paciente e as especificações desejadas para obter a configuração do controlador PID adequada. Além disso, desenvolveuse um programa em linguagem C para o microcontrolador PIC18F4520 que implementa este controlador utilizando o seu conversor A/D interno de 10 bits e um conversor D/A externo de 10 bits. Este controlador pode ser configurado via comunicação serial de forma simples e rápida, permitindo alterar os parâmetros do controlador PID e o tempo de amostragem. Por fim, os resultados obtidos a partir da simulação deste sistema no ambiente Proteus provou a viabilidade do controlador PID projetado.
For decades the quality of life of hemiplegic and patients with spinal cord injuries has been improving through the research and use of Neuromuscular Electrical Stimulation (NMES) in rehabilitation engineering. However, most of the times it has been used without closed loop techniques, which is the approach used in this project, where an embedded PID controller has been designed and implemented to control the NMES. The plant to be controlled, i.e., the behaviour of the muscle response to an electrical stimulus, was represented using a secondorder linear model. The language Python was then used to develop PID control algorithms allowing the use of different specifications so that the user can supply the patient parameters to properly configure the PID controller for different patients. Later, these algorithms were implement in a PIC18F4520 microcontroller using C language, exploiting its internal 10 bit A/D converter and an external 10 bit D/A. The final circuit can be configured serially via a PC, adjusting the controller parameters and the sampling rate. The whole system was simulated in the Proteus environment, proving its viability.
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Cardoso, Pedro. "Efeitos da estimulação elétrica neuromuscular na síndrome de dor patelofemoral." Bachelor's thesis, [s.n.], 2019. http://hdl.handle.net/10284/8807.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em FisioterapiaObjetivo: Determinar os efeitos da estimulação elétrica neuromuscular (EENM) em pacientes com síndrome de dor patelofemoral (SDPF). Metodologia: Pesquisa computadorizada nas bases de dados PubMed/Medline, Scielo, Lilacs, Cochrane Library e PEDro efetuada usando a combinação: (Electrical Muscle Stimulation OR Electrical Stimulation) AND (Patellar Pain OR Patellofemoral Pain Syndrome) de acordo com guias de PRISMA. Apenas estudos randomizados controlados foram incluídos no estudo. Estudos foram analisados usando a Physiotherapy Evidence Database scoring scale (PEDro). Resultados: Cinco estudos cumpriram os critérios de inclusão e obtiveram uma média aritmética de 8,4/10 na escala de PEDro, com um total de 171 participantes. Os estudos selecionados incluíram diferentes tipos de EENM e métodos de avaliação. Foram encontrados resultados estatisticamente significativos em várias escalas de avaliação, ou seja, na efetividade do uso de EENM. Conclusão: Os resultados mostraram que a técnica de EENM pode contribuir para uma diminuição da dor, aumento de funcionalidade e ganho de força muscular, embora não se considere mais eficaz que outros métodos.
Objective: To determine the effects of neuromuscular electrical stimulation (NMES) in patients with patellofemoral pain syndrome (PFPS). Methodology: Computerized search in the databases PubMed/Medline, Scielo, Lilacs, Cochrane Library and PEDro was executed with the following key-words: (Electric Muscle Stimulation OR Electrical Stimulation) AND (Patellofacial Pain or Patellofemoral Pain Syndrome) according to the guidelines of PRISM. Only randomized controlled trials were included in the study. Studies were analyzed with a scoring scale from the Physiotherapy Evidence Database (PEDro). Results: Five studies fulfilled the inclusion criteria and obtained an arithmetic average of 8.4/10 on the PEDro scale, with a total of 171 participants. Studies have included several types of NMES and assessment methods. Statistically significant results were found in several assessment scales, that is, in the effectiveness of NMES use. Conclusion: The results show that an NMES technique can contribute to a rise in potency, increased functionality and gain of muscle strength, although not more effective than other methods.
N/A
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Bouguetoch, Amandine. "Méthodes alternatives de renforcement musculaire : cas de l’imagerie motrice et de la stimulation électrique neuromusculaire." Thesis, Bourgogne Franche-Comté, 2020. http://www.theses.fr/2020UBFCK041.
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Une pratique intensive de l'entraînement contre résistance, i.e. avec des charges lourdes et un faible nombre de répétitions, peut soumettre les sportifs à des charges d'entraînement élevées qui peuvent conduire à des blessures. Afin d'éviter l'apparition de ces blessures ou de limiter le désentraînement dans le cas contraire, des méthodes alternatives d’entraînement ont été développées. Ces méthodes ont une double cible puisqu'elles permettent aussi de faire pratiquer certaines populations qui, suite à différentes pathologies ou traumatismes, ne peuvent pas s’exercer normalement. Cette thèse s’est intéressée plus particulièrement au système neuromusculaire et aux mécanismes mis en jeu lors du développement de la force sur les muscles fléchisseurs plantaires par imagerie motrice (IM), i.e. la simulation mentale d’un mouvement sans sortie motrice concomitante et par stimulation électrique neuromusculaire (NMES), i.e. évoquer des contractions en appliquant un courant électrique sur le muscle via des électrodes de surface.L’étude I a permis d’obtenir des résultats en faveur de l’existence d’un continuum d’activation neurale du repos à l’IM et de l’IM à la contraction réelle. Au minimum, l’IM pourrait représenter une activation subliminale de structures neurales qui sont partagées avec la contraction. L’étude IIa a montré des gains similaires de force entre des entrainements par NMES et par IM, tous les deux reposant sur des adaptations nerveuses qui, de manière générale, impliquent une plus large part du système corticospinal que ce qui est habituellement attendu, incluant à la fois une plasticité spinale et supraspinale. De manière surprenante, effectuer un entrainement en alternant la NMES et l’IM dans la même session n'a pas mené à des gains de force, montrant qu’un entrainement combiné ne représente pas simplement la somme des gains de chacune des modalités. L’IM et la NMES, en fonction des paramètres choisis, pourraient même montrer des effets concurrents. L’étude IIb a montré que l’IM semble être une méthode d'entraînement efficace pour induire un effet controlatéral, i.e. un gain du membre non-entrainée suivant un entrainement unilatéral de l’autre membre. Au contraire, la NMES avec nos paramètres de stimulation n'a pas mené à un effet controlatéral. Les résultats actuels soulignent le fait que l'effet controlatéral ne nécessite pas forcément une activité du muscle de la jambe entraînée. L’étude III n’a pas permis de mettre en lumière des différences de modulations entre les sujets explosifs, sédentaires et endurants. Une étude parallèle à ce travail de thèse avait mis en lumière des profils neuromusculaires différents entre des sujets explosifs et des sujets sédentaires. Les résultats préliminaires de cette étude peuvent suggérer que la pratique sportive, et plus globalement le profil neuromusculaire d’un sujet, n’influence pas le caractère répondeur ou non-répondeur d’un individu à une sollicitation telle que l’IMAn intense practice of resistance training, i.e. with heavy loads and a low number of repetitions, can cause injuries. To avoid them or limit detraining after an injury, alternative training methods have been developed. These methods have a double target since they also allow populations with different pathologies to practice a physical activity. This thesis focused particularly on the neuromuscular system and the mechanisms involved in strength development on plantar flexors muscles following motor imagery (MI), i.e. mental simulation of a movement without its concomitant motor output, and neuromuscular electrical stimulation (NMES), i.e. evoking contractions through electrical current applied on the muscles via surface electrodes.Study I argues in favor of the existence of a continuum of neural activation from rest to MI and from MI to contraction. At least, MI could represent a subliminal activation of neural structures which are shared with actual contraction. Study IIa showed similar gains in strength after NMES and MI trainings, both relying on neural adaptations which involved a larger part of the corticospinal system than usually expected, including both spinal and supraspinal plasticity. Surprisingly, alternating NMES and MI in the same training session did not imply strength gains, highlighting the fact that a combined training does not represent the sum of the gains of each modality. On the contrary, MI and NMES, depending on the parameters, could even imply competitive effects. Study IIb showed that MI seems to be an efficient training method to induce cross education, i.e. strength gains on the untrained limb after unilateral training of the other limb. On the contrary, NMES with our stimulation parameters did not induce cross education. These results highlight the fact that cross education does not necessarily require muscle activity on the trained leg. Study III did not reveal differences in modulation between sedentary participants, explosive athletes, and long-distance runners. A parallel study to this thesis put in evidence different neuromuscular profiles between explosive and sedentary subjects. The preliminary results of this study could suggest that physical practice, and more generally the neuromuscular profile of a subject, does not influence their responsiveness to a solicitation such as MI
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Manhães, Renata Borges. "A engenharia de reabilitação e as características psicossociais de pessoas com lesão medular submetidas a um programa de estimulação elétrica neuromuscular." Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/82/82131/tde-28102004-100130/.
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A estimulação elétrica neuromuscular é um recurso reabilitacional funcional que tem como propósito a recuperação dos movimentos dos membros superiores ou inferiores. Com este recurso, é possível a pessoas que possuem uma lesão medular e que vêem suas vidas modificadas pelo advento da lesão, executarem ações que possam facilitar a sua independência nas habilidades diárias, uma vez que mudanças em seu esquema corporal e limitações reais às suas atividades cotidianas são observadas nestes casos. Acredita-se que seja comum a presença de reações psicológicas a este tratamento, porém, poucos estudos foram registrados até o momento. Considerando-se que uma intervenção que aborde aspectos físicos, psicológicos e sociais destas pessoas é indispensável a qualquer processo reabilitacional, esta pesquisa teve como objetivos identificar e analisar características psicossociais de usuários do programa de estimulação elétrica neuromuscular realizado no Hospital das Clínicas da Universidade Estadual de Campinas, Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas, Laboratório de Biomecânica e Reabilitação do Aparelho Locomotor. Suas concepções, reações e expectativas frente a este tipo de reabilitação também foram investigados, além da identificação das principais necessidades destas pessoas, oferecendo subsídios para a condução de um tratamento psicoterápico adequado ao quadro caracterológico das pessoas com lesão medular submetidas à estimulação elétrica neuromuscular, de forma a favorecer a realização de um processo reabilitacional que os contemplem em sua dinâmica biopsicossocial. Para isso, os participantes desta pesquisa foram divididos em dois grupos distintos. Os que se encontravam no primeiro ano de tratamento e os que o realizavam há mais de um ano. Foi utilizado um roteiro de entrevista semi estruturada que teve como propósito conhecer aspectos, tais como, a visão da pessoa com lesão medular sobre sua própria deficiência, formas de enfrentamento, vida social e familiar, bem como, suas concepções e expectativas no que diz respeito à reabilitação por meio da estimulação elétrica neuromuscular. Os entrevistados consideraram como uma de suas metas, a recuperação total ou parcial das funções que lhes foram subtraídas com a lesão medular, considerando efeitos positivos com a utilização deste tratamento, no alcance de melhorias físicas e psicossociais. Não obstante, eles procuram investir em vários outros aspectos de suas vidas, que não somente o reabilitacional, como por exemplo, os profissionais, familiares, sociais e afetivosNeuromuscular electrical stimulation is a functional resource for rehabilitation, which aims recover the motions of inferior and superior limbs. With this resource, it is possible for spinal cord injury patients, who had their lives changed due to this injury, to execute actions that can make their independency to every day abilities easier, once changes in their body structure and real limitations to daily activities were noticed in this case. It is believed that the remark of psychological reactions are usual for this treatment, however, a few studies were registrated until the moment. In regarding to an intervention that deals with this patients physical and social aspects is essential to any rehabilitation process, this research aims to identify and analyze users psycho-social characteristics of neuromuscular electrical stimulation program made at Campinas State University hospital, Orthopedic and Traumatology Department of Medical Science School, Laboratory of Biomechanics and Rehabilitation of Inferior Limbs. Its concepts, reactions and expectations toward this kind of rehabilitation were also investigated, as well as the identification for the leading of a psychotherapeutic treatment appropriate to the characterization of the process of spinal cord injury patients who were subjected to neuromuscular electrical stimulation in order to be biased toward the achievement of a rehabilitational process, which gives to the spinal cord injured person in his/her biopsycho social dynamic. For this, subjects of this research were divided in two different groups. The first group, people who were in the first year of treatment and the second group, people who had been in treatment for more than one year. A schedule of a half-standard interview was used and aimed to know aspects such as spinal cord injured person´s point of view about his/her own disability, how he/she faces it, social and family life as well as his/her concepts and expectations regarding to rehabilitation through neuromuscular electrical stimulation. The total or partial recovering of the functions that were taken by the spinal cord injury was had as one of the patients´ goals, which were worried about the positive effects by using this treatment, within reach physical and psychosocial improvement. They tried to invest in many other aspects of life, such as professional, family, social and affective aspects
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Doix, Aude-Clémence. "Stratégies d’activation neuromusculaires de la fatigue musculaire volontairement et électriquement induite : mécanismes sous-jacents et implications cliniques." Thesis, Nice, 2013. http://www.theses.fr/2013NICE4098/document.
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La prise en charge thérapeutique de la fatigue musculaire par le biais d’exercices physiques vise à améliorer la qualité de vie et implique habituellement des exercices unilatéraux ou l’électrostimulation neuromusculaire pour compenser une fonction musculaire altérée aussi bien chez les personnes saines ou dites vulnérables (e.g. atteintes d’une pathologie ou d’un traumatisme). La fatigue musculaire est une réduction de la capacité de production maximale de force, induite par l’exercice, que la tâche puisse être maintenue ou non (Bigland-Ritchie et al. 1983; Gandevia 2001; Enoka and Duchateau 2008). L’objectif général de cette thèse était d’étudier les stratégies d’activation neuromusculaire lors de la fatigue musculaire, de l’endurance musculaire et sur la performance musculaire au cours et/ou après des contractions volontaires et évoquées électriquement chez des personnes saines ou vulnérables tels que des enfants atteints d’infirmité motrice cérébrale (IMC) et des patients atteints de dystrophie musculaire facio-scapulo-humérale (DMFSH)The clinical care of muscle fatigue with exercise therapies aim at quality of life improvement and usually involve unilateral exercises or neuromuscular electrical stimulation to compensate impaired muscle function in both healthy and health-compromised people. Muscle fatigue is a decline in maximal force production, induced with exercising, whether or not the task can be maintained (Bigland-Ritchie et al. 1983a; Gandevia 2001a; Enoka and Duchateau 2008). The overall objective of this thesis was to study the effect of neuromuscular activation strategies during muscle fatigue, endurance and muscle performance after voluntary and electrically evoked contractions in healthy and health-compromised populations such as children with cerebral palsy (CP) and patients with facioscapulohumeral muscular dystrophy (FSHD)
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Souza, Marcial Zanelli de. "Interleucinas e perfil quimiometabólico músculo-esquelético de ratos com o membro posterior imobilizado e submetidos à estimulação elétrica neuromuscular /." Rio Claro : [s.n.], 2008. http://hdl.handle.net/11449/100437.
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Orientador: Eliete LucianoBanca: Carlos Alberto da Silva
Banca: Cláudio Alexandre Gobatto
Banca: Gustavo Puggina Rogatto
Banca: Ricardo José Gomes
Resumo: O objetivo deste estudo foi analisar e quantificar a participação das interleucinas (IL-4, IL-6, IL-10 e TNF-alfa) em animais que tiveram uma pata imobilizada e eletroestimulada por 1, 2 e 3 dias consecutivos, analisando-se a repercussão da hipocinesia focal sobre o conteúdo das proteínas musculares, bem como sobre parâmetros metabólicos como glicemia, insulinemia, glicogênio muscular, ácidos graxos livres, ácido ascórbico da glândula adrenal e da enzima creatina quinase (CK). A estimulação elétrica neuromuscular (EE, F=10Hz, T=0,4ms, i=5mA, 20 minutos diariamente), foi aplicada ao membro posterior de ratos, nos músculos Gastrocnêmio e Sóleo. Assim, ratos machos Wistar foram divididos em 7 grupos: controles (C), imobilizados por 1 dia (I1), imobilizados e eletroestimulados por 1 dia (IE1), imobilizados por 2 dias (I2), imobilizados e eletroestimulados por 2 dias (IE2), imobilizados por 3 dias (I3) e imobilizados e eletroestimulados por 3 dias (IE3). A Imobilização foi realizada através de uma órtese confeccionada sob medida em resina acrílica, mantendo o membro em posição a 90º pelos respectivos períodos experimentais. Os resultados demonstraram que a imobilização monosegmentar utilizada neste estudo desencadeou precocemente a proteólise muscular, alem de provocar respostas agudas nos sistemas diretamente relacionados com o fornecimento energético. Tais reações podem ser mediadas por algumas interleucinas, sobretudo a IL-6, que apresentou expressiva variação durante os períodos experimentais. Por outro lado, a eletroestimulação neuromuscular utilizada precocemente pode atenuar algumas destas respostas, minimizando o aspecto catabólico induzido pela imobilização. Assim, os resultados deste estudo leva a sugestiva de que as ações terapêuticas ou preventivas sobre as conseqüências deletérias da imobilização sobre os sistemas orgânicos devem ser adotadas precocemente.
Abstract: The objective of the study was to evaluate and quantilfy the participation of interleukins (IL-4, IL-6, IL-10, and TNF) in rats that underwent paw immobilization and electrical stimulation for 1, 2, and 3 consecutive days, while analyzing the local hypokinesia repercussion on muscular protein content, as well as metabolic parameters of glycemia, insulineamia, muscular glycogen, free fatty acids, ascorbic acid, and createne kinase enzime (CK). The neuromuscular electrical stimulation (EE, F=10Hz, T=0,4ms, i=5mA, 20 minutes daily) was applied to the hindlimb of the animas over the soleus and gastrocnemius muscles. In this manner, albino male Wistar rats were distributed into 7 experimental groups: control (C), immobilized 1 day (I1), immobilized 1 day and electrostimulated (IE1), immobilized 2 days (I2), immobilized 2 days and electrostimulated (IE2), immobilized 3 days (I3) and immobilized 3 days and electrostimulated (IE3). The immobilization of the animals was achieved by an acrylic resin orthesis model which maintained the limb in the position of 90º during the respective experimental periods. The results demonstrated that the mono-segmental immobilization utilized during this study unchained muscular proteolysis prematurely, while also provoked acute responses in systems directly related to energy distribution. Such reactions can be measured by certain interleukins, especially the IL-6, which demonstrated an expressive variation during the experiemntal period. On the other hand, the neuromuscular electrical stimulation, when utilized prematurely, can diminish the occurance of some of these responses, minimizing the catabolic aspect induced by immobilization. Therefore, the results of this study indicate that theurapeutical or preventive actions over deleterious consequences of immobilization on organic systems should be adopted prematurely.
Doutor
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Barnes, Rachel. "The role of peroneal nerve electrical neuromuscular stimulation in the augmentation of lower limb circulatory physiology in lower limb arterial and venous disease." Thesis, University of Hull, 2015. http://hydra.hull.ac.uk/resources/hull:14057.
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Introduction: Studies in healthy volunteers have demonstrated that peroneal nerve stimulation augments blood flow. The studies described within this thesis aimed to establish whether use of the geko™ neuromuscular stimulation device was effective and augments arterial venous and microcirculatory flow in patients with lower limb arterial and venous disease. The fibrinolytic and angiogenic activity of electrical stimulation within this cohort was also examined. Methods: Ethical approval was obtained for all aspects of the described studies. Participants with claudication, varicose veins or post- operative infrainguinal bypass grafts were assigned to receive either unilateral active stimulation or sham. Duplex assessments of arterial and venous volume flow were performed at baseline and following stimulation. Laser Doppler flowmetry measurements of microcirculatory flow were made continuously throughout the study period. ELISA analysis was undertaken of plasma samples drawn at baseline and following stimulation to determine the effect on vascular endothelial growth factor(VEGF), tissue plasminogen activator(t-PA) and plasminogen activator inhibitor 1(PAI-1). Results: The geko™ device was effective at producing visible muscle contraction in only 59% patients tested due to a combination of oedema and neuropathy. 77 participants were recruited in total to either a proof of concept study or the initial phase of a randomised trial: 30 claudicants (25 active, 5 control), 25 post infrainguinal bypass (19 active, 6 control) and 22 varicose veins (17 active, 5 control). Arterial volume flow increased significantly in all patient groups receiving active stimulation: claudicants 60 ml/ min(P<0.001); infra-inguinal bypass grafts 70ml/min(P<0.001) and varicose veins 80 ml/min(P<0.001). Venous volume flow significantly increased in all patient groups: claudicants 30 ml/min(P=0.001); infra-inguinal bypass grafts 30 ml/min(P=0.004) and varicose veins 80 ml/min(P<0.001). Microcirculatory flow increased in all patient groups: claudicants 22.2 flux units(P<0.001); infra-inguinal bypass grafts 21.8 flux units(P<0.001) and varicose veins 28.4 flux units(P<0.001). ELISA analysis demonstrated no statistically significant change in VEGF or t-PA antigen levels when comparing the active with the passive and control limbs. Peroneal nerve stimulation in the active limbs resulted in a significant decrease in PAI-1 of 34 ng/ml(P<0.001). Conclusion: Transcutaneous peroneal nerve stimulation with the geko™ device is potentially beneficial in patients with lower limb arterial and venous disease. This is primarily due to its ability to augment venous, arterial and microcirculatory flow. The results of this study were influential in the NICE guidance approving its use in vascular patients as a means of DVT prophylaxis. The enhanced fibrinolytic effect, by decreasing levels of PAI-1, warrants further investigation.
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Souza, Marcial Zanelli de [UNESP]. "Interleucinas e perfil quimiometabólico músculo-esquelético de ratos com o membro posterior imobilizado e submetidos à estimulação elétrica neuromuscular." Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/100437.
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souza_mz_dr_rcla.pdf: 1750287 bytes, checksum: 1c591025405f7b78fb4b10883aebf64c (MD5)Universidade Estadual Paulista (UNESP)
O objetivo deste estudo foi analisar e quantificar a participação das interleucinas (IL-4, IL-6, IL-10 e TNF-alfa) em animais que tiveram uma pata imobilizada e eletroestimulada por 1, 2 e 3 dias consecutivos, analisando-se a repercussão da hipocinesia focal sobre o conteúdo das proteínas musculares, bem como sobre parâmetros metabólicos como glicemia, insulinemia, glicogênio muscular, ácidos graxos livres, ácido ascórbico da glândula adrenal e da enzima creatina quinase (CK). A estimulação elétrica neuromuscular (EE, F=10Hz, T=0,4ms, i=5mA, 20 minutos diariamente), foi aplicada ao membro posterior de ratos, nos músculos Gastrocnêmio e Sóleo. Assim, ratos machos Wistar foram divididos em 7 grupos: controles (C), imobilizados por 1 dia (I1), imobilizados e eletroestimulados por 1 dia (IE1), imobilizados por 2 dias (I2), imobilizados e eletroestimulados por 2 dias (IE2), imobilizados por 3 dias (I3) e imobilizados e eletroestimulados por 3 dias (IE3). A Imobilização foi realizada através de uma órtese confeccionada sob medida em resina acrílica, mantendo o membro em posição a 90º pelos respectivos períodos experimentais. Os resultados demonstraram que a imobilização monosegmentar utilizada neste estudo desencadeou precocemente a proteólise muscular, alem de provocar respostas agudas nos sistemas diretamente relacionados com o fornecimento energético. Tais reações podem ser mediadas por algumas interleucinas, sobretudo a IL-6, que apresentou expressiva variação durante os períodos experimentais. Por outro lado, a eletroestimulação neuromuscular utilizada precocemente pode atenuar algumas destas respostas, minimizando o aspecto catabólico induzido pela imobilização. Assim, os resultados deste estudo leva a sugestiva de que as ações terapêuticas ou preventivas sobre as conseqüências deletérias da imobilização sobre os sistemas orgânicos devem ser adotadas precocemente.
The objective of the study was to evaluate and quantilfy the participation of interleukins (IL-4, IL-6, IL-10, and TNF) in rats that underwent paw immobilization and electrical stimulation for 1, 2, and 3 consecutive days, while analyzing the local hypokinesia repercussion on muscular protein content, as well as metabolic parameters of glycemia, insulineamia, muscular glycogen, free fatty acids, ascorbic acid, and createne kinase enzime (CK). The neuromuscular electrical stimulation (EE, F=10Hz, T=0,4ms, i=5mA, 20 minutes daily) was applied to the hindlimb of the animas over the soleus and gastrocnemius muscles. In this manner, albino male Wistar rats were distributed into 7 experimental groups: control (C), immobilized 1 day (I1), immobilized 1 day and electrostimulated (IE1), immobilized 2 days (I2), immobilized 2 days and electrostimulated (IE2), immobilized 3 days (I3) and immobilized 3 days and electrostimulated (IE3). The immobilization of the animals was achieved by an acrylic resin orthesis model which maintained the limb in the position of 90º during the respective experimental periods. The results demonstrated that the mono-segmental immobilization utilized during this study unchained muscular proteolysis prematurely, while also provoked acute responses in systems directly related to energy distribution. Such reactions can be measured by certain interleukins, especially the IL-6, which demonstrated an expressive variation during the experiemntal period. On the other hand, the neuromuscular electrical stimulation, when utilized prematurely, can diminish the occurance of some of these responses, minimizing the catabolic aspect induced by immobilization. Therefore, the results of this study indicate that theurapeutical or preventive actions over deleterious consequences of immobilization on organic systems should be adopted prematurely.
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Park, Hyun-Joo. "Motion control of neuromuscular skeletal systems using a multiple contact nerve cuff electrode." Case Western Reserve University School of Graduate Studies / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1309506374.
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Prado, Thiago Alexandre. "Implementação de um controlador PID embarcado para o controle em malha fechada de um estimulador neuromuscular funcional /." Ilha Solteira : [s.n.], 2009. http://hdl.handle.net/11449/87062.
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Orientador: Aparecido Augusto de CarvalhoBanca: Erica Regina Marani Daruichi Machado
Banca: Ernane José Xavier da Costa
Resumo: Por décadas, a aplicação de Estimulação Elétrica Neuromuscular (EENM) em pacientes paraplégicos e hemiplégicos tem melhorado significativamente sua qualidade de vida. Entretanto, comercialmente, essa técnica é aplicada sem o uso de uma lei de controle em malha fechada, o que limita sua eficiência. Assim, neste trabalho, projetou-se e implementouse um controlador PID embarcado para o uso com estimuladores elétricos neuromusculares. O projeto desse controlador se baseou em um modelo matemático linear de segunda ordem, que representa o comportamento da força muscular devido a um estímulo elétrico. Posteriormente, desenvolveram-se algoritmos na linguagem de programação Python que possibilitam o projeto automático de controladores PID com diferentes especificações para diferentes pacientes. Dessa forma, o usuário informa os parâmetros do paciente e as especificações desejadas para obter a configuração do controlador PID adequada. Além disso, desenvolveuse um programa em linguagem C para o microcontrolador PIC18F4520 que implementa este controlador utilizando o seu conversor A/D interno de 10 bits e um conversor D/A externo de 10 bits. Este controlador pode ser configurado via comunicação serial de forma simples e rápida, permitindo alterar os parâmetros do controlador PID e o tempo de amostragem. Por fim, os resultados obtidos a partir da simulação deste sistema no ambiente Proteus provou a viabilidade do controlador PID projetado.
Abstract: For decades the quality of life of hemiplegic and patients with spinal cord injuries has been improving through the research and use of Neuromuscular Electrical Stimulation (NMES) in rehabilitation engineering. However, most of the times it has been used without closed loop techniques, which is the approach used in this project, where an embedded PID controller has been designed and implemented to control the NMES. The plant to be controlled, i.e., the behaviour of the muscle response to an electrical stimulus, was represented using a secondorder linear model. The language Python was then used to develop PID control algorithms allowing the use of different specifications so that the user can supply the patient parameters to properly configure the PID controller for different patients. Later, these algorithms were implement in a PIC18F4520 microcontroller using C language, exploiting its internal 10 bit A/D converter and an external 10 bit D/A. The final circuit can be configured serially via a PC, adjusting the controller parameters and the sampling rate. The whole system was simulated in the Proteus environment, proving its viability.
Mestre
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Pasturel, Solenn. "Assessing the efficacy of Neuromuscular Electrical Stimulation on Maximal Strength in Physical Education Students, Trained and Elite Athletes : A Review with a Systematic approach." Thesis, Högskolan i Halmstad, Biomekanik och biomedicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-26108.
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Background: Neuromuscular electrical stimulation (NMES) is increasingly being usedoutside the realms of physical therapy. Acknowledged as an efficient method to enhancestrength parameters, athletes are increasingly using NMES to facilitate training andstrength gains. A review was designed with a systematic approach with the mainobjective: to assess the effectiveness of transcutaneous NMES on maximal strength inphysical education students, trained and elite athletes in studies involving isometricNMES and Dynamic NMES. Method: A search for all types of trials was performed onPubmed, Sportdiscus, Web of Science Core Collection and The Cochrane ControlledTrials Register, and results were recorded according to the PRISMA recommendations.Twenty-one studies were included and judged for risk of bias and quality according tothe Cochrane guidelines and GRADE. Results: Studies were judged as having either anunclear or high risk of bias. All studies were judged as ‘very low level’ according toGRADE and were lacking bias-limiting methods, detailed information of interventionsand general standardised procedures. Conclusion: Strength gains in physical educationstudents, trained or elite athletes from a training intervention involving either isometricNMES combined with or without voluntary exercise or dynamic NMES are inconclusivedue to the very low level of the quality of the studies. Meta-analysis performed in thisarea should be interpreted with caution as the studies have been judged as eitherunclear or high risk of bias.Key words: isometric NMES (electrical stimulation applied to relaxed muscle), dynamicNMES (electrical stimulation superimposed onto voluntary contractions), strength.
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Man, Ivy Oi Wai. "Evaluation of three tools used to assess lower limb volume and the efficacy of neuromuscular electrical stimulation in the treatment of lower limb swelling." Thesis, King's College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.407822.
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Tancredo, Janaina Roland 1980. "Análise clínica e funcional da espasticidade antes e após a estimulação elétrica neuromuscular e marcha em esteira com EENM em lesados medulares." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313748.
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Orientador: Alberto Cliquet JuniorDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-19T19:00:11Z (GMT). No. of bitstreams: 1 Tancredo_JanainaRoland_M.pdf: 2653289 bytes, checksum: 0b7d643e5438e5de2faf4c696947403b (MD5) Previous issue date: 2012
Resumo: A lesão medular tem como uma de suas conseqüências a espasticidade, que está geralmente presente em lesões acima do último nível torácico (T12) e pode ser avaliada através de indicadores quantitativos e qualitativos. Na pesquisa, foram avaliados dois grupos, o da Estimulação Elétrica Neuromuscular (EENM), com dezesseis pacientes e o grupo da Marcha em Esteira com EENM com oito pacientes; todos com diagnóstico de paraplegia e tetraplegia com algum grau de espasticidade. Foram utilizadas para esta avaliação as escalas: modificada de Ashworth, a de espasmos musculares, a subjetiva da espasticidade e o teste pendular. Para aplicação do teste pendular foi utilizado o Dispositivo de Teste Pendular (DTP) - (equipamento que foi elaborado e construído especificamente para avaliar a espasticidade, que possui um acelerômetro de transdutores de cristais de quartzo e um eletrogoniômetro de fibra óptica flexível que medem as tensões e os deslocamentos angulares, respectivamente) do Laboratório de Biomecânica e Reabilitação do Aparelho Locomotor. Os pacientes do grupo da EENM realizaram EENM nos músculos quadríceps e nervo fibular, sendo que os testes foram aplicados antes e logo após o procedimento. O mesmo foi realizado para o grupo da Marcha em Esteira com EENM. Os dados mostraram uma diminuição da espasticidade nos dois grupos, representado no grupo da EENM por variações nos parâmetros F1Ang, F1 Amp, E1 Amp, Plat Amp e ERI e no parâmetro E1 Ang no grupo da marcha. O grupo da EENM onde foi subdividido (pacientes com e sem medicação) notamos uma diferença significativa no subgrupo sem medicação na maioria dos parâmetros avaliados. Já o subgrupo com medicação apenas os parâmetros On Ang e RI foram significativos. Além disso, os dados da escala subjetiva e da escala modificada de Ashworth, após a estimulação elétrica neuromuscular também apresentaram uma redução nos valores da espasticidade, sendo que no grupo da marcha em esteira apenas a escala subjetiva foi significativa
Abstract: Spinal cord injury has as one of its consequences the spasticity, which is usually present in lesions above the last thoracic level (T12) and it can be assessed through quantitative and qualitative indicators. In the study it was evaluated two groups: Neuromuscular Electrical Stimulation (NMES) group with sixteen patients and the group of eight patients that performed treadmill gait with partial body weigth support and NMES, all of them were diagnosed with paraplegia or tetraplegia with some degree of spasticity. The following scales were used for assessment: Modified Ashworth Scale, Muscle Spasms Scale, Subjective Scale of Spasticity and the pendulum test. For application of the pendulum test it was used Pendular Test Device (PTD) was used, this equipment was designed and built specifically to evaluate spasticity, which has an accelerometer of quartz crystals transducer and a flexible fiber optic electrogoniometer to measure the acceleration and angular displacement, respectively. The patients in the NMES group performed NMES in the quadriceps muscle and fibular nerve, and the tests were applied before and after the procedure. The same was done for the treadmill gait with NMES group. The data showed a decrease in spasticity in both groups, represented in the NMES group by changes in the F1Ang, F1Amp, E1Amp, Plat Amp and ERI parameters of the PTD and the gait group also presented a change in the E1Ang. In the group NMES, which was divided (patients with and without drugs), it was noticed a significant difference in the subgroup without medication in most parameters. However, in the subgroup with medication only the OnAng and RI parameters were significant. In addition, data from the Subjective Scale of Spasticity and the Modified Ashworth Scale also showed a reduction in the values in the spasticity, and in the group of treadmill gait just a Subjective Scale of Spasticity was significant
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
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Balog, Brian Michael. "Brain-Derived Neurotrophic Factor Mediates Recovery from Stress Urinary Incontinence." University of Akron / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=akron1602113592326106.
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Dambrauskaitė, Giedrė. "Kelio sąnario funkcijos atkūrimas taikant raumenų elektrostimuliaciją kineziterapijos metu ir prieš kineziterapijos procedūrą." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2013~D_20130614_131759-88439.
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Po priekinio kryžminio raiščio (PKR) rekonstrukcijos fizinio aktyvumo atgavimas trunka nuo 3 iki 12 mėnesių. Siekiant greitesnio kelio sąnario funkcijos atkūrimo, šiame darbe vertinamas dviejų skirtingų metodikų efektyvumas. Darbo tikslas – palyginti raumenų elektrostimuliacijos (RES), taikomos kineziterapijos metu ir prieš kineziterapijos procedūrą, poveikį kelio sąnario funkcijos atkūrimui po priekinio kryžminio raiščio rekonstrukcinės operacijos. Apžvelgus mokslinę literatūrą numatytą mokslinio darbo tikslą pasiekti buvo iškelti 3 uždaviniai. Pirmuoju uždaviniu siekiama įvertinti kelio sąnario funkcijos kitimą po priekinio kryžminio raiščio rekonstrukcinės operacijos taikant raumenų elektrostimuliaciją prieš kineziterapijos procedūras. Antrasis uždavinys skirtas įvertinti kelio sąnario funkcijos kitimą po priekinio kryžminio raiščio rekonstrukcinės operacijos taikant raumenų elektrostimuliaciją kineziterapijos procedūros metu. Trečiuoju uždaviniu siekiama palyginti kelio sąnario funkcijos atkūrimo pokytį po priekinio kryžminio raiščio rekonstrukcinės operacijos taikant raumenų elektrostimuliaciją kineziterapijos metu ir prieš kineziterapijos procedūrą.
Tyrimo metodai: 1. Judesių amplitudė per kelio sąnarį vertinta goniometrijos metodu.
2. Blauzdą lenkiančių ir tiesiančių raumenų jėga vertinta Medicininių tyrimų tarnybos skale. 3. Skausmo intensyvumui vertinti naudota Skaičių analoginė skausmo skalė. 4. Kelio sąnario funkcinė būklė vertinta Lysholm klausimynu. 5. Operuotos... [toliau žr. visą tekstą]After anterior cruciate ligament (ACL) reconstruction physical activity recovery lasts from 3 to 12 months. Seeking more rapid knee joint function recovery the effectiveness of two different methods are estimated in this research. The aim of the research is to compare the effectiveness of neuromuscular electrical stimulation (NMES) applied before and during physiotherapy procedure, as well as the effect of the knee joint function recovery after anterior cruciate ligament reconstruction. After review of scholarly literature there were 3 tasks set to reach the aim of the research. The first task is to estimate the changes in the knee joint function after anterior cruciate ligament reconstruction applying neuromuscular electrical stimulation before physiotherapy procedures. The second task is to estimate the changes in the knee joint function after anterior cruciate ligament reconstruction applying neuromuscular electrical stimulation during physiotherapy procedures. The third task is to compare the changes in the knee joint function applying neuromuscular electrical stimulation during physiotherapy and before physiotherapy procedure. The methods of the research: 1. The amplitude of the knee joint movements is estimated by goniometry method. 2. The force of the calf flexor and extensor muscles is estimated by Medical Research Council scale. 3. The intensity of the pain is estimated by Numeric Rating Scale. 4. The knee joint function is assessed by Lysholm knee questionnaire. 5... [to full text]
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Bochkezanian, Vanesa. "Effect of a neuromuscular electrical stimulation muscle strength training intervention on muscle force and mass, physical health and quality of life in people with spinal cord injury." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2017. https://ro.ecu.edu.au/theses/1994.
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Spinal cord injury (SCI) leads to significant deficits in muscle strength and mass, impacting negatively on physical health and quality of life (QoL). Physical rehabilitation techniques for people with SCI rely on constant updates and the accumulation of evidence regarding the efficacy of available and/or new physical interventions. Neuromuscular electrical stimulation (NMES) is already commonly used to activate skeletal muscles and subsequently reverse muscle atrophy, however NMES as a high-intensity “strength training” intervention appears to be a particularly promising technique for increasing muscle strength and mass and to subsequently improve physical health and quality of life (QoL) in people with SCI. Nonetheless, there are many factors limiting the use of standard NMES protocols, and further evidence pertaining to the use of high-intensity NMES strength training in clinical populations is warranted. The primary aim of the research described in this thesis was to examine the effects of NMES as a high-intensity muscle strength training intervention, specifically using wide-pulse width (1000 μs), low-to-moderate frequency (30 Hz) NMES combined with tendon vibration, on muscle strength and mass, physical health, symptoms of spasticity and QoL in people with SCI. This thesis includes two cross-sectional studies examining the effects of patellar tendon vibration (55 Hz, 7 mm amplitude) superimposed onto wide-pulse width (1000 μs) NMES (e.g. 30 Hz over 2 s) on the peak muscular (knee extensor) force and total impulse elicited by, and rate of recovery from, the intervention in healthy subjects (Study 1) and in people with chronic SCI (Study 2). The results of Study 1 revealed that superimposing tendon vibration onto wide-pulse width NMES leads to an increase in the muscle work performed before fatigue in only some individuals (i.e. positive responders, 50% of individuals in the current study), but decreases it in others (i.e. negative responders). However, it tends to reduce the voluntary force loss that was consistently experienced after a training session using high-intensity NMES, and may thus allow for additional exercise or rehabilitation work to be performed without ongoing voluntary muscle fatigue in healthy people. The results of Study 2 also identified positive and negative responders to tendon vibration in people with SCI, however the responses were less clear and a defined effect of tendon vibration superimposed onto NMES was not discerned. In Study 3, a 12-week (twice-weekly) high-intensity NMES strength training intervention was implemented in people with chronic SCI; based on results of Study 2, high-force contractions were evoked by NMES without superimposed tendon vibration. A significant increase in muscle mass (45%) and strength (tetanic evoked force; 31.8%), amelioration of spasticity symptoms, and improvement in some aspects of physical health and QoL were observed. Therefore, the use of high-intensity NMES strength training appears to be an effective rehabilitation tool to increase muscle force and mass, ameliorate symptoms of spasticity and improve physical and mental health outcomes in people with SCI.
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Melo, Mônica de Oliveira. "Estimulação elétrica neuromuscular e laserterapia de baixa potência : uso combinado para o tratamento da osteoartrite de joelho em idosos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/93386.
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A estimulação elétrica neuromuscular e a laserterapia de baixa potência têm se mostrado isoladamente efetivas no tratamento da osteoartrite de joelho. A estimulação elétrica neuromuscular parece contribuir com a restauração da força e estrutura do músculo quadríceps femoral, enquanto que a laserterapia parece ser efetiva no controle do processo inflamatório e da dor, bem como na regeneração da cartilagem. A hipótese de que a adição da laserterapia à estimulação elétrica neuromuscular poderia reduzir a dor articular associada à inflamação e consequentemente potencializar os efeitos da estimulação elétrica sobre o sistema muscular motivou a realização do presente estudo. O tema da presente tese de Doutorado é o uso combinado da estimulação elétrica neuromuscular e da laserterapia de baixa potência no tratamento da osteoartrite de joelho em idosos: efeitos sobre parâmetros neuromusculares e funcionais. No Capítulo I, um estudo de revisão sistemática classificou os níveis de evidência científica sobre a efetividade da estimulação elétrica neuromuscular no fortalecimento do quadríceps de idosos com osteoartrite de joelho. Após busca sistematizada nas bases de dados, 9 estudos contemplaram os critérios de inclusão e foram incluídos na revisão. Os resultados principais indicam que existe moderada evidência científica a favor do uso da estimulação elétrica neuromuscular sozinha ou combinada com exercício para o fortalecimento muscular isométrico do quadríceps em idosos com OA de joelho. Apesar dos resultados promissores da estimulação elétrica neuromuscular sobre a força, faltam dados na literatura sobre seus efeitos sobre a massa muscular. Além disso, não foram encontrados estudos sobre o potencial do efeito combinado da laserterapia e estimulação elétrica no tratamento da osteoartrite. Para preencher essa lacuna na literatura, dois estudos originais foram desenvolvidos para verificar: (1) a adaptação neuromuscular e funcional dos extensores de joelho de idosos com osteoartrite à estimulação elétrica neuromuscular em combinação à laserterapia de baixa potência (Capítulo II); e (2) as adaptações na arquitetura do principal extensor de joelho e na capacidade funcional de idosos decorrentes do uso combinado da estimulação elétrica neuromuscular e da laserterapia de baixa potência (Capítulo III). Quarenta e cinco idosas com osteoartrite de joelho foram submetidas a um período controle de quatro semanas sem intervenção seguido por um período de oito semanas de intervenção ou com estimulação elétrica neuromuscular, ou com laserterapia ou com estimulação elétrica neuromuscular em adição à laserterapia. Avaliações de torque, eletromiografia, ultrassonografia e testes funcionais foram realizados antes e após o período controle, assim como após de oito semanas de intervenção. Questionário específico sobre a funcionalidade de idosos com osteoartrite foi aplicado antes e depois das intervenções. As três intervenções geraram aumentos no torque, na ativação muscular, bem como melhorias na funcionalidade. Os valores de espessura muscular, área de secção transversa anatômica e ângulo de penação aumentaram após os tratamentos com estimulação elétrica neuromuscular, mas não com laserterapia. Nossos achados sugerem que: (1) a estimulação elétrica sozinha ou combinada à laserterapia é igualmente efetiva para gerar adaptações neuromusculares e funcionais; (2) a estimulação elétrica sozinha ou combinada gera aumentos no ângulo de penação e na espessura muscular, mas não no comprimento fascicular; (3) o ganho de força obtido pela estimulação elétrica é desproporcional aos incrementos neurais e morfológicos; (4) a laserterapia sozinha é capaz de melhorar a funcionalidade do idoso provavelmente por meio da redução da dor e do aumento da ativação muscular; (5) o uso de programa de estimulação elétrica neuromuscular com intensidades e volumes progressivos é efetivo na promoção da hipertrofia muscular; (6) a laserterapia não potencializa os efeitos da estimulação elétrica neuromuscular sobre os parâmetros neuromusculares e funcionais.Neuromuscular electrical stimulation alone and low-level laser therapy alone have been effective in the treatment of knee osteoarthritis. Neuromuscular electrical stimulation seems to contribute to the reestablishment of strength and structure in the quadriceps muscle, whereas low-level laser therapy seems to contribute to the reduction of the pain and of the inflammatory process and to the promotion of cartilage regeneration. The hypothesis that the association of low-level laser therapy with neuromuscular electrical stimulation could reduce joint pain associated with the inflammation and consequently potentiates the effects of electrical stimulation on the muscular system motivated the present study. The theme of this PhD thesis is the combined use of neuromuscular electrical stimulation and low-level laser therapy in the treatment of knee osteoarthritis in the elderly: effects on neuromuscular and functional parameters. In Chapter I, a systematic review rated levels of scientific evidence on the effectiveness of neuromuscular electrical stimulation on quadriceps strengthening in elderly with knee osteoarthritis. After systematic search in databases, 9 studies contemplated the inclusion criteria and were included in the review. The main results indicate that there is moderate scientific evidence in favour the use of neuromuscular electrical stimulation alone or combined with exercise to strengthen the quadriceps muscle in elderly with knee osteoarthritis. Despite the promising results of neuromuscular electrical stimulation on strength, data are lacking in the literature about its effects on muscle mass. Moreover, no studies were found on the potential effect of the combination of low-level laser therapy and neuromuscular electrical stimulation in the treatment of osteoarthritis. To fill this gap, two original studies were developed to verify: (1) neuromuscular and functional adaptation of knee extensors in elderly patients with osteoarthritis to neuromuscular electrical stimulation in combination with low-level laser therapy (Chapter II); and (2) the changes in the architecture of the vastus lateralis muscle and in the functional ability of elderly patients with osteoarthritis to the combined use of neuromuscular electrical stimulation and low-level laser therapy (Chapter III). Forty-five elderly female individuals with knee osteoarthritis were submitted to a four-week control period with no intervention followed by an eight-week period of intervention with neuromuscular electrical stimulation, low-level laser therapy, or neuromuscular electrical stimulation in combination with low-level laser therapy. Knee extensor evaluations of torque, electromyography, ultrasonography and functional tests were performed before and after the control period as well as after eight weeks of intervention. Questionnaire regarding the functionality of elderly patients with osteoarthritis was applied before and after interventions. The three interventions generated increases in torque, muscle activation, as well as improvements in functionality. The values of muscle thickness, anatomical cross-sectional area and pennation angle increased after treatment with neuromuscular electrical stimulation, but not with low-level laser therapy. Our findings suggest that: (1) electrical stimulation alone or combined with laser therapy is equally effective to generate neuromuscular and functional adaptations; (2) electrical stimulation alone or combined with laser therapy increases pennation angle and muscle thickness, but not fascicle length; (3) gain strength obtained by the electrical stimulation is disproportionate to increases in neural and morphological parameters; (4) low-level laser therapy alone is able to improve the elderly functionality; (5) the use of neuromuscular electrical stimulation with increasing intensities and progressive volumes is effective in promoting muscle hypertrophy; (6) low-level laser therapy does not potentiate the effects of neuromuscular electrical stimulation on neuromuscular and functional parameters.
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Maloy, Lucia. "Comparison of Single-Use and Multiple-Use Electrodes for Sensory, Motor Threshold Amplitudes and Force Production." BYU ScholarsArchive, 2009. https://scholarsarchive.byu.edu/etd/1995.
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Context: Electrodes play an important role in interfacing tissue with electrical stimulation devices. Manufacturers recommend that adhesive metallic mesh cloth electrodes be used no more than 10 times before they are discarded, however, clinically the electrodes are often used up to 30 times. Another concern is sanitation. When electrodes are used on different patients, there is a chance for cross-contamination and bacterial growth on the electrode. Objective: To compare amplitudes of perceived sensation, motor twitch and force produced at specific amplitudes using single-use electrodes that run no risk of cross-contamination, and multiple-use electrodes. Design: Mixed model ANOVA with the subject blocked. Setting: Therapeutic modalities research laboratory. Patients or Other Participants: 20 subjects comprised of 7 males (age 24.7 yrs ± 2.3 yrs, skin fold thickness 5.9 mm ± 2.4 mm) and 13 females (age 21.5 yrs ± 2.3 yrs, skin fold thickness 10.7 mm ± 4.1 mm) recruited by volunteer sample mainly from athletic and athletic training populations. They drew random numbers to determine which group they were assigned to. Interventions: Each subject had electrodes placed on their wrist extensors muscles. Measures were recorded of what intensity it took to achieve perceived sensation, motor twitch, and force produced at a specific intensity. To determine decay, multiple use electrodes were tested initially and on the 10th use. After the multiple use electrodes were tested initially, they were leached out. After eight uses, pretest procedures were repeated (10th use electrode) as the final trial on the subjects. Single use electrodes were tested one time. Main Outcome Measures: The dependent variables were sensation, motor twitch and force production. The experiment was a repeated measures study, using mixed models ANOVA with subjects blocked. Alpha was set at p<0.05. Data was analyzed using a SAS proc mixed 9.1. Results: There was no statistical difference between the measures taken during the initial trial and final trial of the multiple use electrodes for muscle twitch (FMUI MUF muscle twitch= 107.3, p= 0.09) and force production (FMUI MUF force production=28.7, p= 0.11). There was a significant difference between the single use and the multiple use electrodes for the initial and final trial. Average values in mA for perceived sensory were: single use 9.73, multiple use initial 16.70 , multiple use final 21.03; observed muscle twitch: single use 15.87, multiple use initial 29.16, multiple use final 31.78; and force produced: single use 22.8 Newtons, multiple use initial 10.0 Newtons, multiple use final 5.0 Newtons. Conclusion: Single-use electrodes produce more conductive power with fewer milliamps compared to multiple-use electrodes. Single use electrodes are just as, or more efficient as the multiple use electrodes and have the added advantage of eliminating the possibility of cross-contamination of bacteria from patient to patient.
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Stevens, Timothy. "Rehab Tracker: Framework for Monitoring and Enhancing NMES Patient Compliance." ScholarWorks @ UVM, 2019. https://scholarworks.uvm.edu/graddis/1001.
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We describe the development of a cyber-physical system (Rehab Tracker) for improving patient compliance with at-home physical rehabilitation using neuromuscular electrical stimulation (NMES) therapy. Rehab Tracker consists of three components: 1) hardware modifications to sense and store use data from an FDA-approved NMES therapy device and provide Bluetooth communication capability, 2) an iOS-based smartphone/tablet application to receive and transmit NMES use data and serve as a conduit for patient-provider interactions and 3) a back-end server platform to receive device use data, display compliance data for provider review and provide automated positive and remedial push notifications to patients to improve compliance. This system allows for near real-time compliance monitoring via a secure web portal and offers a novel conduit for patient-provider communication during at-home rehabilitation to improve compliance. The system was tested in patients (n=5) who suffered anterior cruciate ligament rupture and surgical repair to provide proof-of-principal evidence for system functionality and an initial assessment of system usability. The system functioned as designed, recording 89% of rehabilitation sessions. Thus, Rehab Tracker is a functionally correct system with the potential to be used as a tool for studying NMES and mobile communication methodologies at scale and improving compliance with at-home rehabilitation programs.
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Krueger, Eddy. "Detecção de fadiga neuromuscular em pessoas com lesão medular completa utilizando transformada wavelet." Universidade Tecnológica Federal do Paraná, 2014. http://repositorio.utfpr.edu.br/jspui/handle/1/961.
Full textAbstract:
CNPqIntrodução: As pessoas com lesão medular (LM) podem ter seus músculos paralisados ativados por meio da estimulação elétrica funcional (FES) sobre vias neurais presentes próximas à pele. Estas estimulações elétricas são importantes para a recuperação do trofismo neuromuscular ou durante o controle de movimento por próteses neurais. No entanto, ao longo da aplicação da FES, a fadiga ocorre, diminuindo a eficiência da contração, principalmente devido à hipotrofia neuromuscular presente nessa população. A aquisição da vibração das fibras musculares como indicador de fadiga é registrada por meio da técnica de mecanomiografia (MMG), que não sofre interferências elétricas decorrentes da aplicação da FES. Objetivo: Caracterizar a vibração do músculo reto femoral durante protocolo de fadiga neuromuscular eletricamente evocada em pessoas com lesão medular completa. Método: 24 membros (direito e esquerdo) de 15 participantes (idade: 27±5 anos) do sexo masculino (A e B na American Spinal Injury Impairment Scale) foram selecionados. Um estimulador elétrico operando como fonte de tensão, desenvolvido especialmente para pesquisa, foi configurado com: freqüência de pulso em 1 kHz (20% de ciclo de trabalho) e trem de pulsos (modulação) em 70 Hz (20% período ativo). O sinal triaxial [X (transversal), Y (longitudinal) e Z (perpendicular)] da MMG foi processado com filtro Butterworth de terceira ordem e banda passante entre 5 e 50 Hz. Previamente ao protocolo, a tensão de saída do estimulador foi incrementada (~3 V/s evitando-se a adaptação/habituação dos motoneurônios) até alcançar a extensão máxima eletricamente estimulada (EMEE) da articulação do joelho. Uma célula de carga foi usada para registrar a resposta de força, onde após a sua colocação, a intensidade da FES necessária para alcançar a EMEE foi aplicada e registrada pela célula de carga como 100% da força (F100%). Durante o protocolo de fadiga neuromuscular, a intensidade do estímulo foi incrementada durante o controle para manter a força em F100%. Quatro instantes (I - IV) foram selecionados entre F100% e a incapacidade da FES manter a resposta de força acima de 30% (F30%). O sinal foi processado nos domínios temporal (energia), espectral (frequência mediana) e wavelet (temporal-espectral com doze bandas de frequência entre 5 e 53 Hz). Os dados extraídos foram normalizados pelo instante inicial (I) gerando unidades arbitrárias (u.a.), e testados com estatística não paramétrica. Resultados: A frequência mediana não apresentou significância estatística. Em relação aos eixos de deslocamento da MMG, o eixo transversal mostrou o maior número de resultados estatisticamente significantivos. A energia da vibração das fibras musculares (domínio temporal) indicou diminuição entre os instantes I (músculo fresco) e II (pré-fadiga), como também entre os instantes I e IV (fadigado) com redução significativa. O domínio wavelet teve como foco o eixo transversal, especialmente as bandas de frequência de 13, 16, 20, 25 e 35 Hz, por terem indicado redução significativa durante a fadiga neuromuscular; principalmente, a banda de 25 Hz, que indicou redução significativa entre o instante I (valor da mediana dos dados de 0,53 u.a.) e os demais instantes [II (0,30 u.a), III (0,28 u.a.) e IV (0,24 u.a.)]. Conclusão: A fadiga neuromuscular é caracterizada pela redução da energia do sinal no eixo de deslocamento transversal (X) da vibração do músculo reto femoral, em pessoas com lesão medular completa, tanto no domínio temporal quanto principalmente no domínio wavelet, sendo a banda de frequência de 25 Hz a mais relevante, porque sua energia diminui com a ocorrência da fadiga neuromuscular. Estes achados abrem a possibilidade de aplicação em sistemas de malha fechada durante procedimentos de reabilitação física utilizando FES ou no controle de próteses neurais.
Introduction: People with spinal cord injury (SCI) may have the paralyzed muscles activated through functional electrical stimulation (FES) on neural pathways present below the skin. These electrical stimulations are important to restore the neuromuscular trophism or during the movement control using neural prostheses. However, prolonged FES application causes fatigue, which decreases the contraction strength, mainly due the neuromuscular hypotrophy in this population. The acquisition of myofibers’ vibration is recognized by mechanomyography (MMG) system and does not suffer electrical interference from the FES system. Objective: To characterize the rectus femoris muscle vibration during electrically evoked neuromuscular fatigue protocol in complete spinal cord injury subjects. Methods: As sample, 24 limbs (right and left) from 15 male participants (age: 27±5 y.o.) and ranked as A and B according to American Spinal Injury Impairment Scale) were selected. An electrical stimulator operating as voltage source, specially developed for research, was configured as: pulse frequency set to 1 kHz (20% duty cycle) and burst (modulating) frequency set to 70 Hz (20% active period). The triaxial [X (transverse), Y (longitudinal) and Z (perpendicular)] MMG signal of rectus femoris muscle was processed with a third-order 5-50 Hz bandpass Butterworth filter. A load cell was used to register the force. The stimulator output voltage was increased (~3 V/s to avoid motoneuron adaptation/habituation) until the maximal electrically-evoked extension (MEEE) of the knee joint. After the load cell placement, the stimuli magnitude required to reach MEEE was applied and registered by the load cell as muscular F100% response. Stimuli intensity was increased during the control to keep the force in F100%. Four instants (I - IV) were selected from F100% up to the inability to keep the FES response force above 30% (F30%). The signal was processed in temporal (energy), spectral (median frequency) and wavelet (temporal-spectral with twelve band frequencies between 5 and 53 Hz) domains. All data were normalized by initial instant, creating arbitrary units (a.u.), and non-parametric tests were applied. Results: The median frequency did not show statistical significance. Regarding the MMG axes, the transverse axis showed most statistical differences. The MMG energy (temporal domain) indicates the decrease between the instants I (unfatigued) and II (pre-fatigue), as well as instants I and IV (fatigued). The wavelet domain focused on the transverse axis, especially on 13, 16, 20, 25 and 35 Hz frequency bands, for having shown significant reduction proven during neuromuscular fatigue. In focus on 25 Hz band frequency that showed a constant decrease between instants I (median value from data de 0.53 a.u.) with subsequent instants [II (0.30 a.u.), III (0.28 a.u.) and IV (0.24 a.u.). Conclusion: Neuromuscular fatigue is characterized by energy decrease in MMG X-axis (transverse) signal of vibration on the rectus femoris muscle for complete spinal cord injured subjects, in the temporal domain but mainly in the wavelet domain. The 25 Hz is the most important band frequency because its energy decreases with neuromuscular fatigue. These findings open the possibility of application in closed-loop systems during physical rehabilitation procedures using FES or in the control of neural prostheses.