Predicting optimal electrical stimulation for repetitive human muscle activation.

Functional electrical stimulation is the use of electrical currents to activate paralyzed muscles to produce functional movements. Muscle force output must meet or exceed the external load to maintain a posture or produce movements. A mathematical force-fatigue modeling system that predicts muscle force responses during repetitive electrical stimulation has been developed in our laboratory to help identify stimulation patterns that optimize force output for individual subjects. This study tests how well this model predicts the number of contractions that can be maintained above a required force level (successful contractions) during repetitive activation of a muscle. Healthy human quadriceps muscles were tested isometrically on 12 subjects. Data were first collected and used to parameterize the model. Next, the model was used to predict the number of successful contractions that were produced by trains with frequencies ranging from 5 to 100 Hz while the pulse durations and amplitudes were held constant. Finally, three clinically relevant stimulation frequencies were selected and tested to verify the model's predictions. Under these conditions, the model accurately predicted the number of successful contractions for clinically relevant stimulation frequencies. Furthermore, the model appears to have the potential to identify the stimulation frequency that maximizes muscle force output and minimizes fatigue for each subject.