Glaviano Neal R, Langston William T, Hart Joseph M, Saliba Susan
Exercise and Sport Injury Laboratory, University of Virginia, Charlottesville, VA USA.
Int J Sports Phys Ther. 2014 Dec;9(7):915-23.
Neuromuscular Electrical Stimulation is a common intervention to address muscle weakness, however presents with many limitations such as fatigue, muscle damage, and patient discomfort that may influence its effectiveness. One novel form of electrical stimulation purported to improve neuromuscular re-education is Patterned Electrical Neuromuscular Stimulation (PENS), which is proposed to mimic muscle-firing patterns of healthy individuals. PENS provides patterned stimulating to the agonist muscle, antagonist muscle and then agonist muscle again in an effort to replicate firing patterns.
The purpose of this study was to determine the effect of a single PENS treatment on knee extension torque and quadriceps activation in individuals with quadriceps inhibition.
18 subjects (10 males and 8 females: 24.2±3.4 years, 175.3±11.8cm, 81.8±12.4kg) with a history of knee injury/pain participated in this double-blinded randomized controlled laboratory trial. Participants demonstrated quadriceps inhibition with a central activation ratio of ≤90%. Maximal voluntary isometric contraction of the quadriceps and central activation ratio were measured before and after treatment. The treatment intervention was a 15-minute patterned electrical stimulation applied to the quadriceps and hamstring muscles with a strong motor contraction or a sham group, who received an identical set up as the PENS group, but received a 1mA subsensory stimulation. A 2×2 (group × time) ANCOVA was used to determine differences in maximal voluntary isometric contraction and central activation ratio between groups. The maximal voluntary isometric contraction was selected as a covariate due to baseline differences.
There were no differences in change scores between pre- and post-intervention for maximal voluntary isometric contraction: (PENS: 0.09±0.32Nm/kg and Sham 0.15±0.18Nm/kg, p=0.713), or central activation ratio:(PENS: -1.22±6.06 and Sham: 1.48±3.7, p=0.270).
A single Patterned Electrical Neuromuscular Stimulation treatment did not alter quadriceps central activation ratio or maximal voluntary isometric contraction. Unlike other types of muscle stimulation, PENS did not result in a reduction of quadriceps torque.
Level III.
神经肌肉电刺激是一种用于解决肌肉无力问题的常见干预措施，但存在许多局限性，如疲劳、肌肉损伤和患者不适等，这些可能会影响其效果。一种据称可改善神经肌肉再训练的新型电刺激形式是模式化神经肌肉电刺激（PENS），它旨在模仿健康个体的肌肉放电模式。PENS对主动肌、拮抗肌然后再次对主动肌进行模式化刺激，以复制放电模式。
本研究的目的是确定单次PENS治疗对股四头肌抑制个体的膝关节伸展扭矩和股四头肌激活的影响。
18名有膝关节损伤/疼痛史的受试者（10名男性和8名女性：年龄24.2±3.4岁，身高175.3±11.8厘米，体重81.8±12.4千克）参与了这项双盲随机对照实验室试验。参与者表现出股四头肌抑制，中枢激活率≤90%。在治疗前后测量股四头肌的最大自主等长收缩和中枢激活率。治疗干预是对股四头肌和腘绳肌进行15分钟的模式化电刺激，伴有强烈的肌肉收缩，或者是假刺激组，该组接受与PENS组相同的设置，但接受1毫安的阈下刺激。使用2×2（组×时间）协方差分析来确定两组之间最大自主等长收缩和中枢激活率的差异。由于基线差异，选择最大自主等长收缩作为协变量。
干预前后最大自主等长收缩的变化分数没有差异：（PENS组：0.09±0.32牛米/千克，假刺激组：0.15±0.18牛米/千克，p = 0.713），或者中枢激活率也没有差异：（PENS组：-1.22±6.06，假刺激组：1.4（此处原文有误，应为1.48）±3.7，p = 0.270）。
单次模式化神经肌肉电刺激治疗并未改变股四头肌中枢激活率或最大自主等长收缩。与其他类型的肌肉刺激不同，PENS并未导致股四头肌扭矩降低。
三级。
