Nonlinear muscle recruitment during intramuscular and nerve stimulation.

Future progress in neuromuscular prostheses will depend on developing techniques for stimulating paralyzed muscle, especially utilizing neuromuscular stimulation. We have found nonlinear force versus stimulus amplitude characteristic (recruitment) curves in the gastrocnemius-soleus-plantaris muscle group of the cat in response to stimulation of the tibial nerve near the muscle entry point. Such response characteristics are undesirable in neuromuscular control systems. Nonlinear recruitment curves usually consisted of two regions in which force increased linearly with stimulus amplitude, separated by a "plateau" region in which force was relatively constant. The two linear regions were associated with activation of separate neuromuscular compartments (lateral or medial gastrocnemius, plantaris, soleus, or subdivisions of those muscles). When the stimulated myoelectric responses from these compartments were plotted versus stimulus amplitude, the region of recruitment between threshold and saturation often did not appreciably overlap for different compartments, suggesting that the axons innervating those compartments were physically segregated within the nerve from axons innervating other compartments. Correlation coefficients between force and stimulated myoelectric response were very high (up to R2 = 0.99) when using a composite curve produced by averaging myoelectric response curves recorded from each of the active compartments. By dividing the tibial nerve into its component bundles or fascicles and stimulating each in turn, it was possible to show that individual bundles innervate non-overlapping groups of muscle compartments, and that recruitment of the nerve bundles over different threshold ranges could account for the nonlinear force/stimulus response curves initially observed. The presence of separate innervation of muscles or compartments by fascicles should be an important factor in designing functional neuromuscular stimulation (FNS) systems.