Bellew James W, Allen Molly, Biefnes Austin, Grantham Sara, Miglin James, Swartzell Dylan
a Krannert School of Physical Therapy , University of Indianapolis , Indianapolis , IN , USA.
Physiother Theory Pract. 2018 Jul;34(7):551-558. doi: 10.1080/09593985.2017.1422820. Epub 2018 Jan 8.
Efficacy of neuromuscular electrical stimulation (NMES) is limited by the discomfort of electrically elicited contractions. Most studies of tolerance to NMES have examined stimulation to maximal tolerance. NMES efficiency is the amount of elicited force at a specific level of tolerance. This study is the first to describe and examine such.
A repeated measures design was used. Electrically elicited force (EEF) was measured using three waveforms: burst-modulated alternating current (BMAC), pulsed current (PC), and burst-modulated pulsed current (BMPC). EEF at a tolerance rating of 5/10 on a visual analog scale (VAS) was recorded. The dependent variables were EEF up to 5/10 VAS, current amplitude at 5/10, and percent maximal isometric force at 5/10.
EEF and percent maximal voluntary isometric force were significantly greater with BMPC versus BMAC (p = 0.001 and 0.004). No differences were noted between PC and BMAC or BMPC and PC. Amplitude was significantly greater with BMAC compared to BMPC and PC (p = 0.003 and 0.015). No difference in amplitude was noted between PC and BMPC.
For the same level of discomfort, BMPC yielded one-third greater muscle force than BMAC and at a lesser current amplitude. These data evidence a greater efficiency for BMPC than BMAC.
神经肌肉电刺激（NMES）的疗效受电诱发收缩不适的限制。大多数关于NMES耐受性的研究都考察了刺激至最大耐受程度的情况。NMES效率是指在特定耐受水平下诱发的力量大小。本研究首次对此进行描述和考察。
采用重复测量设计。使用三种波形测量电诱发力量（EEF）：爆发调制交流电（BMAC）、脉冲电流（PC）和爆发调制脉冲电流（BMPC）。记录视觉模拟量表（VAS）上耐受等级为5/10时的EEF。因变量为VAS达到5/10时的EEF、5/10时的电流幅度以及5/10时的最大等长力量百分比。
与BMAC相比，BMPC的EEF和最大自主等长力量百分比显著更高（p = 0.001和0.004）。PC与BMAC或BMPC与PC之间未观察到差异。与BMPC和PC相比，BMAC的幅度显著更大（p = 0.003和0.015）。PC与BMPC之间的幅度无差异。
在相同不适程度下，BMPC产生的肌肉力量比BMAC大1/3，且电流幅度更小。这些数据证明BMPC比BMAC效率更高。
