J Sport Rehabil. 2022 Feb 8;31(5):554-561. doi: 10.1123/jsr.2021-0326. Print 2022 Jul 1.
When emphasizing muscular strength during postoperative rehabilitation it is recommended to use a neuromuscular electrical stimulation (NMES) waveform that elicits the greatest muscle force and local metabolic demand that is also well tolerated. The present investigation examined the effects that 3 different clinically used NMES waveforms had on the electrically elicited force (EEF), local metabolic demand (exercising muscle oxygen saturation [SmO2]), and the subsequent reactive hyperemia response (recovery total hemoglobin concentration [THb]) of the knee extensors.
Single session repeated-measures design.
EEF, local metabolic demand, and reactive hyperemia responses were measured during and subsequent to 3 NMES waveforms: Russian burst modulated alternating current (RUS), biphasic pulsed current (VMS™), and burst modulated biphasic pulsed current (VMS-Burst™). Exercising SmO2 and recovery THb were assessed noninvasively using a near-infrared spectroscopy sensor placed on the vastus lateralis. Participants completed one set of 10 repetitions of each NMES waveform and were provided with 5 minutes of passive, interset recovery. Two-way, repeated-measures analysis of variance examined if NMES waveform or repetition significantly affected (P < .05) EEF or exercising SmO2. Two-way, repeated-measures analysis of variance examined if NMES waveform or recovery time affected recovery THb.
VMS™ and VMS-Burst™ yielded higher EEF (F = 11.839, P < .001) and greater local metabolic stress (lower exercising SmO2, F = 13.654, P < .001) compared with RUS. Greater rate of EEF decline throughout the NMES set was observed during RUS (%Δ = -50 [6] %Rep1) compared with VMS-Burst™ (%Δ = -30 [7] %Rep1) and VMS™ (%Δ = -32 [7] %Rep1). VMS™ elicited a higher reactive hyperemia response (higher recovery THb) compared with RUS (F = 3.427, P = .048).
The present findings support the use of VMS™ or VMS-Burst™ compared with RUS when promoting muscular strength. In addition, the use of VMS™ might provide a greater blood volume to the target muscle subsequent to NMES contractions compared with RUS.
在术后康复中强调肌肉力量时，建议使用能产生最大肌肉力量和局部代谢需求的神经肌肉电刺激（NMES）波形，且该波形应具有良好的耐受性。本研究旨在探究 3 种不同临床应用的 NMES 波形对膝关节伸肌的电诱发力（EEF）、局部代谢需求（运动肌肉氧饱和度 [SmO2]）和随后的反应性充血反应（恢复总血红蛋白浓度 [THb]）的影响。
单次会话重复测量设计。
在 3 种 NMES 波形（俄罗斯爆发调制交流电 [RUS]、双相脉冲电流 [VMS™]和爆发调制双相脉冲电流 [VMS-Burst™]）期间和之后测量 EEF、局部代谢需求和反应性充血反应。使用放置在股外侧肌上的近红外光谱传感器无创评估运动 SmO2 和恢复 THb。参与者完成了 10 次重复的每种 NMES 波形，每组之间有 5 分钟的被动间歇恢复。采用双向重复测量方差分析检验 NMES 波形或重复是否显著影响（P <.05）EEF 或运动 SmO2。采用双向重复测量方差分析检验 NMES 波形或恢复时间是否影响恢复 THb。
与 RUS 相比，VMS™和 VMS-Burst™产生了更高的 EEF（F = 11.839，P <.001）和更大的局部代谢应激（更低的运动 SmO2，F = 13.654，P <.001）。与 VMS-Burst™（%Δ = -30 [7] %Rep1）和 VMS™（%Δ = -32 [7] %Rep1）相比，RUS 组在整个 NMES 过程中 EEF 下降速度更快（%Δ = -50 [6] %Rep1）。与 RUS 相比，VMS™ 诱发的反应性充血反应（更高的恢复 THb）更高（F = 3.427，P =.048）。
本研究结果支持在促进肌肉力量时使用 VMS™ 或 VMS-Burst™ 代替 RUS。此外，与 RUS 相比，VMS™ 在 NMES 收缩后可能会向目标肌肉提供更大的血容量。
