Yuan Rui, Zheng Yang, Shin Henry, Xu Guanghua, Fan Shengnuo, Du Zhanhong
Institute of Engineering and Medicine Interdisciplinary Studies, State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China.
School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, People's Republic of China.
J Neuroeng Rehabil. 2025 Jun 2;22(1):125. doi: 10.1186/s12984-025-01658-0.
BACKGROUND: Transcutaneous peripheral nerve electrical stimulation using high-frequency pulse clusters has been shown to relieve muscle fatigue, though its efficacy remains limited. Furthermore, this approach tends to exacerbate pain during stimulation, which constrains its clinical applications. This paper proposed a novel stimulation waveform to reduce muscle fatigue and the discomfort associated with high-frequency electrical stimulation, and compares it with previously reported high-frequency pulsed cluster stimulation. METHODS: We evaluated our waveform experimentally and through model simulations. During the experiment, two distinct high-frequency narrow pulse clusters were applied to the proximal segment of the median/ulnar nerve bundles: asymmetric random (aSymR) and previously reported symmetric (Sym) stimulation, both with a carrier frequency of 10 kHz. The two stimulation modes aimed to elicit the same contraction level and were maintained for 5 min to induce muscle fatigue. Finger force, high-density electromyographic (EMG) signals of the flexor muscles and the pain score were recorded. In addition, we developed a finite element model of the upper arm and a motor fiber model to simulate motor axon activation of the peripheral nerve induced by the two electrical stimulation modes. RESULTS: Compared with the Sym stimulation, the aSymR stimulation resulted in less pain and a significant reduction of muscle fatigue rate, which was characterized by slower force decay rate, less absolute force decay, greater plateau force, and ultimately greater force output. In addition, the simulation results showed that the delay for different fibers to reach the threshold was increased by the aSymR mode. Consistent with this, the experiment study showed that the EMG amplitude under the aSymR stimulation condition was smaller before fatigue onset, indicating the less synchronized activation of different muscle fibers. CONCLUSIONS: Compared with the Sym stimulation, the aSymR stimulation can significantly relieve muscle fatigue possibly by reducing the synchronous activation across different fibers. This proposed aSymR stimulation mode not only reduces fatigue but also relieves pain, potentially contributing to the wide application of electrical stimulation in motor function rehabilitation for people with stroke. TRIAL REGISTRATION: Ethics committee of the Medical College of Xi'an Jiaotong University, 2021 - 1550. Registered 4 November 2021.
背景:尽管使用高频脉冲簇的经皮外周神经电刺激已被证明可缓解肌肉疲劳,但其疗效仍然有限。此外,这种方法往往会在刺激过程中加剧疼痛,这限制了其临床应用。本文提出了一种新型刺激波形,以减少肌肉疲劳和与高频电刺激相关的不适,并将其与先前报道的高频脉冲簇刺激进行比较。 方法:我们通过实验和模型模拟对我们的波形进行了评估。在实验过程中,两种不同的高频窄脉冲簇被施加到正中/尺神经束的近端:不对称随机(aSymR)刺激和先前报道的对称(Sym)刺激,两者的载波频率均为10kHz。两种刺激模式旨在引发相同的收缩水平,并持续5分钟以诱导肌肉疲劳。记录手指力量、屈肌的高密度肌电图(EMG)信号和疼痛评分。此外,我们开发了上臂的有限元模型和运动纤维模型,以模拟两种电刺激模式对外周神经运动轴突激活的影响。 结果:与Sym刺激相比,aSymR刺激导致的疼痛更少,肌肉疲劳率显著降低,其特征是力量衰减率更慢、绝对力量衰减更小、平台力更大,最终力量输出更大。此外,模拟结果表明,aSymR模式增加了不同纤维达到阈值的延迟。与此一致的是,实验研究表明,在aSymR刺激条件下,疲劳发作前的EMG振幅较小,表明不同肌肉纤维的同步激活较少。 结论:与Sym刺激相比,aSymR刺激可能通过减少不同纤维之间的同步激活来显著缓解肌肉疲劳。这种提出的aSymR刺激模式不仅可以减轻疲劳,还可以缓解疼痛,可能有助于电刺激在中风患者运动功能康复中的广泛应用。 试验注册:西安交通大学医学院伦理委员会,2021 - 1550。于2021年11月4日注册。
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