Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical Stimulation

Neuromuscular electrical stimulation (NMES) combined with blood flow restriction (BFR) has garnered attention in rehabilitation for its ability to enhance muscle strength, despite the potential to accelerate training-related fatigue. This study examined changes in force scaling capacity immediately...

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Main Authors: Yi-Ching Chen, Chia-Chan Wu, Yeng-Ting Lin, Yueh Chen, Ing-Shiou Hwang
Format: Article
Language:English
Published: IEEE 2025-01-01
Series:IEEE Transactions on Neural Systems and Rehabilitation Engineering
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Online Access:https://ieeexplore.ieee.org/document/10821494/
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author Yi-Ching Chen
Chia-Chan Wu
Yeng-Ting Lin
Yueh Chen
Ing-Shiou Hwang
author_facet Yi-Ching Chen
Chia-Chan Wu
Yeng-Ting Lin
Yueh Chen
Ing-Shiou Hwang
author_sort Yi-Ching Chen
collection DOAJ
description Neuromuscular electrical stimulation (NMES) combined with blood flow restriction (BFR) has garnered attention in rehabilitation for its ability to enhance muscle strength, despite the potential to accelerate training-related fatigue. This study examined changes in force scaling capacity immediately following combined NMES and BFR, focusing on motor unit synergy between agonist pairs. Fifteen participants (<inline-formula> <tex-math notation="LaTeX">$23.3~\pm ~1.8$ </tex-math></inline-formula> years) trained with combined BFR and NMES on the extensor carpi radialis longus (ECRL) muscle, with maximal voluntary contraction (MVC) of wrist extension, along with force and EMG in the ECRL and extensor carpi radialis brevis (ECRB), measured during a designate force-tracking before and after training. Factor analysis identified latent modes influencing motor unit coordination between the ECRB and ECRL. The results showed a significant decrease in MVC after training (<inline-formula> <tex-math notation="LaTeX">$\text {p}\lt 0.001$ </tex-math></inline-formula>). Post-test force fluctuations increased (p =0.031), along with a decrease in the mean inter-spike interval (M_ISI) in the ECRL (p =0.022). Factor analysis revealed an increase in the proportion of motor units (MUs) jointly regulated by the neural mode for both ECRB and ECRL, coupled with a decline in independently regulated MUs. Specifically, the proportion of MUs governed by the ECRL mode decreased, while those regulated by the ECRB mode increased. In conclusion, force generation capacity and force scaling are impaired after receiving combined NMES and BFR treatment. It involves redistribution of the common drive to MUs within two agonists, affecting the flexible coordination of muscle synergy and necessitating compensatory recruitment of MUs from the less fatigable agonist.
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spelling doaj-art-b033fcb77bbb4bf68efbe34b9ad1bea62025-01-21T00:00:10ZengIEEEIEEE Transactions on Neural Systems and Rehabilitation Engineering1534-43201558-02102025-01-013337237910.1109/TNSRE.2025.352551710821494Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical StimulationYi-Ching Chen0https://orcid.org/0000-0002-3234-0435Chia-Chan Wu1https://orcid.org/0009-0007-3244-0659Yeng-Ting Lin2https://orcid.org/0000-0002-6819-0950Yueh Chen3Ing-Shiou Hwang4https://orcid.org/0000-0002-5168-2940Department of Physical Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, TaiwanInstitute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Ball Sport, National Taiwan University of Sport, Taichung, TaiwanOrthopedic Department, Kaohsiung Veterans General Hospital Tainan Branch, Tainan City, TaiwanDepartment of Physical Therapy, the Institute of Allied Health Sciences, and the College of Medicine, National Cheng Kung University, Tainan City, TaiwanNeuromuscular electrical stimulation (NMES) combined with blood flow restriction (BFR) has garnered attention in rehabilitation for its ability to enhance muscle strength, despite the potential to accelerate training-related fatigue. This study examined changes in force scaling capacity immediately following combined NMES and BFR, focusing on motor unit synergy between agonist pairs. Fifteen participants (<inline-formula> <tex-math notation="LaTeX">$23.3~\pm ~1.8$ </tex-math></inline-formula> years) trained with combined BFR and NMES on the extensor carpi radialis longus (ECRL) muscle, with maximal voluntary contraction (MVC) of wrist extension, along with force and EMG in the ECRL and extensor carpi radialis brevis (ECRB), measured during a designate force-tracking before and after training. Factor analysis identified latent modes influencing motor unit coordination between the ECRB and ECRL. The results showed a significant decrease in MVC after training (<inline-formula> <tex-math notation="LaTeX">$\text {p}\lt 0.001$ </tex-math></inline-formula>). Post-test force fluctuations increased (p =0.031), along with a decrease in the mean inter-spike interval (M_ISI) in the ECRL (p =0.022). Factor analysis revealed an increase in the proportion of motor units (MUs) jointly regulated by the neural mode for both ECRB and ECRL, coupled with a decline in independently regulated MUs. Specifically, the proportion of MUs governed by the ECRL mode decreased, while those regulated by the ECRB mode increased. In conclusion, force generation capacity and force scaling are impaired after receiving combined NMES and BFR treatment. It involves redistribution of the common drive to MUs within two agonists, affecting the flexible coordination of muscle synergy and necessitating compensatory recruitment of MUs from the less fatigable agonist.https://ieeexplore.ieee.org/document/10821494/Common synaptic inputmotor neuronsmuscle synergyischemic contractionFEMG
spellingShingle Yi-Ching Chen
Chia-Chan Wu
Yeng-Ting Lin
Yueh Chen
Ing-Shiou Hwang
Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical Stimulation
IEEE Transactions on Neural Systems and Rehabilitation Engineering
Common synaptic input
motor neurons
muscle synergy
ischemic contraction
FEMG
title Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical Stimulation
title_full Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical Stimulation
title_fullStr Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical Stimulation
title_full_unstemmed Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical Stimulation
title_short Adaptive Modification in Agonist Common Drive After Combined Blood Flow Restriction and Neuromuscular Electrical Stimulation
title_sort adaptive modification in agonist common drive after combined blood flow restriction and neuromuscular electrical stimulation
topic Common synaptic input
motor neurons
muscle synergy
ischemic contraction
FEMG
url https://ieeexplore.ieee.org/document/10821494/
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