Electrodes (recording and stimulating) positioning. White pods represent the neuromuscular stimulator active wireless electrodes placed in a bipolar configuration on the soleus, gastrocnemius lateralis and gastrocnemius medialis muscles. sEMG surface electromyography of the soleus muscle

Electrodes (recording and stimulating) positioning. White pods represent the neuromuscular stimulator active wireless electrodes placed in a bipolar configuration on the soleus, gastrocnemius lateralis and gastrocnemius medialis muscles. sEMG surface electromyography of the soleus muscle

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PurposeNeuromuscular electrical stimulation (NMES) superimposed on voluntary muscle contraction has been recently shown as an innovative training modality within sport and rehabilitation, but its effects on the neuromuscular system are still unclear. The aim of this study was to investigate acute responses in spinal excitability, as measured by the...

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Context 1
... electromyography (sEMG) was recorded by means of a wireless system (Delsys Trigno, Boston, MA, USA) at a sample rate of 2000 Hz. Surface electrodes were placed on the soleus (SOL) muscle 2-3 cm below the gastrocnemii musculotendinous junction with Achille's tendon (Fig. 2), and on the tibialis anterior (TA) muscle above the muscle belly parallel to the TA muscle fibres. TA muscle was chosen to control any possible pre-activation of the antagonist muscles during H-reflex assessments, which is known to significantly affect H-reflex responses of the soleus (Hoffmann 1952). Before applying the surface ...
Context 2
... or superimposed on voluntary effort. The stimulator produced a rectangular, balanced biphasic pulse and was always safely handled and controlled by the investigator. Self-adhesive electrodes (Compex DuraStick plus) with positive polarity were placed over the motor points of gastrocnemius lateralis, gastrocnemius medialis, and soleus muscles (Fig. 2). Motor points were identified at the beginning of the experimental session with a handheld cathode ball electrode in accordance with the electrical stimulator user's guide. In addition, three self-adhesive electrodes with negative polarity were placed on each muscle about 3 cm above the positive electrodes located on the motor points. ...

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... Furthermore, it may enhance activation of target muscles resulting in immediate adaptation of the neural system and enhanced neuromuscular control [41]. In addition, earlier studies have shown that FES may facilitate spinal [42] and cortical motor excitability [43,44], especially when combined with voluntary repeated movements. These mechanisms may explain immediate or long-lasting gait modifications following FES observed in patients with neurological conditions [45][46][47]. ...
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... Two frequencies of stimulation were used, 35 and 50 Hz, which were alternately applied at each session in accordance with a previous study (Labanca et al. 2018). The intensity of stimulation was increased by the trainer during each exercise repetition throughout the session, in accordance with patient tolerance, to maximise motor unit recruitment (Maffiuletti, 2010;Borzuola et al. 2020). In addition, the intensity was selectively increased for each muscle to guarantee a homogeneous distribution of the exercise load. ...
... In addition, a trend to an increase in knee joint pain was observed in patients performing only the additional exercises in comparison with those performing the additional exercises with the superimposition of the NMES. In addition, in a more recent study (Borzuola et al. 2020), it was found that only superimposing NMES to voluntary muscle contractions leads to an increase of motoneuron excitability with respect to NMES only, without voluntary muscle contractions, or voluntary muscle contractions only, without NMES. Thus, it seems that in patients showing neural alteration and muscle inhibition, like in ALC reconstructed patients, the most effective way for an early recovery of muscle strength is functional exercise with superimposed NMES. ...
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