Electrical Stimulation Clinical Trial
Official title:
What is the Best Joint Angle of the Knee and Hip to Optimize the Neuromuscular and Tendinous Adaptations Induced by Neuromuscular Electrical Stimulation of the Femoral Quadriceps? Implications for Rehabilitation
Verified date | March 2020 |
Source | University of Brasilia |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Introduction: The muscle contractile effectiveness is influenced by the neural activation of
the motor units, as well as its architecture and the elasticity of the myotendinous junction.
In addition, tendinous properties also affect the production of muscle strength and function.
Neuromuscular electrical stimulation (NMES) is a wide-used tool in rehabilitation for motor
relearning, to reduce muscular atrophy, pain control and to improve functional performance.
Although studies have demonstrated the efficacy of NMES in various clinical situations, the
best joint angle (ideal muscle length) to enhance neuromuscular and tendinous adaptations
induced by NMES has to be determined.
Objective: To investigate the effect of NMES on different hip and knee angles on knee
extensor torque, quadriceps muscle electromyographic activity, architecture, and
tendon-aponeurosis complex elongation, and tendinous properties of the patellar tendon.
Material and Methods: This is a crossover study with healthy males, aged 18-35 years. The
independent variables will be: 1) NMES in different lower limb positions: knee joint
angulation at 20º or 60º with hip at 0º or 80º (four combinations). The dependent variables
will be: knee extensor torque, surface muscle electrical activity, muscle architecture
(muscle thickness, pennation angle and fascicular length), the elongation of the
tendon-aponeurosis complex of the quadriceps muscle components, and the properties
(stiffness, Young's modulus and cross-sectional area) of the patellar tendon. The descriptive
and analytical statistics will be carried out with measures of central tendency and
dispersion, inference tests, tables and graphs. The normality of the data will be verified
with the Shapiro-Wilk test. For the data that present normal distribution, the Two-Way ANOVA
will be applied to verify differences among the measurements, with post-hoc of Bonferroni.
The non-parametric option will be the Friedman test. Correlation coefficients will be
calculated using the Pearson (parametric) or Spearman (non-parametric) correlation test. The
level of statistical significance will be p <0.05.
Expected results: The effect of an NMES session on the neural, muscular and tendon
adaptations related to the angular specificity of the hip and knee, indicating greater
potential for strength and muscle mass gains, will be shown, which is fundamental in the
prescription of electrostimulation in rehabilitation.
Status | Completed |
Enrollment | 20 |
Est. completion date | December 1, 2019 |
Est. primary completion date | December 1, 2019 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Male |
Age group | 18 Years to 35 Years |
Eligibility |
Inclusion Criteria: - Legal adult up to 35 - Males - Body Massa Index: = 18,5 - 24,9 kg/m²) - International Physical Activity Questionnaire: active (but not engaged in systematic strengthening training of lower limbs) Exclusion Criteria: - Pain, edema, dermic injury, deformity or amputation in the body parts to be examined; - Conditions that may affect the studied variables, such as ankylosing spondylitis, rheumatoid arthritis, diabetes mellitus, familial hypercholesterolemia, another neuromuscular disease, congestive heart failure, chronic obstructive pulmonary disease, and chronic alcoholism. - Conditions that may affect cooperation, such as cognitive or psychiatric disease and chemical dependence. |
Country | Name | City | State |
---|---|---|---|
Brazil | University of Brasília | Brasília | DF |
Lead Sponsor | Collaborator |
---|---|
University of Brasilia | University of Burgundy |
Brazil,
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* Note: There are 16 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Dynamometry: Isometric evoked torque | Torque generated in a dynamometer during neuromuscular electrical stimulation of the quadriceps femoris muscle. | The peak torque of a seven-second contraction assessed in four different lower limb positions. | |
Primary | Dynamometry: Maximal Voluntary Isometric Contraction | Torque generated in a dynamometer during maximal voluntary isometric contraction of the quadriceps femoris muscle. | The peak torque of a seven-second contraction assessed in four different lower limb positions. | |
Primary | Ultrasonography: Muscle Thickness | Thickness of each component of the quadriceps muscle assessed by ultrasonography both in rest and during voluntary and evoked contraction. | Change from rest to the end of a seven-second ramp contraction. | |
Primary | Ultrasonography: Pennation angle | Ultrasonography will be used to assess the Angle formed by the fascicles and the deep aponeurosis in which they insert both in rest and during voluntary and evoked contraction. | Change from rest to the end of a seven-second ramp contraction. | |
Primary | Ultrasonography: Fascicle length | Ultrasonography will be used to assess the fascicle length both in rest and during voluntary and evoked contraction. | Change from rest to the end of a seven-second ramp contraction. | |
Primary | Ultrasonography: Tendon-aponeurosis complex elongation | Ultrasonography will be used to assess the tendon-aponeurosis complex elongation of each component of the quadriceps muscle from rest to maximal voluntary and evoked contraction. | Change from rest to the end of a seven-second ramp contraction. | |
Primary | Ultrasonography: Patellar tendon properties | Variables assessed from the elongation of the patellar tendon during maximal voluntary and evoked contraction. | Change from rest to the end of a seven-second ramp contraction. | |
Primary | Surface electromyography | Electromyographic activity of each superficial component of the quadriceps muscle both in rest and during voluntary. | Change from rest to the end of a seven-second ramp contraction. | |
Secondary | Maximal tolerated intensity | Intensity or amplitude (in milliamps) of the electrical pulse during neuromuscular electrical stimulation. | The mean of the 12 repetitions in each session (1 per week, total of 4 sessions). | |
Secondary | Muscle fatigue | Changes in neuromuscular activation at the beginning and at the end of each session. | The mean of 3 repetitions in the beginning and in the end of each session (1 per week, total of 4 sessions). |
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