Chronic Effects of Wide-pulse Neuromuscular Electrostimulation on Neuromuscular and Functional Properties in Healthy Subjects

Not Applicable

Completed

• Conditions: Healthy Volunteers
• Interventions: Device: Wide-pulse neuromuscular electrostimulation (WP NMES); Device: Control (CONT) modality; Device: Conventional neuromuscular electrostimulation (CONV NMES)

• Registration Number: NCT04857710
• Lead Sponsor: Centre Hospitalier Universitaire de Saint Etienne

Brief Summary

Neuromuscular electrostimulation (NMES) is a technique used in the clinical and training fields to increase the strength of a muscle group.The recent use of wide-pulse (WP) stimulations allows, in addition to the direct activation of the muscle fibers, the use of sensory pathways. This more global solicitation of the neuromuscular system (i.e. information going back to the spinal cord and even to the brain) prejudges more nervous adaptations and therefore a greater functional benefit. The first aim of this study is to evaluate and compare the force gains induced by 2 NMES training programs (CONV, WP) applied on knee extensors in healthy subjects for 6 weeks.The second aim is to understand the neuromuscular adaptations involved in these gains, as well as the functional benefit resulting from these improvements.

Detailed Description

Neuromuscular electrostimulation (NMES) is a technique used in the clinical and training fields to increase the strength of a muscle group. The conventional (CONV) parameters of NMES induces a direct activation of the muscle fibers located close to the stimulation electrodes. This means that the neuromuscular system is not fully solicited, which limits its adaptation. The recent use of wide-pulse (WP) stimulations allows, in addition to the direct activation of the muscle fibers, the use of sensory pathways. This more global solicitation of the neuromuscular system (i.e. information going back to the spinal cord and even to the brain) prejudges more nervous adaptations and therefore a greater functional benefit.

The first aim of this study is to evaluate and compare the force gains induced by 2 NMES training programs (CONV, WP) applied on knee extensors in healthy subjects for 6 weeks. The second aim is to understand the neuromuscular adaptations involved in these gains, as well as the functional benefit resulting from these improvements. To consolidate the benefit of NMES programs, a control (CONT) modality is used as a reference and is representative of a sedentary behaviour regularly observed in our populations. The CONV modality allows us to compare with the current clinical application and the majority of the literature on the adaptations induced by NMES training. Finally, the WP modality aims to assess the possible benefits linked to the use of wide-pulses during the application of NMES. A clinical transfer will then be envisaged to confirm the interest and benefits of this type of program. We hypothesise that nervous adaptations will be increased by the use of WP NMES, leading to greater gains in strength and functional benefits than with CONV NMES.

Study Timeline

• Study First Submitted: 2021-04-20
• Study First Submitted QC: 2021-04-20
• Study First Posted: 2021-04-23
• Study Start: 2021-05-05
• Primary Completion: 2022-05-09
• Study Completion: 2022-08-22
• Status Verified: 2022-09
• Last Update Submitted: 2022-09-12
• Last Update Posted: 2022-09-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 39

Inclusion Criteria

• Affiliates or beneficiaries of a social security scheme
• Having freely given their written consent

Exclusion Criteria

• Disease or surgery resulting in a locomotor disorder, within 6 months prior to the study
• Chronic neurological, motor or psychic diseases
• Taking neuro-active substances likely to alter cortico-spinal excitability (hypnotics, antiepileptics, psychotropic drugs, muscle relaxants) for the duration of the study
• Contraindication to neuromuscular electrostimulation
• Contraindication to magnetic stimulation
• Participation at the same time in another interventional experiment or having participated in such a study within 30 days prior to this study
• Sports (>10 hours per week or strength training of the lower limbs)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Wide-pulse neuromuscular electrostimulation (WP)	Wide-pulse neuromuscular electrostimulation (WP NMES)	The use of wide-pulse (WP) stimulations allows, in addition to the direct activation of the muscle fibers, the use of sensory pathways. This more global solicitation of the neuromuscular system (i.e. information going back to the spinal cord and even to the brain) prejudges more nervous adaptations and therefore a greater functional benefit.
Control (CONT)	Control (CONT) modality	A control (CONT) modality is used as a reference and is representative of a sedentary behaviour regularly observed in our populations
Conventional neuromuscular electrostimulation (CONV)	Conventional neuromuscular electrostimulation (CONV NMES)	The CONV (conventional) modality allows us to compare with the current clinical application and the majority of the literature on the adaptations induced by NMES (neuromuscular electrostimulation) training.

Primary Outcome Measures

Name	Time	Method
Maximal voluntary contraction (MVC) of the knee extensor muscle measurement	week 6	Maximal isometric force (maximal voluntary contraction, MVC) of the knee extensor muscle

Secondary Outcome Measures

Name	Time	Method
Voluntary activation measurement (%)	week 12	The level of voluntary activation will be determined by the force increment obtained following stimulation performed during a condition of the muscle in a state of maximum contraction.
Jump performances measurement	week 12	The performance of jumps (height, in cm; length, in cm) will be evaluated during various tests of vertical (Squat Jump and Counter Movement Jump) and horizontal (Single Hop and Triple Hop) jumps.
Postural balance performances measurement	week 12	The postural balance performance (displacement of the center of pressure, in mm) will be evaluated during a unipodal postural balance test performed on a force platform.
Cortico-spinal excitability measurement	week 12	The quantification of cortico-spinal excitability (i.e. motor evoked potentials, in mV) will be evaluated by recording the electromyographic responses (surface EMG) evoked by transcranial magnetic stimulation
Spinal excitability measurement	week 12	The quantification of spinal excitability (i.e. spinal reflex, in mV) will be evaluated by recording the EMG responses evoked by electrical stimulation in the lumbar vertebrae.; The quantification of spinal excitability (i.e. spinal reflex, in mV) will be evaluated by recording the EMG responses evoked by electrical stimulation in the lumbar vertebrae.
Muscular endurance measurement	week 12	Muscle endurance (number of contractions performed before failure) will be assessed during a fatigue protocol consisting of performing quadriceps muscle contractions at incremental strength levels.

Trial Locations

Locations (1)

CHU de Saint-Etienne; 🇫🇷 Saint-Étienne, France