A novel modulation strategy to increase stimulation duration in neuromuscular electrical stimulation

Introduction: Neuromuscular electrical stimulation (NMES) has been shown to be an effective treatment for muscular dysfunction. Yet, a fundamental barrier to NMES treatments is the rapid onset of muscle fatigue. The purpose of this study is to examine the effect of feedback‐based frequency modulation on the closed‐loop performance of the quadriceps during repeated dynamic contractions. Methods: In the first experiment, subjects completed four different frequency modulation NMES protocols utilizing the same amplitude modulation control to compare the successful run times (SRTs). A second experiment was performed to determine the change in muscle response to high‐ and low‐frequency stimulation. Results: Compared with constant‐frequency stimulation, results indicate that using an error‐driven strategy to vary the stimulation frequency during amplitude modulation increases the number of successful contractions during non‐isometric conditions. Conclusion: Simultaneous frequency and amplitude modulation increases the SRT during closed‐loop NMES control. Muscle Nerve 44: 382–387, 2011