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Neuromuscular electrical stimulation: implications of the electrically evoked sensory volley

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Abstract

Neuromuscular electrical stimulation (NMES) generates contractions by depolarising axons beneath the stimulating electrodes. The depolarisation of motor axons produces contractions by signals travelling from the stimulation location to the muscle (peripheral pathway), with no involvement of the central nervous system (CNS). The concomitant depolarisation of sensory axons sends a large volley into the CNS and this can contribute to contractions by signals travelling through the spinal cord (central pathway) which may have advantages when NMES is used to restore movement or reduce muscle atrophy. In addition, the electrically evoked sensory volley increases activity in CNS circuits that control movement and this can also enhance neuromuscular function after CNS damage. The first part of this review provides an overview of how peripheral and central pathways contribute to contractions evoked by NMES and describes how differences in NMES parameters affect the balance between transmission along these two pathways. The second part of this review describes how NMES location (i.e. over the nerve trunk or muscle belly) affects transmission along peripheral and central pathways and describes some implications for motor unit recruitment during NMES. The third part of this review summarises some of the effects that the electrically evoked sensory volley has on CNS circuits, and highlights the need to identify optimal stimulation parameters for eliciting plasticity in the CNS. A goal of this work is to identify the best way to utilize the electrically evoked sensory volley generated during NMES to exploit mechanisms inherent to the neuromuscular system and enhance neuromuscular function for rehabilitation.

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  1. Human Neurophysiology Laboratory, Faculty of Physical Education and Recreation, Centre for Neuroscience, University of Alberta, 6-41 General Services Building, Edmonton, AB, T6G 2H9, Canada

    A. J. Bergquist, J. M. Clair, O. Lagerquist, C. S. Mang, Y. Okuma & D. F. Collins

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  1. A. J. Bergquist
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  2. J. M. Clair
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  3. O. Lagerquist
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  4. C. S. Mang
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  6. D. F. Collins
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Correspondence to D. F. Collins.

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Communicated by Roberto Bottinelli.

This article is published as part of the Special Issue Cluster on the XVIII Congress of the International Society of Electrophysiology and Kinesiology (ISEK 2010) that took place in Aalborg, Denmark on 16–19 June 2010.

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Bergquist, A.J., Clair, J.M., Lagerquist, O. et al. Neuromuscular electrical stimulation: implications of the electrically evoked sensory volley. Eur J Appl Physiol 111, 2409–2426 (2011). https://doi.org/10.1007/s00421-011-2087-9

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