Changes in neuromuscular function after training by functional electrical stimulation

We examined whether the neuromuscular function of rectus femoris (RF) and flexor digitorum brevis (FDB) in humans was modified after a 6-week training period of functional electrical stimulation (FES), and whether any effects persisted at the end of a 6-week post-FES recovery period. In both the stimulated and contralateral nonstimulated muscles, we recorded the muscle force, surface electromyogram, and M wave, and also measured the root mean square (RMS) and the median frequency (MF) during static contraction sustained until exhaustion at 60% of maximal voluntary contraction (MVC). FES was performed with symmetric biphasic pulses, with a ramp modulation of both the stimulation frequency and pulse duration. No changes in MCV and endurance time to exhaustion occurred in nonstimulated muscles, whereas a significant MVC increase occurred immediately after FES in RF (+14 +/- 5%) and FDB (+13 +/- 5%), these effects persisting 6 weeks after the end of FES. In FDB, FES also elicited a significant increase in endurance time to exhaustion (+18 +/- 7%). The M-wave characteristics never varied after FES, but a marked attenuation occurred in the MF decrease and the RMS increase measured at endurance time to sustained 60% MVC, especially in FDB, which contains the higher proportion of type II fibers. These data indicate that FES improves muscle function and elicits changes in central muscle activation. The benefits of FES were greater in FDB, which is highly fatigable, and persisted for at least a 6-week period.