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Updated: Jul 17, 2026

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Peroneal F-wave characteristics under submaximal stimulation
X Kong1, P Bansal, J T Megerian
1NeuroMetrix Inc, Waltham, MA 02451, USA. xuan_kong@neurometrix.com
Purpose:
F-wave studies are valuable tools in clinical neurophysiology. F-wave parameter estimation must be based on multiple F-wave traces due to their inherent variability. Repetitive supramaximal stimulation is uncomfortable for many patients. This study tested the hypothesis that submaximally stimulated nerves yield F-wave parameters equivalent to those obtained with supramaximal stimulation.
Methods:
Thirty-five peroneal nerves from 27 subjects were stimulated both supramaximally and submaximally. CMAP and F-wave responses from the extensor digitorum brevis muscle were recorded and analyzed offline. Automated algorithms were used to determine F-wave parameters.
Results:
Mean, minimum, maximum F-wave latencies, F-wave duration, and chronodispersion showed no statistically significant difference under the two stimulation conditions. F-wave persistence, amplitude, and subject's discomfort level, were lower with statistical significance. The correlation coefficient of submaximal and supramaximal mean F-wave latencies was 0.977 and their intraclass correlation coefficient was 0.976. The bias of the mean latencies was 0.21 ms and the 95% limits of agreement were less than 5% of the mean F-wave latency.
Conclusions:
F-waves acquired with submaximal stimulation possess characteristics statistically equivalent to those obtained under supramaximal stimulation, as measured by the latency and duration parameters. Persistence and amplitude were lower. Reduction in discomfort level was also achieved.
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