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Updated: May 15, 2026

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Neuromuscular electrical stimulation can elicit aerobic exercise response without undue discomfort in healthy
Domenico Crognale1, Giuseppe De Vito, Jean-Francois Grosset
1School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.
Abstract:
Recent studies have suggested that subtetanic neuromuscular electrical stimulation (NMES) protocols applied to the quadriceps and hamstrings may have potential as an alternative aerobic exercise modality. However, its tolerability and effectiveness in the physically active population has been questioned. The primary purpose of this study was to measure physiological and subjective responses to a modified subtetanic NMES protocol in a physically active adult population. Furthermore, the effect of habituation to stimulation on tolerability, the repeatability of response on separate days, and the differences in male and female responses to stimulation were assessed. Oxygen uptake (V[Combining Dot Above]O(2)), heart rate (HR), blood lactate (BLa), rate of perceived exertion, and subjective discomfort were measured in 16 participants (8 men and 8 women) throughout a subtetanic NMES protocol performed at incremental intensities to subjective comfort threshold on 2 separate days, before and after 9 NMES habituation sessions. Peak physiological responses observed at subjective comfort threshold were consistent with therapeutic aerobic exercise intensities (51.5 ± 10.9% V[Combining Dot Above]O(2)max; 72.0 ± 10.9% HRmax; 4.7 ± 2.7 mMol BLa). Peak V[Combining Dot Above]O(2) and current intensity achieved were significantly higher (p < 0.05), yet perceived discomfort was unchanged, after the period of habituation. However, physiological and subjective responses at equivalent stimulation intensities remained unchanged on different days. Male participants showed higher values than female participants. These results suggest that subtetanic NMES can elicit a consistent aerobic exercise response without undue discomfort and could be considered as an alternative exercise modality.
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