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Updated: Mar 27, 2026

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
High-density surface electromyography provides reliable estimates of motor unit behavior
E Martinez-Valdes1, C M Laine2, D Falla3
1Department of Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany.
Objective:
To assess the intra- and inter-session reliability of estimates of motor unit behavior and muscle fiber properties derived from high-density surface electromyography (HDEMG).
Methods:
Ten healthy subjects performed submaximal isometric knee extensions during three recording sessions (separate days) at 10%, 30%, 50% and 70% of their maximum voluntary effort. The discharge timings of motor units of the vastus lateralis and medialis muscles were automatically identified from HDEMG by a decomposition algorithm. We characterized the number of detected motor units, their discharge rates, the coefficient of variation of their inter-spike intervals (CoVisi), the action potential conduction velocity and peak-to-peak amplitude. Reliability was assessed for each motor unit characteristics by intra-class correlation coefficient (ICC). Additionally, a pulse-to-noise ratio (PNR) was calculated, to verify the accuracy of the decomposition.
Results:
Good to excellent reliability within and between sessions was found for all motor unit characteristics at all force levels (ICCs>0.8), with the exception of CoVisi that presented poor reliability (ICC<0.6). PNR was high and similar for both muscles with values ranging between 45.1 and 47.6dB (accuracy>95%).
Conclusion:
Motor unit features can be assessed non-invasively and reliably within and across sessions over a wide range of force levels.
Significance:
These results suggest that it is possible to characterize motor units in longitudinal intervention studies.
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