Relationship between functional electrical stimulation duty cycle and fatigue in wrist extensor muscles of patients...

The purpose of this study was to investigate, in a sample of patients with hemiparesis secondary to cerebrovascular accident, the relationship between the ratio of stimulus on time to off time and muscle fatigue using a commercial electrical stimulation unit. An experimental model was used to test the hypothesis that the smaller the stimulus off time relative to stimulus on time, the greater will be the muscle fatigue over time. The wrist extensor muscles of 18 patients with hemiparesis were stimulated electrically, and isometric force output was recorded continuously using an adapted strain gauge-recorder apparatus. For each testing session, peak on time of the electrical stimulus was set at 5 seconds, and off time was set at 5, 15, or 25 seconds. Six randomly assigned treatment groups participated in three separate treatment sessions in a different order at 48-hour intervals. Treatment sessions were continued either until wrist extensor muscle force output decreased to 50% of its initial value or for a maximum of 30 minutes. Data analysis revealed that significant differences in muscle tension developed among all duty cycles (p less than .01). Duty-cycle ratios of 1:1, 1:3, and 1:5 were shown to be progressively less fatiguing. Within the limits of this investigation, the 1:5 duty-cycle ratio was determined to be the best suited for initial use in programs of prolonged stimulation to the wrist extensor muscles of patients with hemiparesis. The hypothesis was accepted that the smaller the stimulus off time (rest interval) with respect to the stimulus on time, the greater will be the muscle fatigue over time.