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Updated: Oct 7, 2025

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Exercise following immobility increases lower motor neuron excitability: F-wave and H-reflex studies
Mariana Pereira1, Michael Swash2, Mamede de Carvalho3
1Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa. Lisbon, Portugal.
Objectives:
The excitability of lower motor neurons can be explored non-invasively by several neurophysiological techniques, e.g., F-wave and H-reflex studies after a period of immobility and then after subsequent exercise. The aim of this study is to investigate the impact of exercise and high frequency repetitive nerve stimulation (RNS) following changes induced by 75 min of immobility.
Methods:
We studied 10 healthy subjects following 75 min lower limb immobility, then randomized to RNS or cycling on different days. The neurophysiological studies of M-response, F-wave latency, F/M amplitude ratio and persistence; H-reflex threshold and latency, H/M amplitude ratio, and homosynaptic depression were performed at baseline, after immobility and immediately following the intervention, using stimulation of posterior tibial and peroneal nerves.
Results:
After immobility F-wave latencies were delayed and homosynaptic depression at 2 Hz was increased (p < 0.025). RNS had no effect, but cycling exercise reduced H-reflex latencies (p = 0.025) and decreased homosynaptic depression at 2 Hz.
Discussion:
Our findings suggest that both proprioceptive stimulation and supraspinal pathways modulate intraspinal physiological changes after immobility. These observations suggest that specific exercise protocols may be useful in managing patients recovering from periods of immobility.
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