Reducing muscle fatigue in FES applications by stimulating with N-let pulse trains

Applications of electrical stimulation for restoration of functional movements such as standing, gait, and grasp have always been hindered by the rapid fatigue of stimulated muscle. This paper describes an experimental investigation of stimulation with N-lets (a set of N closely spaced stimulation pulses) as a means of producing contractions with improved fatigue characteristics. Experiments were conducted on 27 able-bodied and four SCI human subjects using surface stimulation of the quadriceps muscle to produce isometric knee joint torque. Based upon evidence from the literature on muscle fatigue, parameters of the N-let trains for N = 1-6 were optimized to produce the most force per pulse. The results demonstrated that: 1) nonlinear summation of the twitch response occurs in human subjects with N-let surface stimulation; 2) for most subjects, doublet stimulation (N = 2) with a pulse interval of about 5 ms produced the maximum torque-time integral per pulse of the resulting twitch; and 3) on average, optimal N-let stimulation resulted in a 36% increase in isometric torque tracking when compared to traditional singlet stimulation. The results have immediate implications for alleviating the problem of premature fatigue during functional electrical stimulation.