title: A new paradigm of neuromuscular electrical stimulation for the quadriceps femoris muscle.
abstract: OBJECTIVE
  Neuromuscular electrical stimulation (NMES) with large electrodes and multiple current pathways (m-NMES) has recently been proposed as a valid alternative to conventional NMES (c-NMES) for quadriceps muscle (re)training. The main aim of this study was to compare discomfort, evoked force and fatigue between m-NMES and c-NMES of the quadriceps femoris muscle in healthy subjects.
  
  
  METHODS
  Ten healthy subjects completed two experimental sessions (c-NMES and m-NMES), that were randomly presented in a cross-over design. Maximal electrically evoked force at pain threshold, self-reported discomfort at different levels of evoked force, and fatigue-induced force declines during and following a series of 20 NMES contractions were compared between c-NMES and m-NMES.
  
  
  RESULTS
  m-NMES resulted in greater evoked force (P < 0.05) and lower discomfort in comparison to c-NMES (P < 0.05-0.001), but fatigue time course and magnitude did not differ between the two conditions.
  
  
  CONCLUSIONS
  The use of quadriceps m-NMES appears legitimate for (re)training purposes because it generated stronger contractions and was less discomfortable than c-NMES (due to multiple current pathways and/or lower current density with larger electrodes).
authors.affiliation: Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland, nicola.maffiuletti@kws.ch.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Maffiuletti
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vivodtzev
authors.forename: Marco A
authors.initials: MA
authors.lastname: Minetto
authors.forename: Nicolas
authors.initials: N
authors.lastname: Place
mesh_terms: D000328:Adult; D004558:Electric Stimulation; D005260:Female; D005267:Femoral Nerve / Q000502:physiology; D006801:Humans; D008297:Male; D018763:Muscle Fatigue; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology*; D017288:Pain Threshold