title: Wide-pulse-high-frequency neuromuscular electrical stimulation in cerebral palsy.
abstract: OBJECTIVE
  The present study assesses whether wide-pulse-high-frequency (WPHF) neuromuscular electrical stimulation (NMES) could result in extra-force production in cerebral palsy (CP) patients as previously observed in healthy individuals.
  
  
  METHODS
  Ten CP and 10 age- and sex-matched control participants underwent plantar flexors NMES. Two to three 10-s WPHF (frequency: 100 Hz, pulse duration: 1 ms) and conventional (CONV, frequency 25 Hz, pulse duration: 50 μs) trains as well as two to three burst-like stimulation trains (2s at 25 Hz, 2s at 100 Hz, 2s at 25 Hz; pulse duration: 1 ms) were evoked. Resting soleus and gastrocnemii maximal H-reflex amplitude (Hmax) was normalized by maximal M-wave amplitude (Mmax) to quantify α-motoneuron modulation.
  
  
  RESULTS
  Similar Hmax/Mmax ratio was found in CP and control participants. Extra-force generation was observed both in CP (+18 ± 74%) and control individuals (+94 ± 124%) during WPHF (p<0.05). Similar extra-forces were found during burst-like stimulations in both groups (+108 ± 110% in CP and +65 ± 85% in controls, p>0.05).
  
  
  CONCLUSIONS
  Although the mechanisms underlying extra-force production may differ between WPHF and burst-like NMES, similar increases were observed in patients with CP and healthy controls.
  
  
  CONCLUSIONS
  Development of extra-forces in response to WPHF NMES evoked at low stimulation intensity might open new possibilities in neuromuscular rehabilitation.
authors.affiliation: Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; Institute of Movement Sciences and Sports Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Neyroud
authors.affiliation: Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Armand
authors.affiliation: Service of Pediatric Orthopaedics, Department of Child and Adolescent Health, Geneva University Hospitals and Geneva University, Geneva, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: De Coulon
authors.affiliation: Institute of Movement Sciences and Sports Medicine, University of Geneva, Geneva, Switzerland; School of Physical Education and Sport, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: S R D
authors.initials: SRD
authors.lastname: Da Silva
authors.affiliation: Aix Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Wegrzyk
authors.affiliation: Aix Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Gondin
authors.affiliation: Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; Institute of Movement Sciences and Sports Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Kayser
authors.affiliation: Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland. Electronic address: Nicolas.Place@unil.ch.
authors.forename: N
authors.initials: N
authors.lastname: Place
mesh_terms: D000328:Adult; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000503:physiopathology*; D004558:Electric Stimulation / Q000379:methods; D004576:Electromyography / Q000379:methods*; D005260:Female; D006181:H-Reflex / Q000502:physiology; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000502:physiology*; D009469:Neuromuscular Junction / Q000502:physiology*; D055815:Young Adult
keywords: Cerebral palsy; Extra-force; Hmax/Mmax ratio; Neuromuscular electrical stimulation