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- PublicationDesign considerations for the development of neuromuscular electrical stimulation (NMES) exercise in cancer rehabilitationAim: The aim of this narrative review is to explore design considerations for effective neuromuscular electrical stimulation exercise prescription in cancer rehabilitation, with simultaneous consideration for fundamental principles of exercise training and the current state of the art in neuromuscular electrical stimulation technologies and application methodologies. Method: Narrative review. Results: First, we consider the key neuromuscular electrical stimulation exercise design considerations, with a focus on training objectives and individual training requirements and constraints for individuals with cancer. Here, we contend that concurrent, low and high frequency neuromuscular electrical stimulation exercise, individually prescribed and progressed may be optimal for enhancing physical function. Second, we review the appropriate literature to identify the most appropriate stimulation parameters (pulse frequency, intensity, duration and duty cycle) to deliver effective neuromuscular electrical stimulation in cancer rehabilitation. Conclusions: We propose an informed and innovative neuromuscular electrical stimulation exercise intervention design and provide practical information for clinicians and practitioners who may work with and implement neuromuscular electrical stimulation exercise in cancer.Implications for rehabilitation Neuromuscular electrical stimulation is an emerging technology in cancer rehabilitation to help provide an aerobic and muscle strengthening exercise stimulus. Neuromuscular electrical stimulation may help improve aerobic exercise capacity, muscle strength and augment quality of life. Current prescription in cancer lacks adherence to the fundamental principles of exercise training, which may negatively affect adherence.
199Scopus© Citations 4
- PublicationSelf directed home based electrical muscle stimulation training improves exercise tolerance and strength in healthy elderlyAdvancing age is associated with a gradual decline in muscle strength, exercise tolerance and subsequent capacity for activities of daily living. It is important that we develop effective strategies to halt this process of gradual decline in order to enhance functional ability and capacity for independent living. To achieve this, we must overcome the challenge of sustaining ongoing engagement in physical exercise programmes in the sedentary elderly population, particularly those who experience barriers to exercise participation. Recent developments in electrical muscle stimulation technology could provide a potential solution. In this pilot case-control study we investigated the effects of a self-directed home based programme of electrical muscle stimulation training on muscle strength and exercise tolerance in a group of 16 healthy elderly volunteers (10f, 6m). Study participants completed 30 separate 1-hour electrical muscle stimulation sessions at home over a 6-week period. We observed significant improvements in quadriceps muscle strength and 6-minute walk distance, suggesting that this form of electrical muscle stimulation training has promise as an exercise modality in the elderly population.
578Scopus© Citations 15
- PublicationWhole body oxygen uptake and evoked knee torque in response to low frequency electrical stimulation of the quadriceps muscles: V O2 frequency response to NMESBackground: There is emerging evidence that isometric Neuromuscular Electrical Stimulation (NMES) may offer a way to elicit therapeutically significant increases in whole-body oxygen uptake in order to deliver aerobic exercise to patients unable to exercise volitionally, with consequent gains in cardiovascular health. The optimal stimulation frequency to elicit a significant and sustained pulmonary oxygen uptake has not been determined. The aim of this study was to examine the frequency response of the oxygen uptake and evoked torque due to NMES of the quadriceps muscles across a range of low frequencies spanning the twitch to tetanus transition. Methods: Ten healthy male subjects underwent bilateral NMES of the quadriceps muscles comprising eight 4 minute bouts of intermittent stimulation at selected frequencies in the range 1 to 12 Hz, interspersed with 4 minutes rest periods. Respiratory gases and knee extensor torque were simultaneously monitored throughout. Multiple linear regression was used to fit the resulting data to an energetic model which expressed the energy rate in terms of the pulse frequency, the torque time integral and a factor representing the accumulated force developed per unit time. Results: Additional oxygen uptake increased over the frequency range to a maximum of 564 (SD 114) ml min-1 at 12 Hz, and the respiratory exchange ratio was close to unity from 4 to 12 Hz. While the highest induced torque occurred at 12 Hz, the peak of the force development factor occurred at 6 Hz. The regression model accounted for 88% of the variability in the observed energetic response. Conclusions: Taking into account the requirement to avoid prolonged tetanic contractions and to minimize evoked torque, the results suggest that the ideal frequency for sustainable aerobic exercise is 4 to 5 Hz, which coincided in this study with the frequency above which significant twitch force summation occurred.
473Scopus© Citations 12