Wide-pulse electrical stimulation of the quadriceps allows greater maximal evocable torque than conventional stimulation

Purpose The effectiveness of a neuromuscular electrical stimulation (NMES) program has been shown to be proportional to the maximal evocable torque (MET), which is potentially influenced by pulse characteristics such as duration and frequency. The aim of this study was to compare MET between conventional and wide-pulse NMES at two different frequencies. Methods MET—expressed as a percentage of maximal voluntary contraction (MVC) torque—and maximal tolerable current intensity were quantified on 71 healthy subjects. The right quadriceps was stimulated with three NMES protocols using different pulse duration/frequency combinations: conventional NMES (0.2 ms/50 Hz; CONV), wide-pulse NMES at 50 Hz (1 ms/50 Hz; WP50) and wide-pulse NMES at 100 Hz (1 ms/100 Hz; WP100). The proportion of subjects reaching the maximal stimulator output (100 mA) before attaining maximal tolerable current intensity was also quantified. Results The proportion of subjects attaining maximal stimulator output was higher for CONV than WP50 and WP100 ( p < 0.001). In subjects who did not attain maximal stimulator output in any protocol, MET was higher for both WP50 and WP100 than for CONV ( p < 0.001). Maximal tolerable current intensity was lower for both WP50 and WP100 than for CONV and was also lower for WP100 than for WP50 ( p < 0.001). Conclusion When compared to conventional NMES, wide-pulse protocols resulted in greater MET and lower maximal tolerable current intensity. Overall, this may lead to better NMES training/rehabilitation effectiveness and less practical issues associated with maximal stimulator output limitations.