Distribution of M-Wave and H-Reflex in Hand Muscles Evoked via Transcutaneous Nerve Stimulation: A Preliminary Report
Distribution of M-Wave and H-Reflex in Hand Muscles Evoked via Transcutaneous Nerve Stimulation: A Preliminary Report
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经皮神经刺激诱发的手部肌肉中 M 波和 H 反射的分布：初步报告
DOI：
10.1109/embc46164.2021.9630300
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Hu, Xiaogang
中科院分区：
文献类型：
--
作者：
Vargas, Luis;Baratta, John;Hu, Xiaogang
针对腹部肌肉的神经肌肉电刺激（NMES）通常用于恢复神经系统疾病患者的肌肉力量。然而，早发性肌肉疲劳是一个主要的限制因素。与传统的神经刺激技术相比，经皮神经刺激（TNS）可以延缓肌肉疲劳。然而，Ia传入纤维的募集并不是专门针对通过反射途径最大化肌肉激活的，这可以导致运动单位更有序的募集，进一步延缓疲劳。本初步研究评估了手指内外肌的m波和h反射分布。TNS使用沿上臂内侧放置的电极阵列进行递送。选择性电极对针对支配指屈肌的正中神经和尺神经。利用高密度肌电图（HD EMG）定量测定手指内外肌在手部和前臂的激发激活的空间分布。通过在不同刺激水平和肌电图通道中分离m波和h反射来表征空间模式。我们的初步结果表明，通过改变刺激幅度，可以在肌电通道上诱发不同的m波和h反射反应。此外，不同的刺激位置似乎导致不同水平的反射恢复。我们的研究结果表明，调节刺激参数以最大限度地激活反射是可能的，这可能会促进运动神经元的生理募集顺序。
Neuromuscular electrical stimulation (NMES) targeting the muscle belly is commonly used to restore muscle strength in individuals with neurological disorders. However, early onset of muscle fatigue is a major limiting factor. Transcutaneous nerve stimulation (TNS) can delay muscle fatigue compared with traditional NMES techniques. However, the recruitment of Ia afferent fibers has not be specifically targeted to maximize muscle activation through the reflex pathway, which can lead to more orderly recruitment of motor units, further delaying fatigue. This preliminary study assessed the distribution of M-wave and H-reflex of intrinsic and extrinsic finger muscles. TNS was delivered using an electrode array placed along the medial side of the upper arm. Selective electrode pairs targeted the median and ulnar nerves innervating the finger flexors. High-density electromyography (HD EMG) was utilized to quantify the spatial distribution of the elicited activation of finger intrinsic and extrinsic muscles along the hand and forearm. The spatial patterns were characterized through isolation of the M-wave and H-reflex across various stimulation levels and EMG channels. Our preliminary results showed that, by altering the stimulation amplitude, distinct M-wave and H-reflex responses were evoked across EMG channels. In addition, distinct stimulation locations appeared to result in varied levels of reflex recruitment. Our findings indicate that it is possible to adjust stimulation parameters to maximize reflex activation, which can potentially facilitate physiological recruitment order of motoneurons.
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