Influence of stimulus pulse width on M-waves, H-reflexes, and torque during tetanic low-intensity neuromuscular stimulation.

Neuromuscular electrical stimulation (NMES) has been shown to generate contractions that include a central recruitment of motoneurons; however, the effect of pulse width on electromyographic (EMG) and torque responses during NMES are not well documented. Soleus EMG and isometric plantarflexion torque were recorded from 14 subjects with NMES delivered to the tibial nerve using 50, 200, 500, and 1000 μs pulse widths. M-waves were significantly smaller during 20 Hz NMES compared with responses evoked by single pulses of 200, 500, and 1000 μs, but not 50 μs pulse widths. At all pulse widths, stimulation at 20 Hz depressed soleus H-reflexes compared with single pulses. Two seconds of 100 Hz NMES significantly increased H-reflexes and torque during the subsequent 20 Hz NMES with 200, 500, and 1000 μs, but not 50 μs, pulse widths. NMES delivered using wide pulses generated larger contractions with a relatively greater central contribution than narrow pulses. This may help reduce atrophy and produce fatigue-resistant contractions for rehabilitation.