The Time-Varying Nature of Electromechanical Delay and Muscle Control Effectiveness in Response to Stimulation-Induced Fatigue.

Neuromuscular electrical stimulation (NMES) and Functional Electrical Stimulation (FES) are commonly prescribed rehabilitative therapies. Closed-loop NMES holds the promise to yield more accurate limb control, which could enable new rehabilitative procedures. However, NMES/FES can rapidly fatigue muscle, which limits potential treatments and presents several control challenges. Specifically, the stimulation intensity-force relation changes as the muscle fatigues. Additionally, the delayed response between the application of stimulation and muscle force production, termed electromechanical delay (EMD), may increase with fatigue. This paper quantifies these effects. Specifically, open-loop fatiguing protocols were applied to the quadriceps femoris muscle group of able-bodied individuals under isometric conditions, and the resulting torque was recorded. Short pulse trains were used to measure EMD with a thresholding method while long duration pulse trains were used to induce fatigue, measure EMD with a cross-correlation method, and construct recruitment curves. EMD was found to increase significantly with fatigue, and the control effectiveness (i.e., the linear slope of the recruitment curve) decreased with fatigue. Outcomes of these experiments indicate an opportunity for improved closed-loop NMES/FES control development by considering EMD to be time-varying and by considering the muscle recruitment curve to be a nonlinear, time-varying function of the stimulation input.