Influence of Elbow Flexion and Stimulation Site on Neuromuscular Electrical Stimulation of the Biceps Brachii

Functional electrical stimulation (FES) can individuals with physical disabilities by assisting limb movement; however, the change in muscle geometry associated with limb movement may affect the response to stimulation. The aim of this paper was to quantify the effects of elbow flexion and stimulation site on muscle torque production. Contraction torque about the elbow was measured in 12 healthy individuals using a custom elbow flexion testbed and a transcutaneous electrode array. Stimulation was delivered to six distinct sites along the biceps brachii over 11 elbow flexion angles. Flexion angle was found to significantly influence the optimal (i.e., torque-maximizing) stimulation site (chi(2)( 10, N = 24) = 135.75, p = 3.12 x 10(-24)), with post hoc analysis indicating a proximal shift in optimal stimulation site with increased flexion. Similarly, the biceps stimulation site was found to significantly influence the flexion angle at which peak torque occurred (chi(2)( 5, N = 24) = 101.82, p = 2.18 x 10(-20)), with post hoc analysis indicating an increase in peak-torque flexion angle as stimulation site is moved proximally up the biceps. Since maximizing muscle force per unit stimulation is a common goal in rehabilitative FES, future efforts could examine methods which compensate for the shift in optimal stimulation site during FES-induced limb movement.