Electrical stimulation site influences the spatial distribution of motor units recruited in tibialis anterior

Objective: To compare the spatial distribution of motor units recruited in tibialis anterior (TA) when electrical stimulation is applied over the TA muscle belly versus the common peroneal nerve trunk. Methods: Electromyography (EMG) was recorded from the surface and from fine wires in superficial and deep regions of TA. Separate M-wave recruitment curves were constructed for muscle belly and nerve trunk stimulation. Results: During muscle belly stimulation, significantly more current was required to generate M-waves that were 5% of the maximal M-wave (Mmax; M5% max), 50% Mmax (M50% max) and 95% Mmax (M95% max) at the deep versus the superficial recording site. In contrast, during nerve trunk stimulation, there were no differences in the current required to reach M5% max, M50% max or M95% max between deep and superficial recording sites. Surface EMG reflected activity in both superficial and deep muscle regions. Conclusions: Stimulation over the muscle belly recruited motor units from superficial to deep with increasing stimulation amplitude. Stimulation over the nerve trunk recruited superficial and deep motor units equally, regardless of stimulation amplitude. Significance: These results support the idea that where electrical stimulation is applied markedly affects how contractions are produced and have implications for the interpretation of surface EMG data. (C) 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.