Evidence map›Paper›PMID 40452010›Full record

ArticleJournal of neuroengineering and rehabilitation2025

Delayed muscle fatigue during electrical stimulation of the proximal nerve using asymmetric random high-frequency carrier pulse cluster.

Rui Yuan, Yang Zheng, Henry Shin, Guanghua Xu, Shengnuo Fan, Zhanhong Du

Abstract read
In one paragraph

Article in Journal of neuroengineering and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rui YuanInstitute of Engineering and Medicine Interdisciplinary Studies, State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Yang ZhengInstitute of Engineering and Medicine Interdisciplinary Studies, State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China. yzheng@mail.xjtu.edu.cn.
Henry ShinSchool of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, People's Republic of China. henryhongsukshin@uhrs.edu.cn.
Guanghua XuInstitute of Engineering and Medicine Interdisciplinary Studies, State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Shengnuo FanDepartment of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Zhanhong DuBrain Cognition and Brain Disease Institute, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, Shenzhen Institutes of Advanced Technology (SIAT), CAS Key Laboratory of Brain Connectome and Manipulation, Chinese Academy of Sciences (CAS), Shenzhen, People's Republic of China.

Funding

Key Research and Development Projects of Shaanxi Province 2022ZDLSF04-10National Natural Science Foundation of China Research Fund for International Scholars W2433195.Qin Chuang Yuan Talent Project QCYRCXM-2022-34STI 2030-Major Projects 2022ZD0209800
6 · The paper itself

Abstract

backgroundTranscutaneous peripheral nerve electrical stimulation using high-frequency pulse clusters has been shown to relieve muscle fatigue, though its efficacy remains limited. Furthermore, this approach tends to exacerbate pain during stimulation, which constrains its clinical applications. This paper proposed a novel stimulation waveform to reduce muscle fatigue and the discomfort associated with high-frequency electrical stimulation, and compares it with previously reported high-frequency pulsed cluster stimulation.

methodsWe evaluated our waveform experimentally and through model simulations. During the experiment, two distinct high-frequency narrow pulse clusters were applied to the proximal segment of the median/ulnar nerve bundles: asymmetric random (aSymR) and previously reported symmetric (Sym) stimulation, both with a carrier frequency of 10 kHz. The two stimulation modes aimed to elicit the same contraction level and were maintained for 5 min to induce muscle fatigue. Finger force, high-density electromyographic (EMG) signals of the flexor muscles and the pain score were recorded. In addition, we developed a finite element model of the upper arm and a motor fiber model to simulate motor axon activation of the peripheral nerve induced by the two electrical stimulation modes.

resultsCompared with the Sym stimulation, the aSymR stimulation resulted in less pain and a significant reduction of muscle fatigue rate, which was characterized by slower force decay rate, less absolute force decay, greater plateau force, and ultimately greater force output. In addition, the simulation results showed that the delay for different fibers to reach the threshold was increased by the aSymR mode. Consistent with this, the experiment study showed that the EMG amplitude under the aSymR stimulation condition was smaller before fatigue onset, indicating the less synchronized activation of different muscle fibers.

conclusionsCompared with the Sym stimulation, the aSymR stimulation can significantly relieve muscle fatigue possibly by reducing the synchronous activation across different fibers. This proposed aSymR stimulation mode not only reduces fatigue but also relieves pain, potentially contributing to the wide application of electrical stimulation in motor function rehabilitation for people with stroke.

trial registrationEthics committee of the Medical College of Xi'an Jiaotong University, 2021 - 1550. Registered 4 November 2021.

Indexed as

Median NerveMuscle FatigueMuscle, SkeletalTranscutaneous Electric Nerve StimulationUlnar NerveAdultElectric StimulationElectromyographyFemaleHumansMaleYoung AdultAsynchronous axon activationKilohertz stimulationMuscle fatigueTranscutaneous nerve electrical stimulation

Identifiers

PMID40452010
PMCPMC12128545

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.