Acceptability and feasibility of magnetic femoral nerve stimulation in older, functionally impaired patients

Abstract Objective Magnetic femoral nerve stimulation to test muscle function has been largely unexplored in older people. We assessed acceptability, feasibility, along with reproducibility and correlation with other physical function measures. Results Study 1 recruited older people with sarcopenia. Stimulation was performed at baseline and 2 weeks along with six minute walk (6MW), maximum voluntary quadriceps contraction, short physical performance battery and grip strength. Acceptability was measured using visual analog scales. Study 2 used baseline data from a trial of older people. We correlated stimulation results with 6MW, maximal voluntary contraction and muscle mass. Maximum quadriceps twitch tension was measured in both studies, evoked using biphasic magnetic stimulation of the femoral nerve. In study 1 (n = 12), magnetic stimulation was well tolerated with mean discomfort rating of 9% (range 0–40%) on a visual analog scale. Reproducibility was poor (intraclass correlation coefficient 0.06; p = 0.44). Study 2 (n = 64) showed only weak to moderate correlations for maximum quadriceps twitch tension with other measures of physical function (6 minute walk test r = 0.24, p = 0.06; maximal voluntary contraction r = 0.26; p = 0.04). We conclude that magnetic femoral nerve stimulation is acceptable and feasible but poorly reproducible in older, functionally impaired people

Assessment of voluntary muscle activation using magnetic stimulation

The present study investigated the applicability of magnetic stimulation (MS) for estimating activation capacity. Ten men performed isometric knee extensions at 95% of maximum voluntary contraction level on two testing sessions. MS and electrical stimulation (ES) were applied by placing the coil and stimulating electrodes, respectively, on the quadriceps muscle group. In session 1, MS and ES were applied to allow a comparison between the two stimulating devices. During session 2, MS was applied again to assess the reproducibility of MS measurements. Activation level was estimated with the interpolated twitch technique (ITT) and the central activation ratio (CAR). Activation level determined with MS was highly repeatable, but was only comparable to ES when using ITT (standard error < 1.45%, mean difference < 0.63%, for all). MS with CAR overestimated activation by 3% compared to ES (standard error = 1.13%, mean difference = 2.76%) because the power of the magnetic field was limited. These results indicate that MS is a promising tool for reliable and valid quantification of activation levels when using the ITT approach and potentially suitable for studies involving children or other subjects where the pain of conventional ES is a problem

Communications to the Second Annual Congress of the European College of Sport Science

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