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Muscle contractions induced by calf low-intensity neuromuscular electrical stimulation (C-LI-NMES) can increase venous return and may reduce venous thromboembolism. This study aimed to compare the effect of different C-LI-NMES frequencies and plateau times on hemodynamics, discomfort and energy efficiency, when applied via sock-integrated transverse textile electrodes.
Fifteen healthy participants were stimulated via two 3x3cm transverse textile electrodes integrated in a sock, with ten different combinations of frequency (1Hz or 36Hz) and plateau times (0.5/1.5/3/5/7s), with gradually increasing NMES-intensity until plantar flexion-induction. At this point, popliteal peak venous velocity (PVV), time-averaged mean velocity (TAMV) and ejection volume (EV) were assessed by Doppler-ultrasound, discomfort by a numerical rating scale (NRS, 0-10) and values for current amplitude and energy were calculated based on the NMES-device´s intensity level. Values expressed with median (interquartile range), significance set to p<0.05.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single arm where repeated measures where performed in 15 participants. | Experimental | Each of the 15 participants in the arm was, in addition to the resting state (no intervention), exposed to 10 different interventions repeated after each other to enable repeated measures of the outcomes. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Chattanooga Physio, DJO, neuromuscular electrical stimulation | Device | Neuromuscular electrical stimulation (NMES) was applied with a device called Chattanooga Physio (DJO), testing 10 different combinations of parameter-settings. The parameter-settings that were varied and combined were frequency (1Hz and 36Hz) and plateau times (0.5s, 1.5s, 3s, 5s, 7s). The NMES was applied to the calf of the participants via transversally placed textile electrodes (3x3 cm) integrated in a sock starting with very low current amplitude followed by gradual small increases in current amplitude until induction of ankle plantar flexion, at which time-point the outcomes where measured. |
| Measure | Description | Time Frame |
|---|---|---|
| Peak venous velocity (PVV) | Peak venous velocity (centimeters per second) will be assesed by Doppler ultrasound of in the popliteal vein | Day 1 at rest (baseline, no intervention) and when ankle plantar flexion was induced by the intervention |
| Time averaged mean velocity (TAMV) | Time averaged mean velocity will be assesed by Doppler ultrasound in the popliteal vein (centimeters per second) | Day 1 at rest (baseline, no intervention) and when ankle plantar flexion was induced by the intervention |
| Average duration of blood pulse (ADBP) | Average duration of blood pulse will be assesed by Doppler ultrasound in the popliteal vein (seconds) | Day 1 at rest (baseline, no intervention) and when ankle plantar flexion was induced by the intervention |
| Ejection volume (EV) | Ejection volume of blood will be assesed by Doppler ultrasound in the popliteal vein (milliliters) | Day 1 at rest (baseline, no intervention) and when ankle plantar flexion was induced by the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Numerical rating scale (NRS) | Discomfort estimated using a numerical rating scale from 0 (no pain) to 10 (worst pain) | Day 1 during ankle plantar flexion was induced by the intervention |
| Current amplitude |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Paul Ackermann, PhD, MD | Karolinska Institutet | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Karolinska university Hospital | Stockholm | 17176 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40234723 | Derived | Juthberg R, Flodin J, Aliaga N, Guo L, Rodriguez S, Persson NK, Ackermann PW. Electrically induced hemodynamic enhancement via sock-integrated electrodes is more comfortable and efficient at 1 hz as compared to 36 hz. Sci Rep. 2025 Apr 15;15(1):12944. doi: 10.1038/s41598-025-97431-3. |
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Currently there is no plan to share individual participant data, but individual participant data may be shared upon reasonable request in the future.
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Repeated measures tests on on each of the 15 participants, comparing outcomes for no intervention and 10 different interventions in the form of variations in parameter-settings of neuromuscular electrical stimulation, with gradually increasing current amplitude until induction of ankle plantar flexion.
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Participants did not receive information about what parameter-settings that were used for the different tests.
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Current amplitude in milliampere (mA) will be assessed by using stepwise increases (typically 1mA) on the NMES device until a plantar flexion is induced
| Day 1 during ankle plantar flexion was induced by the intervention |
| Energy | Energy per stimulation cycle in millijoule (mJ) will be assessed by using stepwise increases (typically 1mA) on the NMES device until a plantar flexion is induced, at which point the energy consumption (mJ) is calculated. | Day 1 during ankle plantar flexion was induced by the intervention |
| ID | Term |
|---|---|
| D010146 | Pain |
| D057185 | Sedentary Behavior |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |
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