Transcutaneous electrical nerve stimulation improves fatigue performance of the treated and contralateral knee extensors
Transcutaneous electrical nerve stimulation (TENS) can reduce acute and chronic pain. Unilateral fatigue can produce discomfort in the affected limb and force and activation deficits in contralateral non-exercised muscles. TENS-induced local pain analgesia effects on non-local fatigue performance are unknown. Hence, the aim of the study was to determine if TENS-induced pain suppression would augment force output during a fatiguing protocol in the treated and contralateral muscles.
Three experiments were integrated for this article. Following pre-tests, each experiment involved 20 min of TENS, sham, or a control condition on the dominant quadriceps. Then either the TENS-treated quadriceps (TENS_Treated) or the contralateral quadriceps (TENS_Contra) was tested. In a third experiment, the TENS and sham conditions involved two\; 100-s isometric maximal voluntary contractions (MVC) (30-s recovery) followed by testing of the contralateral quadriceps (TENS_Contra-Fatigue). Testing involved single knee extensors (KE) MVCs (pre- and post-test) and a post-test 30% MVC to task failure.
The TENS-treated study induced greater (p = 0.03; 11.0%) time to KE (treated leg) failure versus control. The TENS_Contra-Fatigue induced significant (p = 0.04; 11.7%) and near-significant (p = 0.1; 7.1%) greater time to contralateral KE failure versus sham and control, respectively. There was a 14.5% (p = 0.02) higher fatigue index with the TENS (36.2 ± 10.1%) versus sham (31.6 ± 10.6%) conditions in the second fatigue intervention set (treated leg). There was no significant post-fatigue KE fatigue interaction with the TENS_Contra.
Unilateral TENS application to the dominant KE prolonged time to failure in the treated and contralateral KE suggesting a global pain modulatory response.
KeywordsCrossover Endurance Pain Strength Isometric
Diffuse noxious inhibitory control
Maximal voluntary contractions
Non-local muscle fatigue
Root mean square of the electromyography signal
Transcutaneous electrical nerve stimulation
TENS-treated dominant quadriceps with testing of treated dominant quadriceps
TENS-treated dominant quadriceps with testing of contralateral non-dominant quadriceps
TENS-treated dominant quadriceps subjected to a fatigue protocol (2 × 100 s MVCs) with testing of treated dominant and untreated non-dominant quadriceps
The study was funded by Natural Sciences and Engineering Research Council of Canada (Grant number 2017-03728).
BDG: data interpretation and writing of manuscript. CEM, PGMJ, AH, BASM, BA, MC, PJ, MB, FK, KS, RM: data collection, analysis, and review of manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest with the contents of this manuscript.
- Aboodarda SJ, Sambaher N, Millet GY, Behm DG (2017) Knee extensors neuromuscular fatigue changes the corticospinal pathway excitability in biceps brachii muscle. Neurosci 340:477–486. https://doi.org/10.1016/j.neuroscience.2016.10.065 CrossRefGoogle Scholar
- Ainsworth L, Budelier K, Clinesmith M, Fiedler A, Landstrom R, Leeper BJ, Moeller L, Mutch S, O'Dell K, Ross J, Radhakrishnan R, Sluka KA (2006) Transcutaneous electrical nerve stimulation (TENS) reduces chronic hyperalgesia induced by muscle inflammation. Pain 120(1–2):182–187. https://doi.org/10.1016/j.pain.2005.10.030 CrossRefPubMedGoogle Scholar
- Amann M, Venturelli M, Ives SJ, McDaniel J, Layec G, Rossman MJ, Richardson RS (2013) Peripheral fatigue limits endurance exercise via a sensory feedback-mediated reduction in spinal motoneuronal output. J Appl Physiol (1985) 115(3):355–364. https://doi.org/10.1152/japplphysiol.00049.2013 CrossRefGoogle Scholar
- Behm DG (1993) Debilitation to adaptation. J Strength Cond Res 7(2):65–75Google Scholar
- Button DC, Behm DG (2008) The effect of stimulus anticipation on the interpolated twitch technique. J Sports Sci Med 7(520):524Google Scholar
- Cavanaugh MT, Doweling A, Young JD, Quigley PJ, Hodgson DD, Whitten JH, Reid JC, Aboodarda SJ, Behm DG (2017) An acute session of roller massage prolongs voluntary torque development and diminishes evoked pain. Eur J Appl Physiol 117(1):109–117. https://doi.org/10.1007/s00421-016-3503-y CrossRefPubMedGoogle Scholar
- Cohen J (1988) Statistical power analysis for the behavioural sciences. L. Erbraum Associates, Hillside, pp 12–82Google Scholar
- Denegar CR, Perrin DH (1992) Effect of transcutaneous Eeectrical nerve stimulation, cold, and a combination treatment on pain, decreased range of motion, and strength loss associated with delayed onset muscle soreness. J Athletic Train 27(3):20–206Google Scholar
- Le Bars D, Villanueva L, Bouhassira D, Willer JC (1992) Diffuse noxious inhibitory controls (DNIC) in animals and in man. Patol Fiziol Eksp Ter 4:55–65Google Scholar
- Pietrosimone BG, Saliba SA, Hart JM, Hertel J, Ingersoll CD (2010) Contralateral effects of disinhibitory tens on quadriceps function in people with knee osteoarthritis following unilateral treatment. N Am J Sports Phy Ther 5(3):111–121Google Scholar
- Sidhu SK, Weavil JC, Venturelli M, Garten RS, Rossman MJ, Richardson RS, Gmelch BS, Morgan DE, Amann M (2014) Spinal mu-opioid receptor-sensitive lower limb muscle afferents determine corticospinal responsiveness and promote central fatigue in upper limb muscle. J Physiol 592(22):5011–5024. https://doi.org/10.1113/jphysiol.2014.275438 CrossRefPubMedPubMedCentralGoogle Scholar
- Takahashi K, Maruyama A, Maeda M, Etoh S, Hirakoba K, Kawahira K, Rothwell JC (2009) Unilateral grip fatigue reduces short interval intracortical inhibition in ipsilateral primary motor cortex. Clin Neurophysiol 120(1):198–203. https://doi.org/10.1016/j.clinph.2008.10.003 CrossRefPubMedGoogle Scholar
- Takahashi K, Maruyama A, Hirakoba K, Maeda M, Etoh S, Kawahira K, Rothwell JC (2011) Fatiguing intermittent lower limb exercise influences corticospinal and corticocortical excitability in the nonexercised upper limb. Brain Stimulation 4(2):90–96. https://doi.org/10.1016/j.brs.2010.07.001 CrossRefPubMedGoogle Scholar
- Whalen A, Farrell K, Roberts S, Smith H, Behm DG (2019) Topical analgesic improved or maintained ballistic hip flexion range of motion with treated and untreated legs. J Sport Sci Med 18:552–558Google Scholar