European Journal of Applied Physiology

, Volume 100, Issue 6, pp 693–700 | Cite as

Effect of transcutaneous electrical acupoint stimulation on fatigue recovery of the quadriceps

  • Raymond C. H. SoEmail author
  • Joseph K.-F. Ng
  • Gabriel Y. F. Ng
Original Article


The aim of this study was to evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) at selected acupoints on enhancing the rate of muscle force recovery after strenuous knee extension/flexion exercise. Ten male and seven female healthy young adults participated in this study in which they performed isokinetic knee fatigue exercise on the Biodex System 3 ergometer on three separate days. After the familiarization trial on day 1, subjects underwent 15 min of either TEAS or pseudo-TEAS recovery treatment after the isokinetic exercise in the following two trials on days 2 and 3, respectively. The TEAS treatment was applied on four selected acupoints [Zusanli (ST36), Chenshan (BL57), Yanglingquan (GB34) and Sanyinjiao (SP6)] while the pseudo-TEAS treatment was applied to the points away from the true acupoints. Isometric knee extension peak torque was measured before and immediately after the test exercise, and again during the 15-min recovery period at 5-min intervals. Blood lactate and median power frequency (MF) of the vastus medialis, vastus lateralis and rectus femoris were also measured at the same time points. The results indicated that the TEAS treatment was significantly more effective than the pseudo-TEAS treatment in enhancing the rate of muscle force recovery (knee extension peak torque recovery after 15 min, from 155 to 195 Nm in TEAS group and from 155 to 182 Nm in the pseudo-TEAS group), but had no effect on lactate removal and MF restitution rate. It is proposed that pain control is a plausible mechanism to explain the benefit of TEAS treatment. As TEAS is a non-invasive and simple treatment, it is feasible to apply it during and immediately after training.


Muscle fatigue Recovery Acupoint Pain control 



This study was fully supported by the Hong Kong Sports Institute research grant. Special thanks go to Dr. Lin Peng on his professional advice on the acupoints identification and to Dr. Trisha Leahy for her great support on writing up this manuscript. Technical assistance provided by Miss Mei Tse, Miss Julysa Chan and Mr Anson Yau are appreciated. Thanks also go to Miss Lo Ka Kay on her statistical assistance to this study.


  1. Bigland-Ritchie B, Woods JJ (1984) Changes in muscle contractile properties and neural control during human muscular fatigue. Muscle Nerve 7:691–699PubMedCrossRefGoogle Scholar
  2. Brody LR, Pollock MT, Roy SH, De Luca CJ, Celli B (1991) pH-induced effects on median frequency and conduction velocity of the myoelectric signal. J Appl Physiol 71(5):1878–1885PubMedGoogle Scholar
  3. Clarys JP, Cabri J (1993) Electromyography and the study of sports movements: a review. J Sports Sci 11(5):379–448PubMedGoogle Scholar
  4. Coloma M, White PF, Ogunnaike BO, Markowitz SD, Brown PM, Lee AQ, Berrisford SB, Wakefield CA, Issioui T, Jones SB, Jones DB (2002) Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and vomiting. Anesthesiology 97(6):1387–1392PubMedCrossRefGoogle Scholar
  5. Craig BW, Shin MK, Kim JS, Blaudow R, Artale L, Gehlsen G (1999) The analgesic effects of acupuncture on exercise induced muscle soreness. J Strength Cond Res 13(4):423Google Scholar
  6. De Luca CJ (1997) The use of surface electromyography in biomechanics. J Appl Biomech 13:135–163Google Scholar
  7. Ehrlich D, Haber P (1992) Influence of acupuncture on physical performance capacity and haemodynamic parameters. Int J Sports Med 13(6):486–491PubMedCrossRefGoogle Scholar
  8. Eshkevari L (2003) Acupuncture and pain: a review of the literature. AANA J 71(5):361–370PubMedGoogle Scholar
  9. Gerdle B, Elert J, Henriksson-Larsen K (1989) Muscular fatigue during repeated isokinetic shoulder forward flexions in young females. Eur J Appl Physiol 58:668–673CrossRefGoogle Scholar
  10. Gerdle B, Karlsson S, Crenshaw AW, Elert J, Friden J (2000) The influence of muscle fiber proportions and area upon EMG during maximal dynamic knee extensions. Eur J Appl Physiol 81:2–10PubMedCrossRefGoogle Scholar
  11. Jacobs C, Uhl TL, Seeley M, Sterling W, Goodrich L (2005) Strength and fatigability of the dominant and nondominant hip abductors. J Athl Train 40:203–206PubMedGoogle Scholar
  12. Knardahl S, Elam M, Olausson B, Wallin BG (1998) Sympathetic nerve activity after acupuncture in humans. Pain 75:19–25PubMedCrossRefGoogle Scholar
  13. Koo ST, Park YI, Lim KS, Chung KS, Chung JM (2002) Acupuncture analgesic in a new rat model of ankle sprain pain. Pain 99:423–431PubMedCrossRefGoogle Scholar
  14. Kuorinka I (1988) Restitution of EMG spectrum after muscular fatigue. Eur J Appl Physiol 57:311–315CrossRefGoogle Scholar
  15. Li H, Zhu MJ, Gao SS (2004) The influence of acupuncturing Tsusanli on physical work capacity and neuroendocrino-immunological parameters in the mice. Chin J Sports Med 23(1):42–45 [Article in Chinese]Google Scholar
  16. Liang F, Luo DL, Hou YF, Zhang J (2003) Effect of acupuncture on the recovery of fatigue after strenuous exercise. J Beijing Univ Phys Educ 26(2):192–194 [Article in Chinese]Google Scholar
  17. Lin JG, Salahin HS, Lin JC (1995) Investigation on the effects of ear acupressure on exercise-induced lactic acid levels and the implications for athletic training. Am J Acupunct 23(4):309–313Google Scholar
  18. Lindstrom L, Magnusson R, Petersen I (1970) Muscular fatigue and action potential conduction velocity changes studied with frequency analysis of EMG signals. Electromyography 10(4):341–356PubMedGoogle Scholar
  19. Linnamo V, Bottas R, Komi PV (2000) Force and EMG power spectrum during and after eccentric and concentric fatigue. J Electrmyogr Kinesiol 10:293–300CrossRefGoogle Scholar
  20. Masuda K, Masuda T, Sadoyama T, Inaki M, Katsuta S (1999) Changes in surface EMG patterns during static and dynamic fatiguing contractions. J Electromyogr Kinesiol 9:39–46PubMedCrossRefGoogle Scholar
  21. Merletti R, Sabbahi MA, De Luca CJ (1984) Median frequency of the myoelectric signal. Effects of muscle ischemia and cooling. Eur J Appl Physiol 52(3):258–265CrossRefGoogle Scholar
  22. Mills KR (1982) Power spectral analysis of electromyogram and compound muscle action potential during muscle fatigue and recovery. J Physiol 326:401–409PubMedGoogle Scholar
  23. Niu D, Wang H, Wang WY (2000) Influence of overload training and post-exercise superficial peroneal nerve acupuncture on blood lactate concentration. Chin J Sports Med 19(1):101–102 [Article in Chinese]Google Scholar
  24. Noakes TD, St Clair Gibson A, Lambert EV (2005) From catastrophe to complexity: a novel model of integrative central neural regulation of effort and fatigue during exercise in humans: summary and conclusions. Br J Sports Med 39:120–124PubMedCrossRefGoogle Scholar
  25. Petrofsky JS, Lind AR (1980) Frequency analysis of the surface electromyogram during sustained isometric contractions. Eur J Appl Physiol 43(2):173–182CrossRefGoogle Scholar
  26. Qu ZQ, Lu DH, Wang YR (1993) Mechanism of acupuncture and effects on recovery of contractile force and ultrastructure in the exhausted muscles. J Beijing Inst Phy Educ 16(2): 35–44 [Article in Chinese]Google Scholar
  27. Richardson PH, Vincent CA (1986) Acupuncture for the treatment of pain: a review of evaluation research. Pain 24:15–40PubMedCrossRefGoogle Scholar
  28. Sabbahi MA, Sedgwick EM (1987) Recovery profile of single motor-neuron after electrical stimuli in man. Brain Res 423(1–2):125–134PubMedCrossRefGoogle Scholar
  29. So R, Chan KM, Siu O (2002) EMG power frequency spectrum shifts during repeated isokinetic knee and arm movements. Res Q Exerc Sport 73(1):98–106PubMedGoogle Scholar
  30. St Clair Gibson A, Lambert EV, Rauch LHG, Tucker R, Baden DA, Foster C, Noakes TD (2006) The role of information processing between the brain and peripheral physiological systems in pacing and perception of effort. Sports Med 36: 705–722PubMedCrossRefGoogle Scholar
  31. Stulen FB, De Luca CJ (1981) Frequency parameters of the myoelectric signal as a measure of muscle conduction velocity. IEEE Trans Biomed Eng 28:515–523PubMedCrossRefGoogle Scholar
  32. Ulett GA, Han S, Han JS (1998) Electroacupuncture: mechanisms and clinical application. Biol Psychiatry 44(2):129–138PubMedCrossRefGoogle Scholar
  33. Wang WY, Niu D, Wang H, Chiu DH, Hu YS (1999) A clinical study on treating exercise-induced fatigue with acupuncture. Chin Acupunct Moxibustion 1:13–15 [Article in Chinese]Google Scholar
  34. White PF, Hamza MA, Recart A, Coleman JE, Macaluso AR, Cox L, Jaffer O, Song D, Rohrich R (2005) Optimal timing of acustimulation for antiemetic prophylaxis as an adjunct to ondansetrin in patients undergoing plastic surgery. Anesth Analg 100(2):367–372PubMedCrossRefGoogle Scholar
  35. White PF, Issioui T, Hu J, Jones SB, Coleman JE, Waddle JP, Markowitz SD, Coloma M, Macaluso AR, Ing CH (2002) Comparative efficacy of acustimulation (ReliefBand) versus ondansetron (Zofran) in combination with droperidol for preventing nausea and vomiting. Anesthesiology 97(5):1075–1081PubMedCrossRefGoogle Scholar
  36. Xiang ZY, Chen YW, Yu SB, Li HY, Zhang S, Wu SP (1998) An applied study on the influence of acupuncture on exercise-induced fatigue. Shandong Sports Sci Technol 20(3):25–51 [Article in Chinese]Google Scholar
  37. Xing J, Larive B, Mekhail N, Soffer E (2004) Transcutaneous electrical acustimulation can reduce visceral perception in patients with the irritable bowel syndrome: a pilot study. Altern Ther Health Med 10(1):38–42PubMedGoogle Scholar
  38. Yan YW, Wu WB, Xu GY (2002) Jing Luo Shu Xue Xue. Chinese Medicine Press, Hong Kong [Book in Chinese]Google Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Raymond C. H. So
    • 1
    Email author
  • Joseph K.-F. Ng
    • 2
  • Gabriel Y. F. Ng
    • 2
  1. 1.Department of Rehabilitation Sciences, The Hong Kong Polytechnic University and Sports Science Deparment Hong Kong Sports InstituteHong KongChina
  2. 2.Department of Rehabilitation Sciences The Hong Kong Polytechnic UniversityHong KongChina

Personalised recommendations