PTOTSLPOtherJournal of neuroengineering and rehabilitation2025

Efficacy of high- versus moderate-intensity spatially distributed sequential stimulation in subjects with spinal cord injury: an isometric study.

Ehsan Jafari, Petar Kajganic, Vance Bergeron and 3 others

PMID 40122808

WHAT IT FOUND

For whole-quadriceps stimulation, moderate intensity preserved force and fatigue resistance better than high intensity.

For the vastus lateralis alone, high intensity did not reduce these benefits compared to moderate intensity.

Key findings

01In quadriceps stimulation, moderate intensity produced significantly greater relative improvements in time to fatigue, maximum force, and average force compared to high intensity.

02In vastus lateralis stimulation, there was no significant difference in relative improvements in time to fatigue, maximum force, or average force between moderate and high intensity.

03The study used single-electrode stimulation as a reference on the opposite leg rather than directly comparing the absolute efficacy of the two stimulation methods.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Very small sample size (6 in Experiment 1, 5 in Experiment 2). Randomisation of session order was unbalanced in Experiment 1, with 4 subjects receiving high intensity first and only 2 receiving moderate intensity first. The design compared the relative difference between SDSS and SES at different intensities, rather than directly comparing the absolute performance of SDSS versus SES. One subject was excluded from Experiment 1 due to spasms, and another declined Experiment 2. Results are based on isometric contractions, which may not translate directly to dynamic FES activities like cycling.

Declared interests

Funded by the Ministry of Science, Technological Development and Innovation of the Republic of Serbia. No commercial conflicts declared.

The easy way to misread this

Do not assume high-intensity SDSS is ineffective for the vastus lateralis. The null result for this muscle may reflect the small sample size and the specific moderate-intensity level chosen, which was relatively high compared to other studies.

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