Search

Neuromuscular Electrical Stimulation (NMES) uses electrical impulses to induce muscle contractions, providing benefits in rehabilitation, muscle activation, and as an adjunct to exercise, particularly for individuals experiencing immobilization or physical disability. NMES technology has significantly progressed, with advancements in device development and a deeper understanding of treatment parameters, such as frequency, intensity, and pulse duration. These improvements have expanded NMES applications beyond rehabilitation to include enhanced post-exercise recovery, improved blood glucose uptake, and increased lower limb venous return, potentially reducing thrombotic risks. Despite its benefits, NMES faces challenges in user compliance, often due to improper electrode placement and discomfort during treatment. Research highlights the importance of optimizing stimulation parameters, including electrode positioning, to improve both comfort and treatment efficacy. Recent innovations, such as automated processes for locating optimal stimulation points and adaptable electrode sizes, aim to address these issues. When combined with wearable technologies, these innovations could improve NMES treatment adherence and deliver more consistent, long-term therapeutic outcomes for patients with various physical limitations. Together, these developments indicate a promising future for NMES, presenting a valuable tool to enhance the benefits of physical activity across diverse populations, from rehabilitative care to broader health and wellness applications.

Abstract Background Contractions of muscles in the calf induced by neuromuscular electrical stimulation (NMES) may prevent venous thromboembolism, help rehabilitation and optimize strength training, among other uses. However, compliance to NMES-treatment is limited by the use of suboptimal stimulation points which may cause discomfort and less effectivity. Knowledge of where one is most likely to find muscle motor points (MP) could improve NMES comfort and compliance. Aims To anatomically map the MPs of the calf as well as to calculate the probability of finding a MP in different areas of the calf. Material and methods On 30 healthy participants (mean age 37 years) anatomical landmarks on the lower limbs were defined. The location of the four most responsive MPs on respectively the medial and lateral head of gastrocnemius were determined in relation to these anatomical landmarks using a MP search pen and a pre-set MP search program with 3 Hz continuous stimulation (Search range:4.0–17.5 mA). The anatomy of the calves was normalized and subdivided into a matrix of 48 (6 × 8) smaller areas (3 × 3 cm), from upper medial to lower lateral, in order to calculate the probability of finding a MP in one of these areas. The probability of finding a MP was then calculated for each area and presented with a 95% confidence interval. Results The MP heatmap displayed a higher concentration of MPs proximally and centrally on the calf. However, there were wide inter-individual differences in the location of the MPs. The highest probability of finding a MP was in area 4, located centrally and medially, and in area 29, located centrolaterally and around the maximum circumference, both with 50% probability (95% CI: 0.31–0.69). The second highest probability of finding MPs was in areas 9, 10, 16, proximally and medially, all with 47% probability (95% CI: 0.28–0.66). These areas 4, 9, 10, 16 and 29 exhibited significantly higher probability of finding motor points than all areas with a mean probability of 27% and lower (p