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pISSN 1225-8962
eISSN 2287-982X

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Phys. Ther. Korea 2022; 29(4): 269-273

Published online November 20, 2022

https://doi.org/10.12674/ptk.2022.29.4.269

© Korean Research Society of Physical Therapy

Neuromuscular Electrical Stimulation of Abdominal Muscles to Improve Standing Balance

Jeongwoo Je , PT, BPT, Woochol Joseph Choi , PT, PhD

Injury Prevention and Biomechanics Laboratory, Department of Physical Therapy, Yonsei University, Wonju, Korea

Correspondence to: Woochol Joseph Choi
E-mail: wcjchoi@yonsei.ac.kr
https://orcid.org/0000-0002-6623-3806

Received: October 23, 2022; Revised: November 3, 2022; Accepted: November 4, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Neuromuscular electrical stimulation (NMES) is used for muscle strengthening. While voluntary muscle contraction follows Henneman et al.’s size principle, the NMES-induced muscle training disrespects the neurophysiology, which may lead to unwanted changes (i.e., declined balance ability). Objects: We examined how the balance was affected by abdominal muscle training with the NMES.
Methods: Fifteen young adults (10 males and 5 females) aged between 21 and 30 received abdominal muscle strengthening with NMES for 23 minutes. Before and after the training, participants’ balance was measured through one leg standing on a force plate with eyes open or closed. Outcome variables included mean distance (MDIST), root mean square distance (RDIST), total excursion (TOTEX), mean velocity (MVELO), and 95% confidence circle area (AREA) of center of pressure data. Two-way repeated measures analysis of variance was used to test if these outcome variables were associated with time (pre and post) and vision.
Results: All outcome variables were not associated with time (p > 0.05). However, all outcome variables were associated with vision (p = 0.0001), and MVELO and TOTEX were 52.4% (45.5 mm/s versus 95.6 mm/s) and 52.4% (364.1 mm versus 764.5 mm) smaller, respectively, in eyes open than eyes closed (F = 55.8, p = 0.0005; F = 55.8, p = 0.0005). Furthermore, there was no interaction between time and vision (F = 0.024, p = 0.877).
Conclusion: Despite the different neurophysiology of muscle contraction, abdominal muscle strengthening with NMES did not affect balance.

Keywords: Abdominal muscles, Balance, Neuromuscular electrical stimulation, One-leg standing

Article

Original Article

Phys. Ther. Korea 2022; 29(4): 269-273

Published online November 20, 2022 https://doi.org/10.12674/ptk.2022.29.4.269

Copyright © Korean Research Society of Physical Therapy.

Neuromuscular Electrical Stimulation of Abdominal Muscles to Improve Standing Balance

Jeongwoo Je , PT, BPT, Woochol Joseph Choi , PT, PhD

Injury Prevention and Biomechanics Laboratory, Department of Physical Therapy, Yonsei University, Wonju, Korea

Correspondence to:Woochol Joseph Choi
E-mail: wcjchoi@yonsei.ac.kr
https://orcid.org/0000-0002-6623-3806

Received: October 23, 2022; Revised: November 3, 2022; Accepted: November 4, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Neuromuscular electrical stimulation (NMES) is used for muscle strengthening. While voluntary muscle contraction follows Henneman et al.’s size principle, the NMES-induced muscle training disrespects the neurophysiology, which may lead to unwanted changes (i.e., declined balance ability). Objects: We examined how the balance was affected by abdominal muscle training with the NMES.
Methods: Fifteen young adults (10 males and 5 females) aged between 21 and 30 received abdominal muscle strengthening with NMES for 23 minutes. Before and after the training, participants’ balance was measured through one leg standing on a force plate with eyes open or closed. Outcome variables included mean distance (MDIST), root mean square distance (RDIST), total excursion (TOTEX), mean velocity (MVELO), and 95% confidence circle area (AREA) of center of pressure data. Two-way repeated measures analysis of variance was used to test if these outcome variables were associated with time (pre and post) and vision.
Results: All outcome variables were not associated with time (p > 0.05). However, all outcome variables were associated with vision (p = 0.0001), and MVELO and TOTEX were 52.4% (45.5 mm/s versus 95.6 mm/s) and 52.4% (364.1 mm versus 764.5 mm) smaller, respectively, in eyes open than eyes closed (F = 55.8, p = 0.0005; F = 55.8, p = 0.0005). Furthermore, there was no interaction between time and vision (F = 0.024, p = 0.877).
Conclusion: Despite the different neurophysiology of muscle contraction, abdominal muscle strengthening with NMES did not affect balance.

Keywords: Abdominal muscles, Balance, Neuromuscular electrical stimulation, One-leg standing

Fig 1.

Figure 1.Participant performed (A) one-leg standing with arms at side, one-leg standing on a force plate (B) before and after NMES training of abdominal muscles.
Physical Therapy Korea 2022; 29: 269-273https://doi.org/10.12674/ptk.2022.29.4.269

Table 1 . Demographic information of participants.

SexHeight (cm)Weight (kg)BMI (kg/m2)Age (y)
Male179.1 ± 3.982.6 ± 11.725.8 ± 3.725.9 ± 2.7
Female159.4 ± 7.055.5 ± 8.021.8 ± 2.023.6 ± 1.8

Values are presented as mean ± standard deviation. BMI, body mass index..


Table 2 . Average values of outcome variables.

MeasureNMESp-value


Eyes closedEyes openVisionTimeInteraction


PrePostPrePost
MDIST (mm)14.4 ± 2.715.2 ± 3.97.6 ± 1.68.3 ± 1.80.0005*0.0920.877
RDIST (mm)15.9 ± 2.917.3 ± 5.48.5 ± 1.89.4 ± 2.10.0005*0.0750.639
TOTEX (mm)764.5 ± 183.7711.0 ± 182.7364.1 ± 103.1344.6 ± 104.70.0005*0.0510.350
MVELO (mm/s)95.6 ± 23.088.9 ± 22.845.5 ± 12.943.1 ± 13.10.0005*0.0510.350
AREA (mm2)2145.3 ± 754.63448.7 ± 4526.1650.3 ± 254.5814.6 ± 352.90.0005*0.1960.313

Values are presented as mean ± standard deviation. MDIST, mean distance; RDIST, root mean square distance; TOTEX, total excursion; MVELO, mean velocity; AREA, 95% confidence circle area. *p < 0.05..