Article
Blood flow response to electrically induced twitch and tetanic lower-limb muscle contractions1

Preliminary data were presented at the 44th Annual Meeting of the American College of Sports Medicine, May 28–31, 1997, Denver, CO.
https://doi.org/10.1016/S0003-9993(03)00037-6Get rights and content

Abstract

Janssen TW, Hopman MT. Blood flow response to electrically induced twitch and tetanic lower-limb muscle contractions. Arch Phys Med Rehabil 2003;84:982–7.

Objectives:

To compare the effect of electric stimulation (ES)-induced twitch with tetanic leg muscle contractions on blood flow responses and to assess blood flow responses in the contralateral inactive leg.

Design:

Intervention with within-subject comparisons.

Setting:

University research laboratory.

Participants:

A volunteer sample of 12 healthy men (mean age, 25.1±3.0y).

Intervention:

ES was applied at 1 and 3Hz to induce twitch contractions and at 35Hz to induce tetanic contractions of the lower- and upper-leg muscles. Exercise periods consisted of ES/rest cycles (6s/20s) for 5 minutes.

Main Outcome Measures:

Blood flow velocity changes measured by echo Doppler ultrasonography at rest and during the first 2 subsequent ES cycles.

Results:

Blood flow significantly increased from resting values for the tetanic 2-leg, tetanic 1-leg, and 3-Hz conditions, but not for the 1-Hz twitch condition or in the inactive leg.

Conclusions:

Both tetanic and 3-Hz twitch contractions, but not 1-Hz twitch contractions, increased leg blood flow in humans. Because blood flow elevations induced by the 3-Hz contractions did not differ statistically from those induced by the tetanic contractions but were realized with less discomfort, this mode is preferable for therapeutic interventions. Because stimulation of the ipsilateral leg muscles did not change blood flow in the contralateral inactive leg, the muscles in the area of desired effect must be stimulated.

Section snippets

Participants

Twelve men (age, 25.1±3.0y; height, 1.83±0.05m; body mass, 79.2±11.8kg) volunteered to participate in the study. All subjects indicated, by completing a questionnaire, that they were healthy and not using prescription medications. All had normal resting heart rates and blood pressure. After being informed of the purpose, procedures, and possible risks of the study, subjects signed an informed consent statement, approved by the institutional review board.

Protocol

The subjects maintained a supine position

Results

Figure 2 shows resting and postcontraction blood flow values for the 5 different ES conditions. The Vmean significantly increased from resting values for the tetanic 2-leg (84%), tetanic 1-leg (95%), and 3-Hz (62%) conditions, but not for the 1-Hz twitch condition or the 35-Hz stimulation of the contralateral leg. Results from the GLM analysis indicated a significant (P<.001) difference among the 5 ES conditions in the change from rest for Vmean. The pairwise comparisons revealed that the

Discussion

In humans, both 35-Hz tetanic and 3-Hz twitch contractions led to an increase in blood flow to the stimulated leg muscles, whereas 1-Hz twitch contractions did not augment muscle blood flow and stimulation of the ipsilateral leg muscles did not change blood flow in the contralateral inactive leg. This knowledge is important for clinical application of ES to improve circulation.

Conclusion

In humans, both 35-Hz tetanic and 3-Hz twitch contractions can markedly increase blood flow in the femoral artery, whereas 1-Hz twitch contractions cannot adequately augment muscle blood flow. Because the 3-Hz contractions produced blood flow elevations not significantly different from those seen with tetanic contractions, but with less discomfort and possibly less fatigue, the 3-Hz twitch contraction mode seems to be preferable for therapeutic interventions aiming on blood flow increase.

Acknowledgements

We appreciate the assistance of Sarah Floris in the data collection and analysis. The 8-channel stimulator was built by William Couch.

References (40)

  • J. Wesche

    The time course and magnitude of blood flow changes in the human quadriceps muscles following isometric contraction

    J Physiol

    (1986)
  • L. Walloe et al.

    Time course and magnitude of blood flow changes in the human quadriceps muscles during and following rhythmic exercise

    J Physiol

    (1988)
  • J.K. Shoemaker et al.

    Failure of prostaglandins to modulate the time course of blood flow during dynamic forearm exercise in humans

    J Appl Physiol

    (1996)
  • D.D. Sheriff et al.

    Is rapid rise in vascular conductance at onset of dynamic exercise due to muscle pump?

    Am J Physiol

    (1993)
  • M.H. Laughlin et al.

    Effects of muscle contraction on skeletal muscle blood flowwhen is there a muscle pump?

    Med Sci Sports Exerc

    (1999)
  • J.A. Taylor et al.

    Differential control of forearm and calf vascular resistance during one-leg exercise

    J Appl Physiol

    (1989)
  • R.G. Victor et al.

    Reflex stimulation of sympathetic outflow during rhythmic exercise in humans

    Am J Physiol

    (1989)
  • C.K. Kim et al.

    Skeletal muscle perfusion in electrically induced dynamic exercise in humans

    Acta Physiol Scand

    (1995)
  • S.P. Levine et al.

    Blood flow in the gluteus maximus of seated individuals during electrical muscle stimulation

    Arch Phys Med Rehabil

    (1990)
  • D.P. Currier et al.

    Effect of graded electrical stimulation on blood flow to healthy muscle

    Phys Ther

    (1986)
  • Cited by (27)

    • The Effect of Surface Electric Stimulation of the Gluteal Muscles on the Interface Pressure in Seated People With Spinal Cord Injury

      2008, Archives of Physical Medicine and Rehabilitation
      Citation Excerpt :

      Second, people with and without SCI show different responses in the periodic oscillations of blood flow after the release of occlusive pressure.23 However, in healthy people, even 3-Hz twitch contractions increase leg blood flow in uncompressed tissue while in a supine position,24 and 0.5-second tetanic contractions in people with SCI might induce similar effects. In addition, during the stimulation protocols of the current study, the muscles showed no sign of fatigue, which indicates that sufficient blood was brought to the muscles to endure the number of contractions.

    • Acute Peripheral Blood Flow Response Induced by Passive Leg Cycle Exercise in People With Spinal Cord Injury

      2007, Archives of Physical Medicine and Rehabilitation
      Citation Excerpt :

      When prolonged treatment is required, this is especially important to counteract blood stasis that occurs in immobilized people. The value of increased femoral blood flow velocity induced by passive leg cycle exercise is close to the increase induced by electric stimulation in isometric conditions in healthy subjects.48 Electric stimulation treatment could be contraindicated for people with cardiorespiratory disorders, autonomic dysreflexia, or sensitive skin.16

    View all citing articles on Scopus
    1

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

    View full text