Does partial activation of the neuromuscular system induce cross-education training effect? Case of a pilot study on motor imagery and neuromuscular electrical stimulation.

INTRODUCTION: Cross education defines the gains observed in the contralateral limb following unilateral strength training of the other limb. The present study questioned the neural mechanisms associated with cross education following training by motor imagery (MI) or submaximal neuromuscular electrical stimulation (NMES), both representing a partial activation of the motor system as compared to conventional strength training. METHODS: Twenty-seven participants were distributed in three groups: MI, NMES and control. Training groups underwent a training program of ten sessions in two weeks targeting plantar flexor muscles of one limb. In both legs, neuromuscular plasticity was assessed through maximal voluntary isometric contraction (MViC) and triceps surae electrophysiological responses evoked by electrical nerve stimulation (H-reflexes and V-waves). RESULTS: NMES and MI training improved MViC torque of the trained limb by 11.3% (P < 0.001) and 13.8% (P < 0.001), respectively. MViC of the untrained limb increased by 10.3% (P < 0.003) in the MI group only, accompanied with increases in V-waves on both sides. In the NMES group, V-waves only increased in the trained limb. In the MI group, rest H-reflexes increased in both the trained and the untrained triceps suraes. CONCLUSION: MI seems to be effective to induce cross education, probably because of the activation of cortical motor regions that impact the corticospinal neural drive of both trained and untrained sides. Conversely, submaximal NMES did not lead to cross education. The present results emphasize that cross education does not necessarily require muscle activity of the trained limb.

Insights into the combination of neuromuscular electrical stimulation and motor imagery in a training-based approach.

INTRODUCTION: Training stimuli that partially activate the neuromuscular system, such as motor imagery (MI) or neuromuscular electrical stimulation (NMES), have been previously shown as efficient tools to induce strength gains. Here the efficacy of MI, NMES or NMES + MI trainings has been compared. METHODS: Thirty-seven participants were enrolled in a training program of ten sessions in 2 weeks targeting plantar flexor muscles, distributed in four groups: MI, NMES, NMES + MI and control. Each group underwent forty contractions in each session, NMES + MI group doing 20 contractions of each modality. Before and after, the neuromuscular function was tested through the recording of maximal voluntary contraction (MVC), but also electrophysiological and mechanical responses associated with electrical nerve stimulation. Muscle architecture was assessed by ultrasonography. RESULTS: MVC increased by 11.3 ± 3.5% in NMES group, by 13.8 ± 5.6% in MI, while unchanged for NMES + MI and control. During MVC, a significant increase in V-wave without associated changes in superimposed H-reflex has been observed for NMES and MI, suggesting that neural adaptations occurred at supraspinal level. Rest spinal excitability was increased in the MI group while decreased in the NMES group. No change in muscle architecture (pennation angle, fascicle length) has been found in any group but muscular peak twitch and soleus maximal M-wave increased in the NMES group only. CONCLUSION: Finally, MI and NMES seem to be efficient stimuli to improve strength, although both exhibited different and specific neural plasticity. On its side, NMES + MI combination did not provide the expected gains, suggesting that their effects are not simply cumulative, or even are competitive.

Optimal stimulation parameters for spinal and corticospinal excitabilities during contraction, motor imagery and rest: A pilot study.

OBJECTIVES: It is commonly accepted that motor imagery (MI), i.e. the mental simulation of a movement, leads to an increased size of cortical motor evoked potentials (MEPs), although the magnitude of this effect differs between studies. Its impact on the spinal level is even more variable in the literature. Such discrepancies may be explained by many different experimental approaches. Therefore, the question of the optimal stimulation parameters to assess both spinal and corticospinal excitabilities remains open. METHODS: H-reflexes and MEPs of the triceps surae were evoked in 11 healthy subjects during MI, weak voluntary contraction (CON) and rest (REST). In each condition, the full recruitment curve from the response threshold to maximal potential was investigated. RESULTS: At stimulation intensities close to the maximal response, MEP amplitude was increased by CON compared to REST on the triceps surae. No effect of the different conditions was found on the H-reflex recruitment curve, except a small variation beyond maximal H-reflex in the soleus muscle. CONCLUSION: Based on our results, we recommend to assess corticospinal excitability between 70% and 100% of maximal MEP intensity instead of the classical use of a percentage of the motor threshold and to elicit H-reflexes on the ascending part of the recruitment curve.

Cortical and spinal excitabilities are differently balanced in power athletes.

It is recognised that power-sport practices have a particular effect on lower-limb neuromuscular parameters. Less is known about corticospinal network adaptation, however, or whether these adaptations are specific to the lower limb. In the present study, the corticospinal and spinal excitabilities of upper and lower limbs have been examined in a group of untrained participants (UT, n = 10) and compared to those of a group of well-trained athletes practicing parkour (PK, n = 10). This activity, consisting of overcoming obstacles offered by the urban environment, was chosen as a model of power activity. The motor evoked potentials (MEPs) induced by transcranial magnetic stimulations and H-reflexes and maximal M-waves evoked by peripheral nerve stimulations were elicited in both upper- (flexor carpi radialis [FCR]) and lower-limb muscles (soleus [SOL] and gastrocnemius medialis [GM]). The results tended toward an overall greater corticospinal excitability in PK than in UT (as evidenced by greater MEP/Mmax ratio) and lower spinal excitability (lower Hmax/Mmax). H/MMAX ratio was lower for PK (0.32) than for UT (0.41) in SOL (p = 0.02), while MEP/MMAX was greater for PK than for UT in FCR (PK: 0.12; UT: 0.06; P = 0.04) and in GM (PK: 0.05, UT: 0.03, P = 0.02). In both limbs, the decrease of spinal excitability induced by parkour practice was counterbalanced by an increase in cortical excitability. Finally, the present study indicates that such long-term power practice leads to similar corticospinal plasticity in upper and lower limbs, explained by the similar solicitation of those muscles.