Estimation of the muscle force by perineural intramuscular electrical stimulation in healthy volunteers

The present study aimed to evaluate the elbow flexor force induced by perineural intramuscular stimulation compared with surface electrical stimulation (ES) and maximal voluntary contraction. Thirty nondominant arms of healthy volunteers were evaluated. Isometric elbow flexion force was evaluated using a surface electrode stimulation at the biceps brachii muscle, a perineural intramuscular stimulation around the musculocutaneous nerve, and maximum voluntary contraction. The elbow flexion force was measured at the wrist volar area in a 90 degrees elbow flexion posture, fixed with a rigid elbow orthosis. Pain and discomfort associated with ES were evaluated using a numeric rating scale. The mean maximum elbow flexion force was 16.6 +/- 4.1 kgf via voluntary contraction. The mean elbow flexion force by ES was 2.9 +/- 2.0 kgf, stimulation intensity was 24.8 +/- 5.5 mA, and the numeric rating scale was 5.0 +/- 2.5 via surface electrode stimulation and 3.1 +/- 2.0 kgf, 5.0 mA, and 3.8 +/- 1.9 via perineural stimulation, respectively. ES provides 16% to 18% of the maximal voluntary contraction force in elbow flexion, which corresponds to a fair grade of muscle force. Perineural intramuscular stimulation can generate an equivocal contraction force with less discomfort in elbow flexion than surface electrode stimulation.