Advances in Electrotherapy

Purpose Neuromuscular electrical stimulation (NMES) training is known to induce improvement in force production capacities and fibre-type transition. The aim of this study was to determine whether NMES training also leads to changes in the mechanical properties of the human triceps surae (TS) muscle.

Methods Fifteen young male subjects performed a training protocol (4 weeks, 18 sessions, 4–5 sessions per week) based on a high-frequency isometric NMES programme of TS muscle.  Quick-release test was used to evaluate Musculo-Tendinous (MT) stiffness index (SI_MT) as the slope of the linear MT stiffness–torque relationships under submaximal contraction. Sinusoidal perturbations allowed the assessment of musculo-articular stiffness index (SI_MA) as well as the calculation of the maximal angular velocity maximal shortening/angular velocity (for in vivo muscle) of TS muscle using an adaptation of Hill’s equation.

Results After NMES training, Maximal Voluntary Contraction under isometric conditions and maximal shortening/angular velocity (for in vivo muscle) increased significantly by 17.5 and 20.6 %, respectively, while SI_MT and SI_MA decreased significantly (-12.7 and -9.3 %, respectively).

Conclusions These changes in contractile and elastic properties may lead to functional changes of particular interest in sport-related activities as well as in the elderly.

Background Plantar fasciitis is the most common cause of heel pain. It may remain symptomatic despite conservative treatment with orthoses and analgesia. There is conflicting evidence concerning the role of extracorporeal shock wave therapy (ESWT) in the management of this condition.

Questions/purposes We investigated whether there was a significant difference in the change of (1) VAS scores and (2) Roles and Maudsley scores from baseline when treated with ESWT and placebo. Specifically we compared overall improvement from baseline composite VAS, reduction in
overall VAS pain, success rate of improving overall VAS pain by 60%, success rate of improving VAS pain by 60% when taking first steps, doing daily activities, and during application of a pain pressure meter.

Conclusions ESWT is a safe and effective treatment of chronic plantar fasciitis refractory to nonoperative treatments.  Improved pain scores with the use of ESWT were evident 12 weeks after treatment. The evidence suggests this improvement is maintained for up to 12 months. We recommend the use of ESWT for patients with substantial heel pain despite a minimum of 3 months of nonoperative treatment.