Concordance of the location of the innervation zone of the tibialis anterior muscle using voluntary and imposed contractions by electrostimulation

Abstract

Background: The innervation zone (IZ) corresponds to the location of the neuromuscular junctions. Its location can be determined by using arranged surface linear electrode arrays. Typically, voluntary muscle contractions (VC) are used in this method. However, it also may be necessary to locate the IZ under clinical conditions such as spasticity, in which this type of contraction is difficult to perform. Therefore, contractions imposed by electrostimulation (ES) can be an alternative. There is little background comparing the locations of IZ obtained by two different types of contractions. Objective: Evaluate the concordance between using voluntary and imposed contractions from electrostimulation in order to determine the location of the innervation zone of the tibialis anterior muscle in healthy volunteers. Methods: The tibialis anterior (TA) muscle of sixteen volunteers (men: 8; women: 8; age: 22.1±1.4years, weight: 61.6±7.5kg, height: 167.1±7.5cm) were evaluated using a linear electrode array. The IZ of the TA muscle was located using two types of muscle contractions, voluntary (10% MVC) and imposed contractions by ES. The concordance between both conditions was evaluated using the Bland–Altman method and the concordance correlation coefficient (CCC). The analyses were applied to the absolute and relative positions to the length of an anatomical landmark frame. Results: CCC for absolute position was 0.98 (p<0.0001, 95% CI [0.98–1.00], and CCC for relative positions also was 0.98 (p<0.0001, 95% CI [0.97–1.00]). The Bland–Altman analysis for absolute data showed an average difference of −0.63mm (SD: 4.1). Whereas, for adjusted data, the average difference was −0.20% (SD: 1.2). The power of the results, based on absolute data, was 98%, whereas for relative data, 82%. Conclusion: In healthy volunteers, there was a substantially concordance between the location of the IZ of the TA muscle derived from using contractions imposed by ES and the location derived from using VC.