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Vol. 43. Issue 7.
Pages 411-417 (January 2007)
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Vol. 43. Issue 7.
Pages 411-417 (January 2007)
Techniques and Procedures
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Magnetic Stimulation of the Quadriceps: Analysis of 2 Stimulators Used for Diagnostic and Therapeutic Applications
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Víctor Bustamante Madariagaa,b,
Corresponding author
victor.bustamantemadariaga@osakidetza.net

Correspondence: Dr. V. Bustamante Madariaga. Servicio de Neumología. Hospital de Basurto. Avda. Montevideo, 18. 48013 Bilbao. España
, Amaia Gorostiza Manterolac, Elena López de Santa María Miróc, Juan B. Gáldiz Iturrib,c
a Servicio de Neumología, Hospital de Basurto, Osakidetza, Bilbao, Vizcaya, Spain
b Departamento de Medicina, Facultad de Medicina, Universidad del País Vasco, Leioa, Vizcaya, Spain
c Servicio de Neumología, Hospital de Cruces, Osakidetza, Baracaldo, Vizcaya, Spain
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Compromised muscle function can be evaluated in respiratory disease patients by supramaximal magnetic stimulation (isometric twitch) of the quadriceps, a technique that is reproducible and objective. We validated the technique, comparing a device used in our laboratory with another reference electromagnet. We also assessed whether the technique could potentially be used to train the muscle by repetitive stimulation.

The Medtronic Magpro (MED) device with a circular coil and the Magstim 200 device (MAG) with a figure-of-eight coil (reference device) were used to stimulate the femoral nerve of 6 volunteers at different percentages of maximal output. MED stimulation was also applied on the quadriceps muscle. We measured voluntary contractions, comparing measurements from the 2 devices and on different days. The stimulation achieved with MED was lower than with MAG, showed greater day-to-day variability, and was not clearly supramaximal. MED quadriceps stimulation was 80.7% of MAG stimulation.

In conclusion, supramaximal stimulation of the quadriceps cannot be guaranteed with MED and the circular coil. However, this device generates sufficient contraction when applied to the muscle to be used for repetitive stimulation.

Key words:
Skeletal muscles
Quadriceps
Femoral nerve
Chronic obstructive pulmonary disease (COPD)
Neuromuscular disease Neurophysiology
Lung function tests
Electromagnetism
Magnetic stimulation

La estimulación supramáxima o twitch magnético isométrico del cuádriceps es una técnica reproducible y objetiva que nos informa sobre la función muscular, que se encuentra comprometida en las enfermedades respiratorias. Hemos validado la técnica estándar y comparado un equipo utilizado en nuestro laboratorio con otro electroimán de referencia. También evaluamos el potencial de la técnica para entrenamiento muscular mediante estimulación repetitiva.

Los equipos Magstim 200 con pala en mariposa (MAG, equipo de referencia) y Medtronic Magpro con pala circular (MED) se aplicaron sobre el nervio femoral de 6 voluntarios, a diferentes porcentajes del estímulo máximo. El MED se aplicó también sobre el músculo cuádriceps (MED-Q). Se realizaron medidas voluntarias y comparaciones entre equipos y días diferentes. El MED alcanzó valores menores que el MAG, con mayor variabilidad entre días y sin clara supramaximalidad. La estimulación MED-Q fue equivalente al 80,7% del MAG.

En conclusión, no puede garantizarse un estímulo supramáximo del cuádriceps con el MED y pala redonda, aunque ésta, aplicada sobre el músculo, genera una contracción que avala este abordaje para la estimulación repetitiva.

Palabras clave:
Músculos esqueléticos
Cuádriceps
Nervio femoral
EPOC
Enfermedad neuromuscular
Neurofisiología
Pruebas de función respiratoria
Electromagnetismo
Estimulación magnética
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Study financed by a Spanish Society for Pulmonology and Thoracic Surgery (SEPAR) 2004 grant and a European Union grant associated with a project of the European network for Investigating the Global Mechanisms of Muscle Abnormalities for COPD.

Copyright © 2007. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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