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The pattern of seven pulses that elicited maximal thenar force was determined for control muscles and those that have been paralyzed chronically by spinal cord injury. For each subject group (n = 6), the peak force evoked by two pulses occurred at a short interval (5-15 ms; a "doublet"), but higher mean relative forces were achieved in paralyzed versus control muscles (41.4 +/- 3.9% vs. 22.7 +/- 2.0% maximal). Thereafter, longer intervals evoked peak force in each type of muscle (mean: 35 +/- 1 ms, 36 +/- 2 ms, respectively). With seven pulses, paralyzed and control muscles reached 76.4 +/- 5.6% and 57.0 +/- 2.6% maximal force, respectively. These force differences resulted from significantly greater doublet/twitch and doublet/tetanic force ratios in paralyzed (2.73 +/- 0.08, 0.35 +/- 0.03) compared with control muscles (2.07 +/- 0.07, 0.25 +/- 0.01). The greater force enhancement produced in paralyzed muscles with two closely spaced pulses may relate to changes in muscle stiffness and calcium metabolism. Peak force-time integrals were also achieved with an initial short interpulse interval, followed by longer intervals. The postdoublet intervals that produced peak force-time integrals in paralyzed and control muscles were longer than those for peak force, however (77 +/- 3 ms, 95 +/- 4 ms, respectively). These data show that the pulse patterns that maximize force and force-time integral in paralyzed muscles are similar to those that maximize these parameters in single motor units and various whole muscles across species. Thus the changes in neuromuscular properties that occur with chronic paralysis do not strongly influence the pulse pattern that optimizes muscle force or force-time integral.

Stimulation Pattern That Maximizes Force in Paralyzed and Control Whole Thenar Muscles