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Muscle fatigue due to functional electrical stimulation still prevents its  widespread use as a gait rehabilitation tool for spinal cord injured  subjects. Although there is an active research towards optimization of pulse  parameters to delay muscle fatigue, changes in stimulated muscle's  performance during repeated contractions due to fatigue have not been yet  determined. In this work, a study conducted in two phases with a sample of  incomplete spinal cord injured patients is presented. In the first phase, a  fatigue protocol based on submaximal isometric contractions allowed to obtain  an objective criterion for estimation of fatigue of knee muscles from initial  changes in muscle performance. The criterion is incorporated in the fatigue  protocol in the second phase of the study, to compare two novel customized  fatigue management strategies. Results showed that knee flexor muscles  develop less force and lower fatigue than extensor muscles. Muscle fatigue  management strategies based on customized modulations of stimulation  frequency are valid to delay muscle fatigue

A comparison of customized strategies to manage muscle fatigue in isometric artificially elicited muscle contractions for incomplete SCI subjects