Effects of Narrow- Vs. Wide-Pulse Neuromuscular Electrical Stimulation Training on Functional Performance
Journal of strength and conditioning research · 2026
Narrow vs wide-pulse NMES built quadriceps strength equally well in healthy men, but neither improved jump performance, so don't expect NMES alone to boost function.
Studiet
RCT, n=36 healthy men randomised to control, narrow-pulse NMES, or wide-pulse NMES quadriceps training for 6 weeks.
Hvad de fandt
Both narrow- (0.2 ms) and wide-pulse (1 ms) NMES produced similar gains in late-phase rate of torque development and isokinetic strength across all tested velocities (p<0.05 for both groups), but neither improved countermovement jump height or fatigue index. No effect sizes or confidence intervals were reported in the abstract, only p-values.
Vurderingen
This is a well-controlled lab study (randomised, dedicated control group, standardised stimulation parameters) but it is small, roughly 12 per arm, and single-sex, so it is underpowered to detect anything but fairly large within-group changes and cannot speak to women or clinical populations. The headline finding is a genuine and useful null: the hypothesised advantage of wide-pulse NMES (thought to recruit motor units more physiologically) over narrow-pulse did not materialise, and strength gains did not transfer to a dynamic, sport-relevant task like the CMJ. The abstract does not state whether the RTD and isokinetic gains outstripped the control group's own pre-post change, so a test-retest or familiarisation effect on the isokinetic dynamometer cannot be excluded as a partial explanation. Without effect sizes or CIs it is also hard to judge whether the improvements are clinically meaningful or just statistically detectable.
Begrænsningen
The study was done in healthy, uninjured men, whereas NMES is used clinically mainly for quadriceps activation failure after injury or surgery (e.g. ACL reconstruction); we don't know if the narrow vs wide pulse question resolves the same way in an inhibited or deconditioned muscle, which is where it actually matters.
Referencestudie
This sits within the NMES literature built up by groups including Gondin and Maffiuletti, who have previously proposed that wide-pulse, higher-frequency NMES may recruit motor units in a more voluntary-like, reversed-order pattern than conventional narrow-pulse stimulation. This trial directly tests that hypothesis for functional outcomes and finds no practical advantage, which pushes back against the idea that pulse width selection meaningfully changes real-world training effects.
Hvad du gør på mandag
Pulse duration (narrow vs wide) is not a variable worth agonising over: this trial found no strength or power advantage of one over the other, so pick whichever setting the patient or athlete tolerates better at higher current intensity, since intensity, not pulse width, is what drives the adaptation. Don't expect NMES-only quadriceps work, regardless of pulse width, to improve jump or explosive dynamic performance; pair it with volitional strength and plyometric/RFD work if power transfer is the goal. Treat the strength gains as promising but not definitive, since the abstract doesn't confirm they exceeded the control group's own change over the same 6 weeks.
In practice
In the physio clinic, this changes NMES parameter selection for quadriceps activation failure (post-ACLR, post-arthroplasty): stop defaulting to wide-pulse settings on the assumption they recruit more physiologically, pick whichever pulse duration the patient tolerates at the highest current intensity, since intensity is the driver, not pulse width, and keep pairing NMES with volitional loading since it won't build jump-relevant power on its own. On the S&C floor, use e-stim as a strength/cross-education adjunct in deload, injury, or heavy-camp-fatigue phases where volitional loading is limited, not as a substitute for plyometric or RFD work, since 6 weeks of NMES in healthy men moved isokinetic and late-RTD numbers but did nothing for CMJ. Caveat in applying it: this is healthy young men over 6 weeks with quadriceps gains that aren't confirmed against the control group's own change, so treat the magnitude as encouraging rather than proven, and don't extrapolate the pulse-width equivalence to markedly inhibited or atrophied muscle without checking it holds there too.
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