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Fatigue increases the time between the beginning of NMES and the onset of muscle force (Delay<jats:sub>TOT<\/jats:sub>). Understanding how much muscle fatigue affects the Delay<jats:sub>TOT<\/jats:sub> in people with SCI could help in the design of closed\u2010loop neuroprostheses that compensate for this delay, thus making the control system more stable. The aim of this study was to evaluate the impact of the extent of fatigue on Delay<jats:sub>TOT<\/jats:sub> and peak force of the lower limbs in people with complete SCI. Fifteen men\u2014young adults with complete SCI (paraplegia and tetraplegia) and stable health\u2014participated in the experiment. Delay<jats:sub>TOT<\/jats:sub> was defined as the time interval between the beginning of NMES application until the onset of muscle force. The electrical intensity of NMES applied was adjusted individually and consisted of the amplitude required to obtain a full extension of the knee (0\u00b0), considering the maximum electrically stimulated extension (MESE). Subsequently, 70% of the MESE was applied during the fatigue induction protocol. Significant differences were identified between the moments before and after the fatigue protocol, both for peak force (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a0.026) and Delay<jats:sub>TOT<\/jats:sub> (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a0.001). The medians and interquartile range of the Delay<jats:sub>TOT<\/jats:sub> were higher in postfatigue (199.0\u00a0ms) when compared to the moment before fatigue (146.5\u00a0ms). The medians and interquartile range of the peak force were higher in unfatigued lower limbs (0.43\u00a0kgf) when compared to the moment postfatigue (0.27\u00a0kgf). The results support the hypothesis that muscle fatigue influences the increase in Delay<jats:sub>TOT<\/jats:sub> and decrease in force production in people with SCI. For future applications, the combined evaluation of the delay and force in SCI patients provides valuable feedback for NMES paradigms. The study will provide potentially critical muscle mechanical evidence for the investigation of the evolution of atrophy.<\/jats:p>","DOI":"10.1111\/aor.13573","type":"journal-article","created":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T20:31:51Z","timestamp":1569443511000},"page":"305-313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fatigue in complete spinal cord injury and implications on total delay"],"prefix":"10.1111","volume":"44","author":[{"given":"Carla Daniele Pacheco","family":"Rinaldin","sequence":"first","affiliation":[{"name":"Human Motricity Laboratory\/PPGTS Pontifical Catholic University of Paran\u00e1 (PUCPR) Curitiba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciane Patr\u00edcia Adreani","family":"Cabral","sequence":"additional","affiliation":[{"name":"Human Motricity Laboratory\/PPGTS Pontifical Catholic University of Paran\u00e1 (PUCPR) Curitiba 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