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However, the optimal stimulation frequency for effective neuromodulation remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eleven able\u2010bodied individuals participated in our study to examine the effects of: (1) low\u2010frequency NMES at 25\u2009Hz, (2) high\u2010frequency NMES at 100\u2009Hz; and (3) mixed\u2010frequency NMES at 25 and 100\u2009Hz switched every second. NMES was delivered to the right tibialis anterior (TA) muscle for 1\u2009min in each condition. The order of interventions was pseudorandomized between participants with a washout of at least 15\u2009min between conditions. Spinal reflexes were elicited using single\u2010pulse transcutaneous spinal cord stimulation applied over the lumbar enlargement to evoke responses in multiple lower\u2010limb muscles bilaterally and maximum motor responses (<jats:italic>M<\/jats:italic><jats:sub>max<\/jats:sub>) were elicited in the TA muscle by stimulating the common peroneal nerve to assess fatigue at the baseline and immediately, 5, 10, and 15\u2009min after each intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our results showed that spinal reflexes were significantly inhibited immediately after the mixed\u2010frequency NMES, and for at least 15\u2009min in follow\u2010up. Low\u2010frequency NMES inhibited spinal reflexes 5\u2009min after the intervention, and also persisted for at least 10\u2009min. These effects were present only in the stimulated TA muscle, while other contralateral and ipsilateral muscles were unaffected. <jats:italic>M<\/jats:italic><jats:sub>max<\/jats:sub> responses were not affected by any intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results indicate that even a short\u2010duration (1\u2009min) NMES intervention using low\u2010 and mixed\u2010frequency NMES could inhibit spinal reflex excitability of the TA muscle without inducing fatigue.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14737","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T09:50:54Z","timestamp":1709545854000},"page":"891-901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inhibition of tibialis anterior spinal reflex circuits using frequency\u2010specific neuromuscular electrical stimulation"],"prefix":"10.1111","volume":"48","author":[{"given":"Suzufumi","family":"Arai","sequence":"first","affiliation":[{"name":"Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering Osaka University  Toyonaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8396-9551","authenticated-orcid":false,"given":"Atsushi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering Osaka University  Toyonaka Japan"},{"name":"The Miami Project to Cure Paralysis University of Miami  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shota","family":"Tsugaya","sequence":"additional","affiliation":[{"name":"Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering Osaka University  Toyonaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6545-2097","authenticated-orcid":false,"given":"Taishin","family":"Nomura","sequence":"additional","affiliation":[{"name":"Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering Osaka University  Toyonaka Japan"},{"name":"Global Center for Medical Engineering and Informatics Osaka University  Suita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7629-1850","authenticated-orcid":false,"given":"Matija","family":"Milosevic","sequence":"additional","affiliation":[{"name":"Graduate School of Engineering Science, Department of Mechanical Science and Bioengineering Osaka University  Toyonaka Japan"},{"name":"The Miami Project to Cure Paralysis University of Miami  Miami Florida USA"},{"name":"Department of Neurological Surgery University of Miami  Miami Florida USA"},{"name":"Department of Biomedical 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