{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T03:16:43Z","timestamp":1767842203874,"version":"3.49.0"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"New Frontiers in Research Fund (NFRF)","award":["2019-01004"],"award-info":[{"award-number":["2019-01004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>We assessed the feasibility of implementing a virtually guided Neuromuscular Electrical Stimulation (NMES) protocol over the tibialis anterior (TA) muscle while collecting heart rate (HR), Numeric Pain Rating Scale (NPRS), and quality of contraction (QoC) data. We investigated if HR, NPRS, and QoC differ ON and OFF the TA motor point and explored potential relationships between heart rate variability (HRV) and the NPRS. Twelve healthy adults participated in this cross-sectional study. Three NMES trials were delivered ON and OFF the TA motor point. HR, QoC, and NPRS data were collected. There was no significant difference in HRV ON and OFF the motor point (p &gt; 0.05). The NPRS was significantly greater OFF the motor point (p &lt; 0.05). The QoC was significantly different between motor point configurations (p &lt; 0.05). There was no correlation between the NPRS and HRV (p &gt; 0.05, r = \u22120.129). We recommend non-electrical methods of measuring muscle activity for future studies. The NPRS and QoC can be administered virtually. Time-domain HRV measures could increase the validity of the protocol. The variables should be explored further virtually to enhance the protocol before eventual ICU studies.<\/jats:p>","DOI":"10.3390\/s24113599","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T05:58:00Z","timestamp":1717394280000},"page":"3599","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Using Physiological Markers to Assess Comfort during Neuromuscular Electrical Stimulation Induced Muscle Contraction in a Virtually Guided Environment: Pilot Study for a Path toward Combating ICU-Acquired Weakness"],"prefix":"10.3390","volume":"24","author":[{"given":"Ahmad","family":"Abou-Hamde","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada"}]},{"given":"Lauren","family":"Philippi","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada"}]},{"given":"Eric","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada"}]},{"given":"Christian","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada"}]},{"given":"Kingsley","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada"}]},{"given":"Michael","family":"Kundell","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5564-9796","authenticated-orcid":false,"given":"Sunita","family":"Mathur","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Therapy, Queen\u2019s University, Kingston, ON K7L 3N6, Canada"}]},{"given":"Alireza","family":"Sadeghian","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3033-5675","authenticated-orcid":false,"given":"Maryam","family":"Davoudpour","sequence":"additional","affiliation":[{"name":"Faculty of Applied Sciences and Technology, Humber College, Toronto, ON M9W 5L7, Canada"}]},{"given":"Jane","family":"Batt","sequence":"additional","affiliation":[{"name":"Division of Respirology, Department of Medicine, Unity Health Toronto, Toronto, ON M5B 1W8, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1932-2797","authenticated-orcid":false,"given":"Adriana","family":"Ieraci","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5202-3736","authenticated-orcid":false,"given":"Sharon","family":"Gabison","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lad, H., Saumur, T.M., Herridge, M.S., Dos Santos, C.C., Mathur, S., Batt, J., and Gilbert, P. 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