Hybrid activation (HA), patterned electrical stimulation (ES) superimposed on attempted voluntary movement in close synchrony, can augment muscle force output. It has been proposed for limb function restoration and neuromodulation. Limited studies have been performed to investigate the influences of HA on muscle oxygenation and brain cortical activity. The present study investigates muscle oxygenation and cortical activity during isometric knee extension tasks with voluntary contraction (VOL) only, ES only, and with HA at three stimulation intensities, namely 10 mA (HA-I), 30 mA (HA-II), and 50 mA (HA-III). A frequencydomain near-infrared spectroscopy system was employed to assess the muscle oxygenation in the vastus lateralis as well as the cortical activity from the bilateral sensorimotor cortices (SMCs), premotor cortices (PMCs), and supplementary motor areas (SMAs). Our results show that the increased ES contribution during HA significantly increased O2 demand in working muscle, implying that the intervention of ES accelerates the muscle metabolism during muscle contraction. For cortical activation, ES only had a similar cortical activation pattern to that during VOL but with lower activation in SMCs, PMCs, and SMAs. Augmented sensorimotor activation was observed during the HA-II condition. The enhanced level of cortical activation during HA was not only affected by the ES contribution within HA but also related to the functional specificity of cortical areas. Our results suggest that HA can effectively enhance the muscle oxygen demand as well as the activation of cortical regions, and that the ES contribution within HA is a key factor.
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