Effects of Percutaneous Neuromodulation on Vertical Jump

N/AActive Not RecruitingNCT07524647

CEU San Pablo University29 enrolled

Overview

Vertical jump performance is a determinant factor in physical performance, both in sports and in daily life and work activities. The muscular power of the lower limbs and the ability to generate explosive strength directly influence vertical jump performance and athletic success. For this reason, the vertical jump is widely used as a field test to evaluate performance capacity. Different strategies have been used to improve vertical jump performance, such as plyometric training (PT) and electrostimulation (EMS). PT consists of stretch-shortening cycle movements that involve high-intensity eccentric contractions followed by rapid and powerful concentric actions. EMS applies electrical current over muscles or peripheral nerves to generate involuntary muscle contractions. Both methods have shown significant effects in improving vertical jump height. In recent years, new therapeutic techniques have emerged in physiotherapy to improve neuromuscular recruitment and functionality, such as ultrasound-guided percutaneous neuromodulation (PNM-e). This technique consists of the electrical stimulation of a peripheral nerve or a motor point through a needle under ultrasound guidance, for therapeutic purposes. Evidence suggests that PNM-e can improve pain, functionality, balance, and muscle endurance, and increase muscle strength immediately after application. Specifically, low-frequency PNM-e applied to the femoral nerve has been shown to increase maximal quadriceps strength and vertical jump height in athletes. The femoral nerve plays a key role in quadriceps activation, a muscle group essential for knee extension and hip flexion, functions that are indispensable for both daily and sports activities. However, the specific effects of femoral nerve PNM-e on power and biomechanics of the vertical jump have not been sufficiently explored. Therefore, the main objective of this pilot study was to evaluate the effects of ultrasound-guided percutaneous neuromodulation of the femoral nerve on vertical jump performance. The secondary objective was to compare the effects of isolated plyometric training versus its combination with PNM-e to determine whether the combined approach offers additional benefits on jump performance. A randomized experimental study was carried out with healthy athletes who regularly practice sports. Participants were randomly assigned to a control group (two plyometric training sessions) or to an experimental group (two plyometric training + PNM-e interventions sessions); in both cases the sessions were separated by 7 days. Vertical jump performance was measured twice using the countermovement jump (CMJ) test (before the first session and after the second one). It is expected that ultrasound-guided percutaneous neuromodulation of the femoral nerve, combined with plyometric training, will produce greater improvements in jump performance due to enhanced quadriceps activation and neuromuscular efficiency.

This study arises from the growing interest in exploring new therapeutic tools that can optimize neuromuscular function and physical performance through minimally invasive physiotherapy techniques. Among these, ultrasound-guided percutaneous neuromodulation (PNM-e) has recently gained attention as a procedure that enables direct electrical stimulation of peripheral nerves or motor points via a needle under ultrasound guidance. Previous research has shown that PNM-e can provide clinical benefits such as pain reduction, improved balance, and increased muscle strength. However, scientific evidence regarding its effects on sports performance remains limited. The femoral nerve, which innervates the quadriceps femoris, plays a crucial role in knee extension and hip flexion-movements essential for generating power during vertical jumping and other dynamic lower-limb actions. Recent studies suggest that electrical stimulation of this nerve may produce immediate increases in maximal quadriceps strength and vertical jump height in athletes. These findings form the rationale for the present study, which hypothesizes that femoral nerve neuromodulation could enhance neuromuscular performance by selectively activating fast-twitch muscle fibers and reducing neural inhibition. Unlike conventional methods such as surface electrostimulation or standard plyometric training, PNM-e provides precise and localized neuromuscular modulation, targeting specific neural structures under ultrasound control. This level of precision allows a safe and reproducible motor response, potentially translating into functional gains in athletic performance. The main objective of this research was to evaluate the effects of ultrasound-guided percutaneous neuromodulation of the femoral nerve on vertical jump performance. A secondary objective was to compare the outcomes of isolated plyometric training versus the combined intervention (PNM-e plus plyometric training), to determine whether the combination produces superior improvements. A randomized, experimental study was conducted with healthy physically active young athletes. Participants were randomly assigned to a control group (plyometric training only) or to an experimental group (plyometric training plus two sessions of PNM-e, one week apart). Vertical jump performance was assessed using the countermovement jump (CMJ) test, recorded and analyzed with the MyJump 2 mobile application, a validated tool for measuring jump parameters such as height, flight time, velocity, and power. Assessments were performed at two time points: before the first intervention and after the second intervention (7 days after the first intervention). The study was approved by the Ethics Committee of Universidad CEU San Pablo (code 1023-25 TFM) and conducted in accordance with the Declaration of Helsinki. All participants provided written informed consent after receiving detailed information about the procedures, risks, and benefits, and were free to withdraw at any time. It is expected that the combination of ultrasound-guided femoral nerve neuromodulation and plyometric training will enhance neuromuscular efficiency and lead to significant improvements in jump performance compared to plyometric training alone. This study aims to provide preliminary evidence on the potential of percutaneous neuromodulation as an adjunctive intervention for optimizing muscle performance and athletic function. The findings may contribute to the growing field of invasive physiotherapy by expanding its applications beyond rehabilitation toward performance enhancement. Ultimately, this research could inform future large-scale studies exploring the use of neuromodulation as a targeted and safe method to improve motor performance in both clinical and athletic populations.

Interventions

Plyometric TrainingBEHAVIORAL

The plyometric training program used was the one described by Sankey et al. as an effective exercise program for improving vertical jump: * 2 sets of 10 tuck jumps. * 2 sets of 10 alternating leg bounds. * 2 sets of 15 two-footed bench hops. * 2 sets of 20 rim jumps. The rest time between sets was 60 seconds.

Bilateral femoral nerve ultrasound guide neuromodulationBEHAVIORAL

Bilateral application of an asymmetric biphasic current to the femoral nerve with a frequency of 10 Hz and a pulse width of 240 µs. The intensity of the current was increased until a visible but painless motor response was achieved, using the 10-10-10 protocol (10 seconds of stimulation - 10 seconds of rest - 10 repetitions) described by MVClinic Institute. The current was applied using Physio Invasiva 2.0 ®, and Agupunt APS® needles were used, the length of which depended on the patient's anatomy, taking as a safety reference the measurement of the distance from the skin to the target tissue, estimating the size between 0.30 x 40 and 0.30 x 50 mm. Before needle insertion, the skin was cleansed with isopropyl alcohol and chlorhexidine, a clean skin antiseptic. After locating the femoral nerve in the femoral triangle using a General Electrics LOGIQ S7 ultrasound system, the needle was introduced using a long-axis approach, at a 45° angle to the skin, until it reached the epineurium of t

Outcomes

Primary Outcomes

Vertical Jump Height

Vertical jump height will be assessed using the MyJump2 app. This tool allows for precise measurement of jump height through video recording and frame-by-frame analysis. Each participant will perform ten maximum jumps in each measurement, and all results will be recorded. The evaluation will be carried out under standardized conditions, with participants dressed in athletic wear and after a warm-up.