Natural Sensations Evoked in Distal Extremities Using Surface Electrical Stimulation

Julia P. Slopsema, John M. Boss, Lane A. Heyboer, Carson M. Tobias, Brooke P. Draggoo, Kathleen E. Finn, Payton J. Hoff, Katharine H. Polasek*
Hope College Depatment of Engineering, 223F Vanderwerf 27 Graves Place, Holland, MI 49423, USA

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Creative Commons License
© 2018 Slopsema et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Hope College, 223F Vanderwerf, 27 Graves Place, Holland, MI 49423, Tel: 616-395-7079, Fax: 616-395-7123; E-mail:



Electrical stimulation is increasingly relevant in a variety of medical treatments. In this study, surface electrical stimulation was evaluated as a method to non-invasively target a neural function, specifically natural sensation in the distal limbs.


Electrodes were placed over the median and ulnar nerves at the elbow and the common peroneal and lateral sural cutaneous nerves at the knee. Strength-duration curves for sensation were compared between nerves. The location, modality, and intensity of each sensation were also analyzed. In an effort to evoke natural sensations, several patterned waveforms were evaluated.


Distal sensation was obtained in all but one of the 48 nerves tested in able-bodied subjects and in the two nerves from subjects with an amputation. Increasing the pulse amplitude of the stimulus caused an increase in the area and magnitude of the sensation in a majority of subjects. A low frequency waveform evoked a tapping or tapping-like sensation in 29 out of the 31 able-bodied subjects and a sensation that could be considered natural in two subjects with an amputation. This waveform performed better than other patterned waveforms that had proven effective during implanted extra-neural stimulation.


Surface electrical stimulation has the potential to be a powerful, non-invasive tool for activation of the nervous system. These results suggest that a tapping sensation in the distal extremity can be evoked in most able-bodied individuals and that targeting the nerve trunk from the surface is a valid method to evoke sensation in the phantom limb of individuals with an amputation for short term applications.

Keywords: Artificial Sensation, Strain hardening, Electrical Stimulation, Referred Sensation, Surface electrodes, Surface Electrical Stimulation, Phantom Limb.