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. 2019 Feb 25;9:2732. doi: 10.1038/s41598-019-39522-6

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Coordination of the combined electric and mechanical stimulation and synergistic performance enhancement following 3 minutes of stimulation. (a) Four patterns of coordination: electrical (Elec) and mechanical (Mech) stimulations alone, and in-phase (In, 0° phase shift) and out-of-phase (Out, 180° phase shift) co-stimulations. (b) Improvement in the contractile force induced by the combined stimulation with different phase shifts. SEM, n = 10, 5, 10 and 5. (c) Improvement in the contractile force induced by stimulations with different frequencies. SEM, n = 3, 10, and 3. (d) Comparison of the performance improvements in the contractile force induced by the four patterns of stimulation in (a), the two single types of stimulation (Elec and Mech) and two co-stimulations (In and Out). SEM, n = 9, 11, 10 and 10. Out-of-phase co-stimulation increased the contractile force by 18% in 3 minutes. *P < 0.05, **P < 0.01, and ***P < 0.001.