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Research Article

Acute Effects of Neuromuscular Electrical Stimulation Priming on Volleyball Spike Performance and Three-Dimensional Kinematics

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DOI:

10.3791/72492

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September 3rd, 2026

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* These authors contributed equally

In This Article

Summary

This study examined the acute effects of neuromuscular electrical stimulation priming on volleyball spike performance and three-dimensional kinematics in male university volleyball players. Compared with the time-matched control group, the NMES conditioning group demonstrated greater ball velocity and phase-specific differences in lower-limb joint angles, segmental velocities, and shoulder–hip separation angle.

Abstract

Volleyball spiking is a complex explosive skill that requires coordinated force generation and transfer across the upper limbs, trunk, and lower limbs. Neuromuscular electrical stimulation (NMES) has been proposed as a preconditioning strategy for enhancing neuromuscular activation; however, its acute effects on phase-specific volleyball spike kinematics remain unclear. This study investigated the acute effects of NMES priming on spike performance and three-dimensional kinematics in male university volleyball players. Thirty participants were randomly assigned to an NMES conditioning group (n = 15) or a control group (n = 15). All participants completed a baseline spike assessment and a second assessment 72 h later. Immediately before the second assessment, the NMES group received 30 min of stimulation applied to the upper-limb muscles, including the deltoid, biceps brachii, and triceps brachii; the external oblique as a core muscle; and the vastus lateralis as a lower-limb muscle. The control group completed the same time-matched assessment without NMES. Three-dimensional kinematic data were collected using a synchronized four-camera three-dimensional motion-analysis system. The primary analysis compared performance and kinematic variables between the groups at the second assessment. Compared with the control group, the NMES group demonstrated greater ball velocity, smaller knee and ankle angles at bilateral-foot contact, greater hip, knee, and ankle angles at bilateral take-off, and higher thigh, calf, and foot segmental velocities. The NMES group also showed a smaller shoulder–hip separation angle at bilateral take-off and ball contact. These findings indicate that acute NMES priming applied to upper-limb, core, and lower-limb muscles may influence phase-specific joint configurations, lower-limb segmental velocities, and ball velocity during volleyball spiking. NMES may therefore have potential as a pre-performance neuromuscular activation strategy, although further studies using concealed allocation, blinded assessment, and direct group-by-time analyses are required.

Introduction

Volleyball is a competitive sport that relies heavily on explosive power and coordination, and spiking is one of the most important means of scoring1. This technical movement places high demands on the athlete’s muscle output capacity, movement timing control, and neuromuscular control ability2. A successful spike consists of three key stages: the run-up, take-off, and aerial hitting phases. Effective performance across these stages depends on coordinated force production and efficient energy transfer through the segments of the kinetic chain3. Previous studies have shown that hip-knee-ankle triple extension, trunk stability, and upper limb joint angles and velocity at the moment of hitting the ball are all important factors affecting spiking performance4.

During competition and high-intensity training, athletes often suffer from insufficient neural drive and poor movement pre-activation, which leads to reduced coordination of the kinetic chain and decreased muscle strength, and affects their overall athletic performance5. NMES is a non-invasive neural activation technology that addresses this and has attracted significant attention in sports science in recent years6. Studies have shown that NMES can stimulate target muscle groups via an external electric current, and increase the excitability of spinal motor neurons and the recruitment efficiency of fast muscle fibers, thereby enhancing muscle strength output and motor control performance7,8. Although NMES has been widely used in long-term training strategies, such as rehabilitation and muscle strength enhancement, its single, immediate application in the field of competitive sports has not been fully tested9. Although sports like volleyball are highly dependent on accurate timing and integrated movements, investigations of empirical research into the impact of NMES on the three stages of spiking (run-up, take-off, and aerial hitting) based on kinematic indicators are rare10. The volleyball spike jump is characterized by a rapid stretch–shortening cycle. During the final approach and bilateral-foot contact, the lower-limb muscles undergo eccentric loading as the hip, knee, and ankle joints flex. This is followed immediately by rapid concentric action and coordinated triple extension during take-off. The effective transition between these eccentric and concentric actions contributes to the production of vertical impulse and take-off performance during spiking.

Previous NMES research in sport has largely focused on rehabilitation, isolated muscle strengthening, or general neuromuscular performance, whereas its immediate application to complex sport-specific skills remains less clearly understood. In addition, existing volleyball biomechanical studies have primarily characterized spike technique, joint motion, or arm-swing patterns without directly examining the acute effects of multiregional NMES conditioning. Therefore, the present study investigated whether a single NMES session applied to upper-limb, core, and lower-limb muscles was associated with differences in volleyball spike performance and phase-specific three-dimensional kinematics. The methodological contribution of this study lies in the synchronized analysis of body-segment motion and ball velocity across the run-up, bilateral-foot contact, take-off, and aerial ball-contact events within a randomized, time-matched controlled design. This approach extends conventional volleyball kinematic analysis by linking an acute neuromuscular conditioning intervention with movement characteristics across the complete spike sequence.

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Protocol

Participants and eligibility criteria

The study protocol was approved by the Academic Ethics Committee of Jimei University (Approval No. JD02RS02406) and was conducted in accordance with the Declaration of Helsinki. Before enrollment, all participants received a detailed explanation of the study purpose, experimental procedures, potential risks, and their right to withdraw from the study at any time without penalty. Written informed consent was obtained from all participants before any study-related procedures were performed. Thirty healthy male university students with volleyball training experience were recruited from elective volleyball courses at a normal university through course announcements. Potential participants completed a health- and injury-history questionnaire before enrollment. Participants were eligible if they: (1) were male university students; (2) had completed formal volleyball training; (3) demonstrated stable proficiency in the volleyball spike technique; (4) had previous competitive or organized volleyball experience; and (5) were able to complete the testing procedures safely. Participants were excluded if they had current musculoskeletal pain or injury that could affect spike performance, a history of recent surgery involving the upper limbs, lower limbs, or trunk, a neurological or cardiovascular disorder, or any contraindication to NMES. The participants’ mean age, height, and body mass were 20.2 ± 1.15 years, 182.1 ± 3.17 cm, and 70.6 ± 8.34 kg, respectively. Details of the equipment and materials used in this study, including manufacturers and model or catalog numbers, are provided in the Table of Materials.

Randomization, allocation concealment, and blinding

After completion of the baseline assessment, eligible participants were randomly assigned in a 1:1 ratio to either the NMES conditioning group or the control group using a simple drawing-of-lots procedure. Thirty identical folded cards, 15 labeled “NMES” and 15 labeled “Control,” were placed in an opaque container and drawn individually by the participants. No formal allocation-concealment procedure was used because the group labels became visible immediately after each card was drawn. Because the NMES intervention was readily identifiable, participants and the personnel administering the intervention could not be blinded to group assignment. The assessors responsible for motion capture, marker tracking, and outcome assessment were also not blinded to the intervention condition. The absence of allocation concealment and assessor blinding was acknowledged as a methodological limitation. Participants were assigned to the NMES conditioning group (n = 15) or the control group (n = 15). Independent-samples t-tests showed no significant between-group differences in age, height, body mass, or body mass index at baseline (all p > 0.05).

Experimental design

This study used a randomized, parallel-group, two-assessment controlled design. All participants completed a baseline spike assessment and a second assessment 72 h later. During the 72 h interval, participants were instructed to avoid organized training, strenuous exercise, and other high-intensity physical activity. Immediately before the second assessment, participants in the NMES conditioning group received a 30 min NMES intervention. Participants in the control group received no NMES intervention and completed the same time-matched second assessment. The values reported in Table 1 were obtained during the second assessment. Therefore, the NMES-group values represent measurements obtained immediately after NMES, whereas the control-group values represent measurements obtained during the second assessment without NMES. Table 1 does not present baseline values or pre–post change scores.

Experimental setting and equipment

Testing was conducted on an indoor volleyball court. The equipment included synchronized LED signal lights, a three-dimensional motion-analysis system, a three-dimensional calibration frame measuring 2.0 m x 1.5 m x 2.0 m (Figure 1A), four high-speed cameras, five frequency-modulated pulse therapy devices (Figure 1B), and standard volleyballs. The four cameras were positioned around the calibrated capture volume near the attacking zone at position 4. Video was recorded at a resolution of 1920 x 1080 pixels, a sampling frequency of 180 Hz, and a shutter speed of 1/1000 s. The global x-axis represented the mediolateral direction, the y-axis represented the direction of the spike approach, and the z-axis represented the vertical direction. Before testing, participants completed a standardized 20 min warm-up consisting of light running, dynamic lower- and upper-limb stretching, paired passing, setting, defensive movements, and submaximal spike practice.

Volleyball court setup with numbered positions (A) and player movement diagram (B) for strategy analysis.
Figure 1: Experimental setup for volleyball spike testing. (A) Three-dimensional calibration frame (2.0 m × 1.5 m × 2.0 m). (B) Four-camera arrangement for three-dimensional motion capture. Please click here to view a larger version of this figure.

Standardization of spike trials

A marked starting position was established 3 m behind the take-off area at position 4. The same experienced setter performed all sets during both assessments and remained at position 3. The setter was instructed to deliver the ball to a consistent height and position above the net so that each participant could use the same approach and spike technique. A 3 m x 3 m target area was marked in the opponent’s court. A valid trial was defined as one in which: (1) the participant began from the marked starting position; (2) the prescribed approach, bilateral take-off, and aerial hitting sequence was completed; (3) the ball was contacted cleanly; (4) the ball landed within the predefined target area; and (5) the anatomical and ball markers remained visible during the relevant analysis period. Each participant completed two familiarization attempts followed by recorded attempts until three valid trials were obtained. A 60 s passive rest interval was provided between attempts.

A trial was considered invalid if the set was unsuitable, the participant altered the prescribed approach, the participant failed to contact the ball cleanly, the ball landed outside the predefined target area, or marker visibility was insufficient. Invalid trials were excluded and repeated until three valid trials had been recorded. Among the three valid trials, the best-performing trial was selected for kinematic and performance analysis. The same trial-selection procedure was applied to both groups and at both assessments.

NMES intervention and stimulated muscle groups

The NMES intervention was administered for 30 min using five frequency-modulated pulse therapy devices. NMES was applied to upper-limb, core, and lower-limb muscles. The stimulated upper-limb muscles were the deltoid, biceps brachii, and triceps brachii. The stimulated core muscle was the external oblique, and the stimulated lower-limb muscle was the vastus lateralis. Self-adhesive electrodes were positioned over the muscle bellies according to anatomical landmarks and the device manufacturer’s instructions. Stimulation intensity was increased gradually until a clearly visible muscle contraction was produced without causing pain or intolerable discomfort. The mean recorded output values were 35.73 W for the deltoid, 35.21 W for the biceps brachii, 34.36 W for the triceps brachii, 33.85 W for the external oblique, and 37.09 W for the vastus lateralis. Immediately after completion of the NMES intervention, participants began the second spike assessment. Participants in the control group completed the same testing procedures without receiving electrical stimulation.

Stimulation parameters

The frequency-modulated pulse therapy device was operated at a fixed pulse frequency of 1000 Hz for all participants. Stimulation intensity was the only participant-specific output parameter and was gradually increased until a clearly visible muscle contraction was produced without pain or intolerable discomfort. The available study records did not contain independent settings for the pulse waveform, pulse width, duty cycle, contraction/rest cycle, or ramp-up/ramp-down times. These parameters could not be retrospectively retrieved; therefore, they are reported as unavailable rather than estimated.

NMES contraindications and safety monitoring

Before enrollment, participants were screened for contraindications to NMES using a health-history questionnaire and verbal confirmation by the research personnel. Participants were excluded if they had an implanted electronic device or cardiac pacemaker, epilepsy, clinically diagnosed cardiovascular disease, impaired skin sensation, open wounds, skin infection or irritation at an electrode site, an acute musculoskeletal injury, or a previous adverse reaction to electrical stimulation. Before electrode placement, the skin over each target muscle was inspected for wounds, irritation, infection, or other abnormalities. During stimulation, participants were continuously monitored and were instructed to report pain, dizziness, excessive muscle cramping, skin irritation, abnormal muscle contractions, or other unexpected symptoms. The stimulation intensity was reduced if excessive discomfort occurred. The intervention was discontinued if a participant experienced intolerable pain, dizziness, persistent skin irritation, abnormal muscle contractions, or another potentially unsafe response. Any adverse response and the action taken by the research personnel were documented.

Motion capture and calibration

Before each testing session, the measurement space was calibrated using a three-dimensional calibration frame measuring 2.0 m x 1.5 m x 2.0 m. All calibration points were visible in at least two camera views. The four cameras were synchronized using an LED signal that was visible in all camera recordings. Three-dimensional coordinates were reconstructed using three-dimensional motion-analysis software and a direct linear transformation procedure. Calibration quality was assessed by comparing the known coordinates of the calibration-frame control points with their reconstructed coordinates. The root-mean-square reconstruction error was 0.138 cm. Calibration was repeated when all required control points were not clearly visible or when the reconstruction error exceeded the laboratory acceptance criterion.

Marker placement and tracking

Twenty-one reflective markers were attached to anatomical landmarks on each participant. The marker locations included the top of the head; left and right ears; left and right acromia; left and right anterior superior iliac spines; left and right radial heads; left and right radial styloid processes; distal phalanges of the third fingers; left and right upper tibiae; left and right lateral malleoli; left and right calcanei; and distal phalanges of the left and right feet. One additional lightweight reflective marker was securely attached to the surface of the volleyball. The marker attachment was checked before every attempt to ensure that it remained fixed during the spike. Markers were digitized manually and tracked frame by frame using three-dimensional motion-analysis software. Automatic trajectories were visually inspected and manually corrected when necessary. Marker gaps of no more than five consecutive frames were reconstructed using cubic-spline interpolation. Trials containing longer gaps or missing marker data at a key event were excluded and repeated.

Event detection and technical phase division

Four key events were identified through frame-by-frame inspection of the synchronized camera recordings: (1) initial left-foot contact, defined as the first frame in which the left foot visibly contacted the floor (Figure 2A); (2) bilateral-foot contact, defined as the first frame in which both feet were simultaneously in contact with the floor (Figure 2B); (3) bilateral take-off, defined as the first frame in which both feet had completely left the floor (Figure 2C); (4) ball contact, defined as the first frame in which the hitting hand visibly contacted and displaced the ball (Figure 2D). The run-up phase extended from initial left-foot contact to bilateral-foot contact. The take-off phase extended from bilateral-foot contact to bilateral take-off. The aerial hitting phase extended from bilateral take-off to ball contact11,12. All events were identified by the same assessor to maintain consistency.

Motion analysis diagram; four frames illustrating movement path; kinetic study, biomechanics tracking.
Figure 2: Key events of the volleyball spike. (A) Initial left-foot contact. (B) Bilateral-foot contact. (C) Bilateral take-off. (D) Ball contact. Please click here to view a larger version of this figure.

Data processing

The kinematic parameters of volleyball spiking technique analyzed in this study are: shoulder-hip separation angle (Figure 3A) [the x-axis of the trunk coordinate system is defined as the line connecting the left anterior superior iliac spine to the right anterior superior iliac spine, the y-axis is defined as the forward direction of the anterior superior iliac spine, the z-axis is defined as the line connecting the midpoints of the two anterior superior iliac spines to the midpoints of the two acromion on the longitudinal axis, the angle formed by the local vector of the left anterior superior iliac spine relative to the right anterior superior iliac spine and the local vector of the left acromion relative to the right acromion and rotated relative to the xy plane of the coordinate system]; shoulder joint angle (Figure 3B) [the angle formed by the elbow joint, shoulder joint and hip joint]; elbow joint angle (Figure 3B) [the angle formed by the shoulder joint, elbow joint and wrist joint]; wrist joint angle (Figure 3B) [the angle formed by the elbow joint, wrist joint and finger joint]; hip joint angle (Figure 3C) [the angle formed by the shoulder joint, hip joint and knee joint]; knee joint angle (Figure 3C) [the angle formed by the hip joint, knee joint and ankle joint]; ankle joint angle (Figure 3C) [the angle formed by the knee joint, ankle joint and toes]13,14,15,16,17,18,19. Thigh, calf, and foot segmental velocities were calculated from the three-dimensional displacement of the corresponding segment center between consecutive frames. Linear velocity was obtained using a central-difference numerical differentiation procedure and was expressed in meters per second. Ball velocity was calculated from the resultant three-dimensional displacement of the ball marker divided by the sampling interval of 1/180 s. Peak ball velocity was defined as the highest resultant velocity recorded during the first three frames after hand–ball contact and was expressed in meters per second.

Kinematic analysis diagrams showing joint angles in 3D: shoulder-hip, elbow, wrist, hip, knee, ankle.
Figure 3: Kinematic parameters of the volleyball spike. (A) Shoulder–hip separation angle. (B) Shoulder, elbow, and wrist joint angles. (C) Hip, knee, and ankle joint angles. Please click here to view a larger version of this figure.

Statistical analysis

Statistical analyses were performed using SPSS. Continuous variables are presented as means and standard deviations. Independent-samples t-tests were used to compare age, height, body mass, and body mass index between the groups at baseline. The primary analysis compared the second-assessment kinematic and performance variables between the NMES conditioning group and the time-matched control group using the Mann–Whitney U test. The standardized Z statistic was reported for Mann–Whitney U comparisons. Effect size was calculated as r = |Z|/√N, where N was the total sample size for each comparison (N = 30); values of 0.10, 0.30, and 0.50 were interpreted as small, moderate, and large effects, respectively. The 95% confidence intervals for the mean difference (NMES − Control) were estimated from the reported means, SDs, and sample sizes using the Welch method. Pearson product–moment correlation coefficients were calculated using the second-assessment data from the NMES conditioning group to examine relationships among the kinematic and performance variables. The 95% confidence intervals for the correlation coefficients were calculated using Fisher’s z transformation. Benjamini–Hochberg false-discovery-rate correction was applied separately within each event family. Each run-up event family comprised three comparisons, whereas the bilateral take-off and ball-contact event families comprised 55 comparisons each. Statistical significance was set at α = 0.05 (Table 2 and Table 3).

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Results

Between-group differences in spike performance and kinematic parameters

Table 1 presents the between-group differences in volleyball spike performance and phase-specific kinematic parameters at the second assessment. Each group included 15 participants. During the aerial hitting phase, ball velocity at the moment of ball contact was significantly higher in the NMES conditioning group than in the control group (11.69 ± 2.14 vs. 9.95 ± 1.48 m/s; Z = &#...

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Discussion

The study investigated the acute effects of a single immediate NMES intervention on volleyball players’ spiking performance, with a focus on kinematic changes during the run-up, take-off, and aerial hitting phases. The results showed that when NMES was applied immediately to the lower limbs and key core muscle groups, participants’ joint angles, movement velocity, and ball velocity were significantly improved. This shows that NMES can instantly improve neuromuscular coordination and movement output efficiency...

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Disclosures

The authors declare no conflicts of interest. A generative artificial intelligence tool, ChatGPT (OpenAI), was used during manuscript revision to assist with English-language editing, grammatical correction, and improvement of clarity and readability. The AI tool was not used to generate, manipulate, or interpret the research data; perform the statistical analyses; produce the study results; or prepare or modify the figures. All AI-assisted text was critically reviewed, verified, and revised by the authors, who take full responsibility for the accuracy, integrity, and content of the final manuscript.

Acknowledgements

This study was supported by the Key Project of the Fujian Province Young and Middle-aged Teachers’ Education and Research Project (Science and Technology) (No. JZ240034), the Social Science Foundation of Fujian Province (No. FJ2025T011), the PhD Research Start-up Fund of Jimei University (No. Q202440), and the Ministry of Education Industry–Academia Collaborative Education Project (No. 231104575130151).

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Materials

List of materials used in this article
NameCompanyCatalog NumberComments
Frequency-modulated pulse therapy deviceManufacturer not specified in the study recordsGuangzhou, ChinaZN-566
High-speed cameraSony CorporationTokyo, JapanPXW-FS7
SPSSIBMArmonk, NY, USAVersion 27 for Windows
Three-dimensional motion-analysis systemVisol Inc.Gwangmyeong, Republic of KoreaKwon3D

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