The Immediate Carryover Effects of Peroneal Functional Electrical Stimulation Differ between People with and without Chronic Ankle Instability

Abstract

Chronic ankle instability (CAI) is a common condition that may develop after an ankle sprain. Compared with healthy individuals, those with CAI demonstrate excessive ankle inversion and increased peroneal electromyography (EMG) activity throughout the stance phase of gait, which may put them at greater risk for re-injury. Functional electrical stimulation (FES) of targeted muscles may provide benefits as a treatment modality to stimulate immediate adaptation of the neuromuscular system. The present study investigated the effect of a single, 10 min peroneal FES session on ankle kinematics and peroneal EMG activity in individuals with (n = 24) or without (n = 24) CAI. There were no significant differences in ankle kinematics between the groups before the intervention. However, after the intervention, healthy controls demonstrated significantly less ankle inversion between 0–9% (p = 0.009) and 82–87% (p = 0.011) of the stance phase. Furthermore, a significant within-group difference was observed only in the control group, demonstrating increased ankle eversion between 0–7% (p = 0.011) and 67–81% (p = 0.006) of the stance phase after the intervention. Peroneal EMG activity did not differ between groups or measurements. These findings, which demonstrate that peroneal FES can induce ankle kinematics adaptations during gait, can help to develop future interventions for people with CAI.

Effects of Functional Electrical Stimulation on Gait Characteristics in Healthy Individuals: A Systematic Review

“…Most studies [13,14,16,[21][22][23][24][25][27][28][29] obtained a PEDro score of 6 or higher (n = 10), i.e., a good methodological quality (Table 2). The remaining five studies [15,22,24,26,31] scored 5, corresponding to a moderate methodological quality. The included studies are subject to common biases, especially in relation to items 6 and 7, which indicate that none of the examiners or researchers involved in these studies was blinded.…”

“…Fourteen studies examined the effects of FES on gait characteristics in healthy young individuals (186 participants; mean age: 25 years), whereas only one study investigated the effects of FES in the elderly (29 participants; mean age: 75 years) [16]. Two of these studies focused on the effects of FES during walking in healthy young subjects, comparing them to pathological populations such as post-stroke patients and individuals with chronic ankle instability [27,31]. In this systematic review, only data on healthy participants were considered and are summarized in Table 1.…”

“…The most frequently targeted muscle was the gastrocnemius [13,14,16,22,23,25,29,30], followed by the biceps femoris [13,15,16,23,25,26,30], tibialis anterior [13,16,23,25,27,30], rectus femoris [13,16,21,25,30], and soleus [13,14,22]. Additionally, isolated studies investigated the effects of FES on the gluteus medius [24], peroneus longus [31], and abductor hallucis [28].…”

“…Wave type. Regarding the type of current used, most of the experiments used a biphasic current [13,14,16,24,29,31]. Among them, three delivered a rectangular waveform stimulation [16,23,27] and two used an asymmetric waveform current [14,24].…”

A single-center, assessor-blinded, randomized controlled clinical trial to test the safety and efficacy of a novel brain-computer interface controlled functional electrical stimulation (BCI-FES) intervention for gait rehabilitation in the chronic stroke population

“…Functional electrical stimulation (FES) is another commonly used approach to mitigate post-stroke gait deficits. While primarily used in conjunction with AFOs to manage FD [ 23 ], repeated FES use may have a temporary “carryover” effect [ 24 , 25 ]. However, there are contradictory reports in randomized controlled trials (RCTs) on the therapeutic effect of FES as a standalone therapy [ 23 , 26 – 28 ].…”