Pilot randomized trial demonstrates NMES may improve knee strength and reduce pain in transtibial amputees, suggesting practical benefits.
Objective To investigate the feasibility and preliminary efficacy of a home-based NMES program on knee extension strength, residual limb volume, pain, and gait performance in individuals with transtibial amputation (TTA). Design Twenty unilateral TTA participants were randomized to control or NMES groups. The NMES group received residual limb stimulation targeting the vastus laterals (VL), vastus medialis (VM), tibialis anterior (TA), and lateral and medial gastrocnemius muscles (GM) for 15 contractions per site, five times weekly for 12 weeks. The control group continued activities of daily living without intervention. Baseline and 12-week assessments included knee extension strength, residual limb volume, chronic and phantom limb pain, and gait outcomes. Results A high compliance rate of 82% was found in the intervention group. In the intervention group (n = 5), residual limb pain (scale 0 to 10) significantly decreased at 12 weeks (p = 0.03; 1.20 ± 1.30 reduction). Effects on limb volume and strength remain unclear, warranting further research. Conclusion NMES is feasible for individuals with amputation with high compliance and potential to reduce residual limb pain. Future research with improved measurement methods, muscle mass quantification, and optimized dosage to stabilize or increase limb volume in a larger cohort is needed.
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Peterson et al. (2025) studied this question.