Bursting TENS increases walking endurance more than continuous TENS in middle-aged adults

The application of transcutaneous electrical nerve stimulation (TENS) can improve motor performance in both healthy individuals and those who present with clinically detectable sensory impairments. The purpose of our study was to compare the influence of continuous and intermittent TENS applied to the anterior thigh and tibialis anterior muscles on walking endurance and kinematics in healthy, middle-aged adults. Twenty-seven participants completed 4 trials of the 6-min walk test: Baseline, Continuous TENS (0.2 ms pulses at 50 Hz), Fast burst TENS (seven 0.15 ms pulses in 5 Hz bursts), and Slow burst TENS (seven 0.15 ms pulses in 0.5 Hz bursts). Linear mixed-effects models revealed that participants walked further (p ≤ 0.046) during all three TENS trials compared with Baseline (560 ± 76 m) and that they walked even further during both burst TENS trials (576 ± 83 m and 576 ± 83 m) compared with Continuous TENS (566 ± 79 m). Increases in walking speed were predicted by increases in stride length (p < 0.001) and stride frequency (p < 0.001) with toe-off angle being the only significant predictor (p ≤ 0.013) of both kinematic variables for the increase in walking speed. Bursting TENS was more effective than Continuous TENS at improving walking endurance in middle-aged, healthy adults.