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Updated: Jun 18, 2025

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Gastrocnemius electrical stimulation increases ankle dorsiflexion strength in patients with post-acute sequelae of
Myeounggon Lee1, Alejandro Zulbaran-Rojas1, Miguel Bargas-Ochoa1
1Digital Health Access Center (DiHAC), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 7200 Cambridge St, B01.529, Houston, TX, 77030, USA.
Abstract:
Post-Acute sequelae of SARS-CoV-2 (PASC) is a multisystem disorder causing persistent musculoskeletal deconditioning and reduced lower extremity strength. Electrical stimulation (E-Stim) to the gastrocnemius muscle can enhance strength outcomes by increasing the frequency of muscle fiber activation. We investigated its effect on individuals with PASC. Participants were randomized into intervention (IG) or control (CG) groups. The IG self-administered daily one-hour E-Stim to both their gastrocnemius muscles using a functional device over 4-week, while the CG used a sham device. Primary outcomes were ankle dorsiflexion strength assessed via dynamometry during maximum voluntary contractions, and gastrocnemius voluntary activation (GVA) via surface electromyography. The secondary outcome assessed activities of daily living (ADL), instrumental ADL, and mobility queries. Percentage improvement was calculated. Eighteen patients were analyzed (IG = 10; CG = 8). After 4 week, the IG showed a significantly higher improvement in ankle dorsiflexion strength (222.64%) compared to the CG (51.27%, p = 0.002). Additionally, the IG's ankle dorsiflexion strength improvement significantly correlated with GVA improvement (rho = 0.782) at 4 week. The secondary outcomes did not reveal significant changes in neither group. Self-administered gastrocnemius E-Stim improves ankle dorsiflexion strength in individuals with PASC. However, larger sample sizes and longer interventions are needed to validate these findings.
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