Neuromuscular electrical stimulation combined with dynamic multidirectional therapeutic exercise for chronic ankle
Laura Obeng-Frimpong1, Damian A Coleman2, Daniel T P Fong3
1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK; Section of Sport, Exercise and Rehabilitation Science, School of Science, Psychology, Arts & Humanities, Computing, Engineering and Sport, Canterbury Christ Church University, North Holmes Road, Canterbury, CT1 1QU, UK.
Objectives:
To compare the effects of a 4-week dynamic, multidirectional therapeutic exercise (TEx) programme alone versus TEx combined with neuromuscular electrical stimulation (NMES) in individuals with chronic ankle instability (CAI).
Design:
Randomised intervention study.
Setting:
Laboratory.
Participants:
Twenty physically active adults with CAI.
Main Outcome Measures:
Participants were randomised to either a TEx group or an NMES group. Both groups completed the same 4-week dynamic, multidirectional therapeutic exercise programme, while the NMES group received bilateral peroneal stimulation during exercise sessions. Outcomes included the Cumberland Ankle Instability Tool (CAIT), the Lower Quadrant Y-Balance Test (LQ-YBT), and lower-limb muscle activation latency during inversion-simulation and drop-jump tasks.
Results:
Both groups improved CAIT scores post-intervention (p < 0.001), although only NMES maintained improvements at follow-up (p < 0.001). NMES demonstrated greater reductions in inversion-related muscle activation latency across multiple muscles, including tibialis anterior and peroneus longus (p < 0.05). Within-group improvements in posteromedial, posterolateral, and composite LQ-YBT scores were observed in the TEx group (p < 0.05). Drop-jump outcomes demonstrated variable changes between groups.
Conclusions:
NMES combined with TEx may improve the timing of neuromuscular activation during inversion-simulation tasks, while TEx showed within-group improvements in some dynamic balance outcomes.
