Adjunctive neuromuscular electrical stimulation and cognitive-motor interference during gait in older inpatients
Gilles Loggia1, Evrim Gökçe2, Alyzée Henry3
1University of Caen Normandy, COMETE, INSERM, CYCERON, Caen, France; Post-Acute Care and Rehabilitation Department, University of Caen Normandy, CHU de Caen, Caen, France.
Background:
Dual-task gait cost reflects cognitive-motor interference during walking and represents a clinically meaningful parameter in older adults undergoing rehabilitation. Whether neuromuscular electrical stimulation (NMES) may influence this parameter remains unknown.
Methods:
We conducted an exploratory analysis of a pragmatic pilot trial with a quasi-experimental allocation process incorporating partial randomization, comparing usual rehabilitation care with or without adjunctive NMES. Dual-task gait cost was calculated from Timed Up and Go performance under single-task and dual-task conditions before and after a three-week intervention.
Results:
Complete data were available for 19 participants (NMES n = 10; usual care n = 9). Baseline dual-task gait cost was higher in the NMES group than in usual care (39.0% vs 16.8%). A Time × Group interaction was observed, with reduced dual-task gait cost in the NMES group and minimal change in usual care (β = 20.68 percentage points, 95% CI [7.92, 33.44], p = 0.003). Sensitivity analyses supported the change-based signal, whereas the unadjusted post-intervention comparison was null.
Conclusions:
In this exploratory, partially randomized comparison, TUG-derived dual-task gait cost decreased more in the NMES group, but the marked baseline imbalance limits causal interpretation. DTC appears feasible and potentially responsive as an outcome for future fully randomized sham-controlled rehabilitation trials.
