Feasibility and Preliminary Efficacy of Neuromuscular Electrical Stimulation in A Pilot Randomized Control Trial in Individuals With Transtibial Amputations.

Peterson, Sara L; Wang, Hongwu; Miknevich, Mary Ann; Piva, Sara R; Cooper, Rory A; Koontz, Alicia M · Am J Phys Med Rehabil · 2026

rct · Level II

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Abstract

The aim of the study was to investigate the feasibility and preliminary efficacy of a home-based neuromuscular electrical stimulation program on knee extension strength, residual limb volume, pain, and gait performance in individuals with transtibial amputation. Twenty unilateral transtibial amputation participants were randomized to control or neuromuscular electrical stimulation groups. The neuromuscular electrical stimulation group received residual limb stimulation targeting the vastus laterals, vastus medialis, tibialis anterior, and lateral and medial gastrocnemius muscles for 15 contractions per site, five times weekly for 12 wks. The control group continued activities of daily living without intervention. Baseline and 12-wk assessments included knee extension strength, residual limb volume, chronic and phantom limb pain, and gait outcomes. 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 wks ( P = 0.03; 1.20 ± 1.30 reduction). Effects on limb volume and strength remain unclear, warranting further research. Neuromuscular electrical stimulation 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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