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Context: While there is mounting evidence to suggest neuromuscular electrical stimulation (NMES) as a promising modality for enhancing lower limb muscle strength, the functional effects of a single electrical stimulation session for improving intrinsic foot muscles (IFM) function has not been evaluated. Objective: To investigate the immediate effects of a NMES session on foot force production, foot dome stability and dynamic postural control in participants with static foot pronation compared to a sham stimulation session. Design: Single-blinded Randomized Controlled Clinical Trial. Setting: Laboratory Patients or Other Participants: A total of 46 participants (23 males, 23 females) with static foot pronation according to their Foot Posture Index (score ≥6) were randomly assigned to an NMES group (n=23) or a control group (n=23). Intervention(s): The NMES group received a single, 15-minute NMES session on the dominant foot across the IFM. The control group participants received a 15-minute sham electrical stimulation session. Main Outcome Measure(s): All the outcome measurements were assessed before and after intervention and included foot force production on a pressure platform, foot dome stability and dynamic postural control. Statistical analysis was based on responsiveness of outcome measures and responder analysis utilizing the minimum detectable change (MDC) scores for each outcome measure. Results: In the NMES group, we found that 78% of the participants were classified as responders for at least two of the three outcomes compared to only 22% in the control group. The relative risk of being a responder in the NMES group compared to the control group was 3.6 [1.6 to 8.1]. Interestingly, we found that all the participants (n=8) who concomitantly responded to foot strength and navicular drop, were also responders for dynamic postural control. Conclusions: A single NMES session was effective at immediately improving foot function and dynamic postural control in participants with static foot pronation compared to a sham stimulation session. This study supports the role of NMES to improve IFM function in this population.

Effects of a Single Electrical Stimulation Session on Foot Force Production, Foot Dome Stability, and Dynamic Postural Control