Neuromuscular Electrical Stimulation Use in Transtibial Amputations: A Pilot Study

Functional neuromuscular electrical stimulation (NMES) activates targeted nerves to improve strength, circulation, and muscle function. While NMES has been widely studied in neurological populations, no randomized controlled trials have examined its potential to strengthen the residual limb or reduce post-amputation symptoms such as edema and pain. This pilot study evaluates whether a 12-week, home-based NMES program benefits individuals with chronic unilateral transtibial amputations.

Twenty participants more than one year post-amputation were randomized to either an NMES intervention or a control group. Baseline and follow-up assessments include knee extension strength, residual limb volume, pain measures, the Prosthetic Evaluation Questionnaire, and gait parameters using the GAITRite® system. A mixed-model repeated measures ANOVA will compare outcomes between groups over time.

Although data collection is ongoing, preliminary results from the first four intervention participants indicate promising outcome, including improved knee extension strength in most participants, increases in residual limb volume across all participants, early trends toward reduced pain, and mixed but encouraging changes in gait parameters.

These early findings suggest that a home-based NMES protocol may offer a low-cost, accessible method to support residual limb health, manage chronic pain, and potentially improve gait. Continued data collection will clarify the full clinical impact, with implications for clinicians, prosthetists, rehabilitation specialists, and researchers seeking effective treatment strategies for individuals with limb loss.