Trial reportEuropean journal of applied physiology2026
Neuromuscular electrical stimulation with blood flow restriction shows preliminary effects on abductor hallucis muscle size and toe flexor strength: a pilot randomized controlled trial.
Trial report in European journal of applied physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors.
Funding
Abstract
purposeTo examine the effects of neuromuscular electrical stimulation (NMES) combined with blood flow restriction (BFR) on abductor hallucis (ABH) cross-sectional area (CSA) compared with NMES alone in a pilot randomized controlled trial. Toe flexor strength (TFS) and foot posture were also examined as secondary and exploratory outcomes, respectively.
methodsThirty participants were randomly allocated to either an NMES + BFR group or an NMES-alone group. Both groups received 15 min of ABH NMES three times weekly for 6 weeks, while the NMES + BFR group additionally received BFR. ABH CSA, TFS, and Foot Posture Index-6 (FPI-6) scores were assessed pre- and post-intervention by a blinded assessor. Post-intervention between-group differences were analyzed using baseline-adjusted analysis of covariance.
resultsThe NMES + BFR group showed greater post-intervention ABH CSA than the NMES group (adjusted mean difference [95% confidence interval] = 0.19 [0.08-0.30] cm², p = 0.001). The between-group difference in TFS favored the NMES + BFR group but was not statistically significant (1.83 [- 0.09-3.75] kg, p = 0.061). Exploratory analysis showed lower post-intervention FPI-6 scores in the NMES + BFR group than in the NMES group (- 1.59 [- 2.46--0.72] points, p = 0.001). No adverse events or intolerance leading to discontinuation occurred.
conclusionSix weeks of NMES combined with BFR showed preliminary favorable effects on ABH CSA compared with NMES alone, whereas evidence for superior improvement in TFS was inconclusive. All findings, including the exploratory foot posture results, require confirmation in larger studies with more complete intervention-dose reporting.
trial registrationRegistration number (date): UMIN000054853 (August 1, 2024).
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