Gastrocnemius Electrical Stimulation Increases Ankle Dorsiflexion Strength in Patients With Post-Acute Sequelae of SARS-Cov-2 (Pasc): A Double-Blind Randomized Controlled Trial

Authors

Myeounggon Lee
Alejandro Zulbaran-Rojas
Miguel Bargas-Ochoa
Bernardo Martinez-Leal
Rasha Bara
Areli Flores-Camargo
M G Finco
Ram Kinker Mishra
Jaewon Beom
Dipaben Modi
Fidaa Shaib
Bijan Najafi

Publication Date

8-2-2024

Journal

Scientific Reports

DOI

10.1038/s41598-024-68100-8

PMID

39095520

PMCID

PMC11297025

PubMedCentral® Posted Date

8-2-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Male, Muscle, Skeletal, Female, Middle Aged, COVID-19, Muscle Strength, Electric Stimulation Therapy, Double-Blind Method, SARS-CoV-2, Aged, Post-Acute COVID-19 Syndrome, Activities of Daily Living, Electromyography, Adult, Ankle, Ankle Joint, Treatment Outcome, Rehabilitation, Biomedical engineering

Abstract

Post-Acute sequelae of SARS-CoV-2 (PASC) is a multisystem disorder causing persistent musculoskeletal deconditioning and reduced lower extremity strength. Electrical stimulation (E-Stim) to the gastrocnemius muscle can enhance strength outcomes by increasing the frequency of muscle fiber activation. We investigated its effect on individuals with PASC. Participants were randomized into intervention (IG) or control (CG) groups. The IG self-administered daily one-hour E-Stim to both their gastrocnemius muscles using a functional device over 4-week, while the CG used a sham device. Primary outcomes were ankle dorsiflexion strength assessed via dynamometry during maximum voluntary contractions, and gastrocnemius voluntary activation (GVA) via surface electromyography. The secondary outcome assessed activities of daily living (ADL), instrumental ADL, and mobility queries. Percentage improvement was calculated. Eighteen patients were analyzed (IG = 10; CG = 8). After 4 week, the IG showed a significantly higher improvement in ankle dorsiflexion strength (222.64%) compared to the CG (51.27%, p = 0.002). Additionally, the IG's ankle dorsiflexion strength improvement significantly correlated with GVA improvement (rho = 0.782) at 4 week. The secondary outcomes did not reveal significant changes in neither group. Self-administered gastrocnemius E-Stim improves ankle dorsiflexion strength in individuals with PASC. However, larger sample sizes and longer interventions are needed to validate these findings.

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