Targeted Exercise with Multiple Waveform Neuromuscular Electrical Stimulation in Chronic Stroke on Gait Velocity and Capacity - Longitudinal Case Studies.
Faculty Mentor
Nicholas J. Siekirk, Ph.D.
Location
Russell Union Ballroom
Type of Research
On-going
Session Format
Poster Presentation
College
Waters College of Health Professions
Department
Health Sciences and Kinesiology
Abstract
Background: Ischemic stroke has transitioned from being a frequently fatal event to one that is often survivable, marking a fundamental transition in which more people will live with stroke’s residual effects. Approximately 80% of stroke survivors continue to have physical impairments, indicating that stroke recovery is often a lifelong process. Targeted exercise is a key tool to not only counter impairments post stroke but also constitutes a clear method to reduce recurrent stroke risk. Pairing neuromuscular electrical stimulus (NMES) with targeted exercise has been shown to produce moderate improvements in motor functions in chronic stroke. Technological advances combine DC-NMES with both secondary and tertiary alternating currents (AC) or carrier waveforms to construct a multi-waveform NMES (MWF-NMES). However, research examining whether MWF-NMES elicits additive benefits in chronic stroke is limited. Purpose: Therefore, we aimed to investigate the efficacy of MWF-NMES on walking velocity and capacity/endurance and determine whether clinically meaningful improvements could be observed. Methods: Two participants (R.S. and M.C.) were 4 – 10 years post stroke and underwent supervised MWF-NMES protocols (RxBlack, ARPWave, Minneapolis, MN) at 30 – 432 pulse per second (pps) 1x/week (Kinesiology Labs, Georgia Southern University, Statesboro, GA, USA), and unsupervised concurrent at-home protocols at 245 pps (FlexDoctor; ARPWave Technologies, Minneapolis, MN) 3-5x/week, over a 4 – 8 month period. Results: We observed 23% (+0.39 m/sec) to 54% (+0.07 m/sec) improvements in gait velocity. However, only the 0.39 m/sec (RS) improvement was sustained and above the minimal detectable change (MDC) and minimally clinically important difference (MCID). Distance covered in the Six Minute Walk Test (6MWT) increased from 7m to 125m. Participant RS improvement exceeded upper thresholds for gait-velocity-adjusted MDC and MCID. Conclusion: These data support the use of MWF-NMES to increase gait velocity and endurance in chronic stroke and warrant scaled investigations.
Program Description
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Start Date
4-23-2026 2:00 PM
End Date
4-23-2026 4:00 PM
Recommended Citation
Gragg, Morgan A.; Tanner, Kaitlyn; Grace, Collis; and Siekirk, Nicholas J., "Targeted Exercise with Multiple Waveform Neuromuscular Electrical Stimulation in Chronic Stroke on Gait Velocity and Capacity - Longitudinal Case Studies." (2026). GS4 Student Scholars Symposium. 151.
https://digitalcommons.georgiasouthern.edu/research_symposium/2026/2026/151
Targeted Exercise with Multiple Waveform Neuromuscular Electrical Stimulation in Chronic Stroke on Gait Velocity and Capacity - Longitudinal Case Studies.
Russell Union Ballroom
Background: Ischemic stroke has transitioned from being a frequently fatal event to one that is often survivable, marking a fundamental transition in which more people will live with stroke’s residual effects. Approximately 80% of stroke survivors continue to have physical impairments, indicating that stroke recovery is often a lifelong process. Targeted exercise is a key tool to not only counter impairments post stroke but also constitutes a clear method to reduce recurrent stroke risk. Pairing neuromuscular electrical stimulus (NMES) with targeted exercise has been shown to produce moderate improvements in motor functions in chronic stroke. Technological advances combine DC-NMES with both secondary and tertiary alternating currents (AC) or carrier waveforms to construct a multi-waveform NMES (MWF-NMES). However, research examining whether MWF-NMES elicits additive benefits in chronic stroke is limited. Purpose: Therefore, we aimed to investigate the efficacy of MWF-NMES on walking velocity and capacity/endurance and determine whether clinically meaningful improvements could be observed. Methods: Two participants (R.S. and M.C.) were 4 – 10 years post stroke and underwent supervised MWF-NMES protocols (RxBlack, ARPWave, Minneapolis, MN) at 30 – 432 pulse per second (pps) 1x/week (Kinesiology Labs, Georgia Southern University, Statesboro, GA, USA), and unsupervised concurrent at-home protocols at 245 pps (FlexDoctor; ARPWave Technologies, Minneapolis, MN) 3-5x/week, over a 4 – 8 month period. Results: We observed 23% (+0.39 m/sec) to 54% (+0.07 m/sec) improvements in gait velocity. However, only the 0.39 m/sec (RS) improvement was sustained and above the minimal detectable change (MDC) and minimally clinically important difference (MCID). Distance covered in the Six Minute Walk Test (6MWT) increased from 7m to 125m. Participant RS improvement exceeded upper thresholds for gait-velocity-adjusted MDC and MCID. Conclusion: These data support the use of MWF-NMES to increase gait velocity and endurance in chronic stroke and warrant scaled investigations.