Continuous and gait-synchronized TENS combined with standardized gait training were feasible and well tolerated in individuals with chronic stroke, but the adjusted analysis did not provide robust evidence of differential clinical effects among stimulation-timing groups after correction for multiple outcome testing.
Intervention adherence was high and no adverse events were reported across all stimulation conditions.
Comfortable gait speed showed no significant group × time interaction among the three stimulation conditions.
Maximal gait speed and Berg Balance Scale showed nominal group × time interaction effects that did not survive false discovery rate correction.
Gait-synchronized TENS delivered stimulation according to stance and swing phases, distinguishing it from continuous non-phase-specific stimulation.
The pilot trial did not provide robust evidence that timing of TENS stimulation differentially affects clinical outcomes in chronic stroke gait rehabilitation.
This research suggests that using electrical nerve stimulation (TENS) during walking rehabilitation after stroke is safe and practical, regardless of whether the stimulation is delivered continuously or timed to match the phases of the walking cycle. In this small pilot study, 24 people with chronic stroke were randomly assigned to receive one of three conditions during standardized walking training over 4 weeks: constant electrical stimulation, stimulation timed to their walking phases (stance and swing), or fake stimulation. Nearly all scheduled sessions were completed and no harmful side effects occurred in any group. However, when the researchers rigorously analyzed whether one type of stimulation produced better walking or balance outcomes than another, they found no convincing differences after accounting for the multiple outcomes being tested. Some measures like maximum walking speed and balance scores showed hints of differences between groups before statistical correction, but these hints disappeared once the analysis was adjusted to reduce the chance of false positives. The primary measure — comfortable walking speed — showed no meaningful difference among the three groups. This research suggests that while TENS combined with gait training appears safe and acceptable for people recovering from stroke, this small pilot study was not able to demonstrate that the timing of stimulation matters for rehabilitation outcomes. The findings highlight the need for larger studies with more participants to properly test whether either form of TENS — continuous or walking-phase-synchronized — offers real benefits over sham stimulation during post-stroke walking rehabilitation.
Na J, Song M, Park H, Choi I, Lee J, Yoon J, et al.. (2026). Comparison of Continuous and Gait-synchronized Transcutaneous Electrical Nerve Stimulation During Gait Training in Chronic Stroke: A Pilot Randomized Trial.. Revista de neurologia. https://doi.org/10.31083/RN53766