Comparative Effectiveness of Neuromuscular Electrical Stimulation and Russian Current Stimulation of Tibialis Posterior in Individuals with Flexible Flat Foot: A Prospective Randomized Controlled Trial

Background: Intrinsic and extrinsic musculatures along with inert structures provide both mobility and stability to the foot. Dysfunction of tibialis posterior (TP) tendon causes pathomechanical alteration in the foot initiating temporary and later leading to permanent changes in the foot. TP strengthening may lead to improvement in flat foot. Electrical stimulation has proven effects on the strengthening of muscle. Objective: The objective was to evaluate and compare the effect of neuromuscular electrical stimulation (NMES) and Russian current (RC) on TP muscle in subjects with flexible flat foot. Materials and Methods: The study participants ( n = 60) were recruited and randomly allocated into control, NMES, and RC groups ( n = 20 in each group). Outcome measures included were Chippaux index, 5-min walk test, and single heel raise test which were assessed pre- and postintervention. Sixth-week follow-up was taken to determine the carryover effects. Results: Between-group comparison showed both NMES and RC groups to be significantly better ( P < 0.01) than the control group for all outcome measures. However, RC and NMES groups demonstrated to be equally effective, in terms of all study variables. Conclusion: RC and NMES show promising improvement in the TP strength and walking distance for the management of flexible flat foot secondary to the dysfunction of the TP tendon.