Comprehensive clinical effect evaluation of low-frequency electrical stimulation combined with proprioception training in sports injury rehabilitation

Lateral ankle sprains in martial arts athletes frequently leave persistent proprioceptive and neuromuscular deficits. This prospective cohort study evaluated whether adding low-frequency electrical stimulation (LFES) to proprioceptive neuromuscular facilitation (PNF) augments recovery. Five hundred sixty athletes with grade I-II sprains (mean age 22.6 ± 2.7 years) were stratified to LFES + PNF (n=280) or proprioception-only (n=280) for 12 weeks, with assessments at baseline and Weeks 2, 6, and 12. Outcomes included pain (VAS), pressure pain threshold (PPT), ankle range of motion (ROM), joint position sense (JPS), surface EMG, somatosensory evoked potentials (SEP), electromechanical delay (EMD), Functional Movement Screen (FMS), and dynamic balance. Mixed ANOVA/ANCOVA with effect sizes and nonparametric validation (Friedman/Wilcoxon) were applied. Compared with proprioception-only, LFES produced greater pain reduction (VAS -5.0 vs -4.1; p<0.001), higher PPT (+1.6 kg/cm²), and larger ROM gains (+9.2° dorsiflexion; +6.4° plantarflexion). JPS error decreased by -3.5°, with 78% achieving ≤3° accuracy. EMG latency decreased by 7.8 ms and amplitude increased by 17.2 µV; SEP latency normalized in 78% with amplitudes reaching 4.1 µV. EMD improved by -19.7 ms (p=0.001), FMS increased by +2.9 points, and composite recovery criteria were met more often with LFES (51% vs 28%; p<0.001). No serious adverse events occurred. These findings indicate that LFES adjunct to proprioceptive training accelerates sensorimotor recovery and enhances functional outcomes after lateral ankle sprain in martial arts athletes.