Acute Effect of Percutaneous Tibial Nerve Stimulation on Postural Control: A Randomized Controlled Trial.

INTRODUCTION

Ankle sprains are common severe injuries leading to changes in muscular activity and postural control impairments. Postural control integrates neural components, including cognitive processing. Due to its relevance, neuromodulation techniques such as percutaneous tibial nerve stimulation (PTNS) have gained attention for improving balance, proprioception, and stability. However, the effects of PTNS on postural control remain insufficiently investigated. This study evaluated the acute effects of PTNS on postural control in healthy individuals.

METHODS

Ninety-four healthy participants (mean age 22.85 ± 5.02 years, BMI 23.8 ± 3.52) were recruited. Baseline postural control assessments were conducted, followed by random assignment to three groups: (1) PTNS (EXP), (2) sham (SHAM), and (3) control (CON). The EXP group received biphasic electrical stimulation (10 Hz, 250 μs, maximum tolerable intensity for 1.5 min). Postural control was measured using a force platform at baseline, and 0, 2, 24, and 48 h post-intervention. Participants performed two single-leg stance tests with eyes open and closed. Center of pressure (CoP) displacement and anteroposterior (Ampl_AP) and mediolateral (Ampl_ML) amplitudes were analyzed.

RESULTS

Both the EXP and SHAM groups showed significant reductions in the CoP displacement area with eyes closed at 24 and 48 h post-intervention compared to baseline. The SHAM group also exhibited significant reductions in Ampl_AP at these time points. No significant changes were observed in the control group.

DISCUSSION: Percutaneous tibial nerve stimulation (PTNS) improves single-leg postural control with eyes closed at 24 and 48 h, similar to sham (SHAM). No significant differences were observed between groups.

TRIAL REGISTRATION: ISRCTN177653522.