Abstract Body (Do not enter title and authors here): Introduction: Lower extremity peripheral artery disease (PAD) can lead to walking impairment. To date, no clear clinical indication can be drawn regarding the efficacy of neuromuscular electrical stimulation (NMES) for the management of impaired walking function in patients with PAD. The ELECTROPAD study aimed to investigate the efficacy of NMES program on maximal walking distance (MWD) in patients with PAD.

Methods: In this multicenter trial (NCT03795103), PAD patients with a maximal treadmill walking distance ≤300 m were randomized in the NMES or control group. The NMES program consisted of a 12-week program of NEMS sessions at the calf-muscle level, 2-3 h/day, 5 days/week. The primary outcome of the study was the change in treadmill MWD at 12 weeks. Main secondary outcomes included changes in the treadmill pain-free walking distance (PFWD) and 6 min total walking distance (6MWD). Results are reported in median [IQR]. Mann-Whitney Wilcoxon or Student t tests were used for comparisons.

Results: Between 2019 and 2022, 73 patients were randomized and 63 with a mean age of 63 ± 9 years old were analyzed. Baseline treadmill MWD was 131[108;166]m and 130[98;213]m (p=0.85) in the control and NMES groups, respectively. The change of treadmill MWD was greater in the NMES group compared to the control group (58[18;139]m vs 19[3;55]m; p=0.026). The change of PFWD was not different between the NMES and control groups (23[2;48]m vs 10[-2;30]m; p=0.209). The change of 6MWD was greater in the NMES group compared to the control group (29[3;54]m vs 2[-14;30]m; p=0.019).
Conclusion: A 12-week NMES program significantly improves treadmill and 6-minute walking performance in PAD patients. NMES could be considered as a complementary therapeutic option for PAD patients.