Effect of Combined Neuromuscular Electrical Stimulation and Disease-Modifying Antirheumatic Drug Therapy Versus Disease-Modifying Antirheumatic Drug Therapy Alone on Enhancing Gait and Reducing Fall Risks in Patients with Rheumatoid Arthritis and Peripheral Neuropathy

Abstract

Background: Rheumatoid Arthritis (RA) with Peripheral Neuropathy (PN) significantly impacts gait and balance, posing challenges in patient management. While Disease-Modifying Antirheumatic Drug (DMARD) therapy is effective for RA, it may not fully address these functional impairments. Neuromuscular Electrical Stimulation (NMES) has been proposed as a complementary therapy to improve these outcomes. Objective: This study aimed to assess the effectiveness of combining NMES with DMARD therapy versus DMARD therapy alone in enhancing gait and reducing fall risks among RA patients with PN. Methods: In a randomized controlled trial, 66 RA patients with PN were allocated to either Group A (NMES + DMARD, n=33) or Group B (DMARD only, n=33). Baseline demographics (age, gender, BMI, RA duration) and clinical outcomes (stride length, gait speed, cadence, etc.) were measured. Assessments were conducted at the study’s onset and after an 8-week intervention period, with data analyzed using independent t-tests. Results: Baseline data revealed no significant differences between the groups. Post-intervention, Group A exhibited marked improvements: stride length reduced to 58.26 cm (± 5.0) compared to Group B’s 69.1 cm (± 5.2, p=0.036), gait speed decreased to 0.77 m/s (± 5.1) against Group B’s 0.94 m/s (± 5.2, p=0.020), and cadence lowered to 81.43 steps/min (± 4.5) versus Group B’s 97.06 steps/min (± 4.7, p=0.029). Significant improvements were also seen in step width, double support time, and balance scales in Group A. However, biochemical markers did not show significant differences post-intervention. Conclusion: The integration of NMES with DMARD therapy resulted in significant improvements in gait and balance parameters compared to DMARD therapy alone in RA patients with PN. These findings suggest that NMES could be an effective adjunct to DMARDs in managing functional impairments in this population.