Therapeutic Effects of a Short-Term Inpatient Functional Electrical Stimulation Protocol on Gait and Balance in a Heterogeneous Neurological Population

Background: Neurological patients presenting with foot drop suffer from profound mobility restrictions that severely impair daily activities, independence, and community reintegration. Traditional rehabilitation often overlooks the biomechanical quality of gait, leading to suboptimal compensatory strategies. Therefore, effective interventions must focus on enhancing walking speed and endurance while preserving gait quality and minimising pathological compensations. Methods: This facility-based pilot study involved a heterogeneous cohort of 18 hospitalised neurological patients with unilateral foot drop. The intervention consisted of 6 to 8 sessions of overground walking with a Functional Electrical Stimulation (FES) applied at a frequency of 2 to 3 times per week as an adjunct to standard intensive daily physiotherapy. Functional mobility was assessed at baseline and post-treatment (with FES turned off) using the 6-Minute Walk Test (6 MWT), Timed Up and Go (TUG) test, and the 10-Meter Walk Test (10 MWT) at preferred and fast speeds. Changes were benchmarked against established Minimal Clinically Important Difference (MCID) thresholds. Results: Post-treatment assessments revealed statistically significant improvements across all parameters (p < 0.001) with exceptionally large effect sizes. Submaximal walking endurance (6 MWT) improved by 62.16%, while dynamic balance (TUG) and gait velocities (10 MWT) improved by more than 30%. Clinical relevance was highlighted by substantial MCID responder rates ranging from 78% to 94% across all tested domains. Conclusions: Integrating a short-term, low-frequency FES protocol into standard inpatient rehabilitation significantly enhances both objective statistical and clinical gait parameters. Beyond biomechanical recovery, this scalable intervention facilitates greater autonomy, restores self-confidence, and supports successful community reintegration in mixed neurological populations.