{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:54:18Z","timestamp":1760147658385,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Greek General Secretariat for Research and Technology","award":["ERA-NET NEURON JTC 2020","T12EPA5-00018"],"award-info":[{"award-number":["ERA-NET NEURON JTC 2020","T12EPA5-00018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>This systematic review documents the protocol characteristics of studies that used neuromuscular electrical stimulation protocols (NMES) on the plantar flexors [through triceps surae (TS) or tibial nerve (TN) stimulation] to stimulate afferent pathways. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, was registered to PROSPERO (ID: CRD42022345194) and was funded by the Greek General Secretariat for Research and Technology (ERA-NET NEURON JTC 2020). Included were original research articles on healthy adults, with NMES interventions applied on TN or TS or both. Four databases (Cochrane Library, PubMed, Scopus, and Web of Science) were systematically searched, in addition to a manual search using the citations of included studies. Quality assessment was conducted on 32 eligible studies by estimating the risk of bias with the checklist of the Effective Public Health Practice Project Quality Assessment Tool. Eighty-seven protocols were analyzed, with descriptive statistics. Compared to TS, TN stimulation has been reported in a wider range of frequencies (5\u2013100, vs. 20\u2013200 Hz) and normalization methods for the contraction intensity. The pulse duration ranged from 0.2 to 1 ms for both TS and TN protocols. It is concluded that with increasing popularity of NMES protocols in intervention and rehabilitation, future studies may use a wider range of stimulation attributes, to stimulate motor neurons via afferent pathways, but, on the other hand, additional studies may explore new protocols, targeting for more optimal effectiveness. Furthermore, future studies should consider methodological issues, such as stimulation efficacy (e.g., positioning over the motor point) and reporting of level of discomfort during the application of NMES protocols to reduce the inherent variability of the results.<\/jats:p>","DOI":"10.3390\/s23042347","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T01:39:28Z","timestamp":1676943568000},"page":"2347","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Protocols Targeting Afferent Pathways via Neuromuscular Electrical Stimulation for the Plantar Flexors: A Systematic Review"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-5482","authenticated-orcid":false,"given":"Anastasia","family":"Papavasileiou","sequence":"first","affiliation":[{"name":"Laboratory of Neuromechanics, School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62110 Serres, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3315-9865","authenticated-orcid":false,"given":"Anthi","family":"Xenofondos","sequence":"additional","affiliation":[{"name":"Physical Education and Sports Sciences, Frederick University, 1036 Nicosia, Cyprus"}]},{"given":"St\u00e9phane","family":"Baudry","sequence":"additional","affiliation":[{"name":"Laboratory of Applied Biology, Research Unit in Applied Neurophysiology (LABNeuro), Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}]},{"given":"Thomas","family":"Lapole","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Jean Monnet Saint-Etienne, Lyon 1, Universit\u00e9 Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricit\u00e9, F-42023 Saint-Etienne, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3731-8998","authenticated-orcid":false,"given":"Ioannis G.","family":"Amiridis","sequence":"additional","affiliation":[{"name":"Laboratory of Neuromechanics, School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62110 Serres, Greece"}]},{"given":"Dimitrios","family":"Metaxiotis","sequence":"additional","affiliation":[{"name":"2nd Orthopaedic Department, Papageorgiou Hospital, 56429 Thessaloniki, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6658-5764","authenticated-orcid":false,"given":"Themistoklis","family":"Tsatalas","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8921-4176","authenticated-orcid":false,"given":"Dimitrios A.","family":"Patikas","sequence":"additional","affiliation":[{"name":"Laboratory of Neuromechanics, School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62110 Serres, Greece"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/jes.0b013e318156e785","article-title":"Electrical stimulation as a modality to improve performance of the neuromuscular system","volume":"35","author":"Vanderthommen","year":"2007","journal-title":"Exerc. 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