The Pulse

Addressing Frailty with Electrical Stimulation

Posted by ACP on Jul 16, 2018 10:18:44 AM

Aging results in a decline in muscle mass (sarcopenia) with a resulting decline in muscle strength which may lead to decreased function and frailty. The geriatric population may have other comorbidities making exercise difficult. Recent research highlights the impact of frailty on individuals and how exercise and electrical stimulation may counteract this decline.

  • Frailty and pre-frailty are significant predictors of nursing home placement among community-dwelling older adults. Physical exercise may prevent or reverse frailty and may lead to decreased risk of nursing home placement.¹
  • Electrical stimulation, similarly to physical exercise, attenuates the functional decline associated with aging, improving muscle strength and mass, maintaining the overall size of the muscle fibers (decreasing during aging), activating satellite cell, and guaranteeing muscle adaptation.²
  • NMES of the lower limbs may be applied as a supplemental form of pulmonary rehabilitation in COPD patients or in patients who cannot undertake physical training due to locomotor disorders.³


Neuromuscular Re-Education
E-stim Focus: Reducing motor neuron disuse atrophy, enhancing muscle contractility, and improving movement patterns.

  • Patterned electrical neuromuscular stimulation (PENS) Upper Extremity Biphasic
  • PENS Upper Extremity Triphasic 
  • PENS Lower Extremity Triphasic

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Muscle Re-Education 
E-stim Focus: Facilitating development of muscle hypertrophy, strength, power and endurance.

  • Low volt pulsed current (LVPC) Small Muscle
  • LVPC Medium Muscle
  • Medium frequency alternating current (MFAC) Large Muscle

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Functional Re-Education
E-stim Focus: Improving reciprocal movement patterns and facilitating muscle contraction  during functional activity to restore mobility and activities of daily living (ADLs).

  • PENS (cycle or walk)
  • LVPC Hand Control (small and medium muscles)
  • MFAC Hand Control (large muscles)

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1. Gotaro K: Frailtiy as a Predictor of Nursing Home Placement Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. J Geriatr Phys Ther. 41(1):42-48, 2018.

2. Kern, H., et al.: Electrical stimulation counteracts muscle decline in seniors. Front Aging Neurosci., 189(6):1-11, 2014.

3. Kucio C, Niesporek J, Kucio E, Narloch D, Wegrzyn B: Evaluation of the Effects of Neuromuscular Electrical Stimulation of The Lower Limbs Combined with Pulmonary Rehabilitation on Exercise Tolerance in Patients wiht Chronic Pulmonary Disease. Journal of Human Kinetics (54)75-82, 2016.

Topics: Fall Prevention & Balance, Clinical Tip, E-Stim