Can electrical stimulation enhance effects of a functional training program in hospitalized geriatric patients?

BACKGROUND: Hospitalization of older medical patients may lead to functional decline. This study investigated whether simultaneously applied neuromuscular electrical stimulation (NMES) can enhance the effects of a functional training program in hospitalized geriatric patients.

METHOD: This was a quasi-randomized controlled trial in geriatric hospitalized patients (N = 16, age = 83.1 ± 8.1 years, mean ± SD). The patients performed a simple and time efficient chair-stand based functional exercise program daily, either with (FT + NMES, N = 8) or without (FT, N = 8) simultaneous NMES to the knee extensor muscles. Physical function was assessed at day 2 and 6-10 of the hospitalization with the De Morton Mobility Index (DEMMI), a 30-second chair stand test (30 s-CST) and a 4-meter gait speed test (4 m-GST). Additionally, the pooled results of training from the two training groups (TRAINING, N = 16) was compared to a similar historical control-group (CON, N = 48) receiving only standard-care.

RESULTS: Eight patients were assigned to FT, 12 to FT+NMES with 4 dropouts during intervention. During the 6-10 days of hospitalization, both groups improved in all functional measures (p < 0.05), but with no difference between groups (p > 0.05). The training sessions within the FT+NMES-group were more time consuming (~11 vs ~7 min) and entailed higher levels of discomfort than FT-training sessions. Compared to standard-care, training resulted in significantly larger improvements in the 30 s-CST (TRAINING: +3.8 repetitions; CON: +1.4 repetitions, p < 0.01), but not in the DEMMI-test and the 4 m-GST.

CONCLUSION: A short-duration daily functional training program improves chair stand performance in hospitalized geriatric patients, with no additional effect of simultaneous electrical muscle stimulation.