Department of Geriatrics, Bispebjerg Hospital, Copenhagen, Denmark; Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
Department of Geriatrics, Bispebjerg Hospital, Copenhagen, Denmark.
Exp Gerontol. 2018 Jun;106:101-108. doi: 10.1016/j.exger.2018.02.024. Epub 2018 Feb 26.
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.
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.
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.
A short-duration daily functional training program improves chair stand performance in hospitalized geriatric patients, with no additional effect of simultaneous electrical muscle stimulation.
老年住院患者的住院治疗可能会导致功能下降。本研究旨在探讨同时应用神经肌肉电刺激（NMES）是否可以增强住院老年患者的功能训练计划的效果。
这是一项针对老年住院患者的半随机对照试验（N=16，年龄=83.1±8.1 岁，均值±标准差）。患者每天进行简单且耗时短的基于椅式站立的功能锻炼计划，要么同时（FT+NMES，N=8），要么不进行（FT，N=8）对股四头肌进行 NMES。在住院的第 2 天和第 6-10 天，使用德莫顿活动能力指数（DEMMI）、30 秒椅式站立测试（30 s-CST）和 4 米步行速度测试（4 m-GST）评估身体功能。此外，将来自两个训练组（TRAINING，N=16）的训练综合结果与仅接受标准护理的类似历史对照组（CON，N=48）进行比较。
8 名患者被分配到 FT 组，12 名患者被分配到 FT+NMES 组，其中 4 名在干预过程中退出。在住院的第 6-10 天，两组在所有功能测量指标上均有所改善（p<0.05），但组间无差异（p>0.05）。FT+NMES 组的训练课程时间更长（11 分钟 vs7 分钟），且不适感更高。与标准护理相比，训练在 30 s-CST 方面产生了显著更大的改善（TRAINING：+3.8 次重复；CON：+1.4 次重复，p<0.01），但在 DEMMI 测试和 4 m-GST 方面没有改善。
每天进行短时间的功能训练计划可以改善住院老年患者的椅式站立表现，同时应用电刺激没有额外效果。
