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.