Bloeckl Joerg, Raps Sebastian, Weineck Michael, Kob Robert, Bertsch Thomas, Kemmler Wolfgang, Schoene Daniel
Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg, Nuremberg, Germany.
Front Physiol. 2022 Jun 24;13:856681. doi: 10.3389/fphys.2022.856681. eCollection 2022.
Whole-body electromyostimulation (WB-EMS) induces high-intense stimuli to skeletal muscles with low strain on joints and the autonomic nervous system and may thus be suitable for frail, older people. However, if trained at very high intensities, WB-EMS may damage muscles and kidneys (rhabdomyolysis). This study aimed at investigating the feasibility, safety and preliminary efficacy of WB-EMS in frail, older people. Seven frail (81.3 ± 3.5 years), 11 robust (79.5 ± 3.6 years), 10 young (29.1 ± 6.4 years) participants completed an eight-week WB-EMS training (week 1-4: 1x/week; week 5-8: 1.5x/week) consisting of functional exercises addressing lower extremity strength and balance. Feasibility was assessed using recruitment, adherence, retention, and dropout rates. The satisfaction with WB-EMS was measured using the Physical Activity Enjoyment Scale for older adults (PACES-8). In week 1, 3, and 8 creatine kinase (CK) was assessed immediately before, 48 and 72 h after WB-EMS. Symptoms of rhabdomyolysis (muscle pain, muscle weakness, myoglobinuria) and adverse events were recorded. Functional capacity was assessed at baseline and after 8 weeks using the Short Physical Performance Battery (SPPB), Timed Up-and-Go Test (TUG), Choice Stepping Reaction Time Test (CSRT), 30-second Chair-Stand Test (30-STS), maximum isometric leg strength and handgrip strength. The recruitment rate of frail individuals was 46.2%, adherence 88.3% and the dropout rate 16.7%. All groups indicated a high satisfaction with WB-EMS. CK activity was more pronounced in young individuals with significant changes over time. Within older people CK increased borderline-significantly in the frail group from baseline to week 1 but not afterwards. In robust individuals CK increased significantly from baseline to week 1 and 3. No participant reached CK elevations close to the threshold of ≥5,000 U/l and no symptoms of rhabdomyolysis were observed. With the exception of the TUG ( = 0.173), frail individuals improved in all tests of functional capacity. Compared to the young and robust groups, frail individuals showed the greater improvements in the SPPB, handgrip strength, maximum isokinetic hip-/knee extension and flexion strength. WB-EMS is feasible for frail older people. There were no clinical signs of exertional rhabdomyolysis. WB-EMS proved to be sufficiently intense to induce meaningful changes in functional capacity with frail individuals showing greater improvements for several measures.
全身肌电刺激（WB - EMS）能以较低的关节和自主神经系统应变，对骨骼肌施加高强度刺激，因此可能适用于体弱的老年人。然而，如果以非常高的强度进行训练，WB - EMS可能会损伤肌肉和肾脏（横纹肌溶解）。本研究旨在调查WB - EMS在体弱老年人中的可行性、安全性和初步疗效。七名体弱（81.3±3.5岁）、11名健壮（79.5±3.6岁）、10名年轻（29.1±6.4岁）的参与者完成了为期八周的WB - EMS训练（第1 - 4周：每周1次；第5 - 8周：每周1.5次），训练内容包括针对下肢力量和平衡的功能性锻炼。通过招募率、依从率、留存率和退出率评估可行性。使用老年人身体活动愉悦量表（PACES - 8）测量对WB - EMS的满意度。在第1、3和8周，在WB - EMS前、后48小时和72小时立即评估肌酸激酶（CK）。记录横纹肌溶解的症状（肌肉疼痛、肌肉无力、肌红蛋白尿）和不良事件。在基线和8周后，使用简短体能状况量表（SPPB）、定时起立行走测试（TUG）、选择步阶反应时间测试（CSRT）、30秒椅子站立测试（30 - STS）、最大等长腿部力量和握力评估功能能力。体弱个体的招募率为46.2%，依从率为88.3%，退出率为16.7%。所有组对WB - EMS均表示高度满意。CK活性在年轻人中更为明显，且随时间有显著变化。在老年人中，体弱组的CK从基线到第1周有临界显著升高，但之后没有。在健壮个体中，CK从基线到第1周和第3周显著升高。没有参与者的CK升高接近≥5000 U/l的阈值，也未观察到横纹肌溶解的症状。除TUG（P = 0.173）外，体弱个体在所有功能能力测试中均有改善。与年轻和健壮组相比，体弱个体在SPPB、握力、最大等速髋/膝关节伸展和屈曲力量方面有更大改善。WB - EMS对体弱老年人是可行的。没有运动性横纹肌溶解的临床迹象。WB - EMS被证明强度足以在功能能力上引起有意义的变化，体弱个体在多项指标上有更大改善。
