Neuromuscular Electrical Stimulation in the Elderly: Multifaceted Applications of Electrical Stimulation in Geriatric Rehabilitation

Abstract

Neuromuscular electrical stimulation (NMES) is rapidly expanding as a comprehensive therapeutic tool in geriatric rehabilitation, offering diverse applications beyond traditional muscle strengthening. This article examines various applications and effectiveness of NMES in the elderly across multiple functional domains. Recent evidence suggests that NMES can aid in enhancing brain plasticity, increasing muscle mass and strength, improving balance and postural control, and facilitating functional recovery in the elderly. Studies have shown that this form of stimulation can elevate serum levels of brain-derived neurotrophic factor (BDNF), which is considered an indicator of potential neuroprotective effects. In the domain of muscle performance, promising results have been observed with NMES in preventing age-related muscle atrophy and improving strength, particularly when regular exercise may be challenging. Furthermore, significant improvements in balance and postural control have been observed in the elderly, which are enhanced when combined with voluntary muscle contractions. NMES has also demonstrated its efficacy in specific clinical conditions common among the elderly, such as post-stroke rehabilitation, dysphagia, and muscle weakness due to severe illness. Recent technological advancements, including wearable devices and brain-controlled systems, have broadened the scope of this intervention. However, variability in protocols, stimulation parameters, and outcome measures across different studies presents challenges for establishing standardized treatment guidelines. This article analyzes the current evidence regarding the multifaceted applications of NMES in geriatric rehabilitation and discusses its established benefits and emerging applications. Understanding these varied applications and their underlying mechanisms is critical for healthcare providers to optimize the implementation of NMES in elderly rehabilitation programs.