The Use of Electrical Stimulation for Older Adults at Risk for Developing Sarcopenia: A Systematic Review

Abstract

This study aimed to compile evidence on the effectiveness of neuromuscular electrical stimulation (NMES) for improving muscle strength in older adults, with or without systemic pathologies. A systematic search of PubMed, Cochrane Library, and Scopus databases was conducted for randomized controlled trials (RCTs) published between 2017 and 2023. Eligible studies included: older adults over 55 years, the use of either static stimulation (neuromuscular electrical stimulation NMES) in a stationary position or dynamic stimulation (functional electrical stimulation - FES applied during single or multi-joint movement), examined at least one muscle strength outcome, reported stimulation parameters (e.g., frequency, duration, amplitude), and involved participants with or at risk for sarcopenia. This review included 12 RCTs with Physiotherapy Evidence Database (PEDro) scores ranging from 5-9 (good quality). 9 studies reported significant increase in isometric muscle strength following electrical stimulation. Common parameters were 50-100 Hz with variable intensity and pulse duration. The findings suggest that both dynamic stimulation, or static stimulation delivered prior to strength or endurance training, respectively, proved more effective than static stimulation alone. However, parameter selection varied widely and was often unjustified, highlighting the need for standardization to optimize outcomes in community-dwelling older adults.