Abstract
Percutaneous electrical stimulation is used for reconditioning functional capabilities in older subjects. However, its optimal application depends on the specific physiological needs of the individual. Depending on whether his/her needs are related to motor function or sensory and central functions, the relevant modality of electrical stimulation differs significantly. In fact, there are two main modalities of electrical stimulation, that is, neuromuscular electrical stimulation (NMES) and sensory electrical stimulation (SES). NMES involves high-intensity currents (above the motor threshold) and provokes involuntary visible direct muscle contractions. With chronic application, the induced adaptations occur mainly at the neuromuscular function level and thus enhance muscle strength/power and motor output. SES involves low-intensity currents (below, at or only just above the sensory threshold), does not induce any visible muscle contraction and provides only sensory information. With chronic application, the induced adaptations occur at the level of potentiation and transmission of proprioceptive afferents and thus facilitate sensorimotor activity (movement and balance). Overall, SES is interesting for the improvement/maintenance of sensorimotor capabilities in non-frail older subjects while NMES is relevant to develop muscle strength/power and thus reduce the risk of falls due to a lack of muscle strength/power in frail older subjects.
Highlights
Advancing age engenders progressive structural and functional alterations of different organs and systems linked to the motor and postural functions
Since the absence of physical activity accentuates all the impairments mentioned above, the functional capabilities are primarily and clearly impeded due to excessive degradation of motor output (Paillard, 2017b; Trajkov et al, 2018). This corresponds to the second physiological profile described above and its needs are primarily based on the development of muscle strength/ power at least in order to partially recondition the basal functional capabilities more (Paillard, 2017b)
Evidence suggests that neuromuscular electrical stimulation (NMES) regularly applied on quadriceps femoris or dorsi/plantarflexor muscles in older subjects (>60 years old) improves lowerlimb muscle strength (Caggiano et al, 1994; Paillard et al, 2004; Bezerra et al, 2011; Caulfield et al, 2013; Kern et al, 2014; Mignardot et al, 2015; Von Stengel et al, 2015; Mani et al, 2018; Acaröz Candan et al, 2019; Langeard et al, 2021) and postural balance (Amiridis et al, 2005; Paillard et al, 2005a,b; Nejc et al, 2013; Mignardot et al, 2015; Alptekin et al, 2016; Bondi et al, 2021)
Summary
Laboratoire Mouvement, Equilibre, Performance et Santé, EA 4445, Département STAPS, Université de Pau et des Pays de l’Adour, E2S, Tarbes, France. Depending on whether his/her needs are related to motor function or sensory and central functions, the relevant modality of electrical stimulation differs significantly. There are two main modalities of electrical stimulation, that is, neuromuscular electrical stimulation (NMES) and sensory electrical stimulation (SES). NMES involves high-intensity currents (above the motor threshold) and provokes involuntary visible direct muscle contractions. The induced adaptations occur mainly at the neuromuscular function level and enhance muscle strength/power and motor output. SES involves low-intensity currents (below, at or only just above the sensory threshold), does not induce any visible muscle contraction and provides only sensory information. The induced adaptations occur at the level of potentiation and transmission of proprioceptive afferents and facilitate sensorimotor activity (movement and balance).
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