The Application of Neuromuscular Electrical Stimulation Training in Various Non‐neurologic Patient Populations: A Narrative Review

Abstract

In the last 2 decades, neuromuscular electrical stimulation has been used increasingly in deconditioned patients with the aim of increasing muscle force. Much basic research has been conducted in the area of increasing a muscle's fatigue resistance by neuromuscular electrical stimulation but similarly thorough research with regard to increasing maximal force is missing. Insufficient clinical and basic knowledge exists on the selection of stimulation parameters that will optimize muscle hypertrophy and gains in muscle force. For volitional training, established stimuli for muscle hypertrophy (which more or less parallels maximal muscle force) are muscle tension, metabolic stress, and muscle damage. The present review summarizes findings from clinical and basic research in terms of muscle mechanical as well as acute and chronic physiologic effects of different stimulation protocols, explains the role of the various stimulation parameters in determining the effect of NMES training protocols, and gives clinical recommendations for the choice of stimulation parameters for different patient populations with different training goals, such as increasing muscle force, mass, endurance, or energy consumption. We limit this review to non-neurologic patients, because training goals of neurologic patients are specific to their functional deficits.

A Single Session of Neuromuscular Electrical Stimulation Enhances Vascular Endothelial Function and Peripheral Blood Circulation in Patients With Acute Myocardial Infarction

“…1,2) Recently, a long-term NMES therapy for thigh muscles was reported to not only increase muscle strength but also improve exercise capacity and health-related quality of life in patients with chronic heart failure.…”

Functional, physiological and subjective responses to concurrent neuromuscular electrical stimulation (NMES) exercise in adult cancer survivors: a controlled prospective study

“…Preliminary, exploratory work in an oncology population suggests that concurrent NMES exercise may be best implemented in more deconditioned individuals to enhance functional outcomes 14,15 . This is a common finding in the general NMES literature [16][17][18] , and is a pragmatic consideration given the exercise limiting symptoms experienced by those with advanced disease stages. However, adherence to concurrent NMES exercise for extremely deconditioned individuals can be affected by the ability to apply NMES garments unsupervised 19 .…”

Investigation of the Relationship Between Electrical Stimulation Frequency and Muscle Frequency Response Under Submaximal Contractions

“…Bichler and Celichowski (30) observed that the mechanomyographic signal amplitude and frequency relationships with the stimulation amplitude and frequency are also influenced by the contractile properties of the muscle, such as time of contraction, relaxation, and half relaxation, in addition to the kinetics of calcium in the sarcoplasmic reticulum (2,30,57). However, the results of the present study demonstrate that the applied NMES frequencies do not mechanically influence the behavior of the MMG signal, and this demonstrates the tendency of signal concentration near the 25-Hz band.…”