Effects of electrical muscle stimulation exercise on lower limb muscles and lumbar movement in older adults with disabilities: A pre- and post-test controlled experimental study

Bomjin Lee ,Jeongok Yang ,Youngsoo Kim ,Inhyung Kim ,Joonsung Park ,Himchan Shim ,Changho Jang ,Myeongcheol Kim ,Jongbin Kim

doi:10.24294/jipd8832

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Effects of electrical muscle stimulation exercise on lower limb muscles and lumbar movement in older adults with disabilities: A pre- and post-test controlled experimental study

Bomjin Lee

Jeongok Yang

Youngsoo Kim

Inhyung Kim

Joonsung Park

Himchan Shim

Changho Jang

Myeongcheol Kim

Jongbin Kim

Journal of Infrastructure Policy and Development 2024, 8(14), 8832; https://doi.org/10.24294/jipd8832

Submitted：27 Aug 2024

Accepted：31 Oct 2024

Published：25 Nov 2024

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Abstract

In older adults with disabilities, muscle weakness reduces mobility and causes postural issues. Electrical muscle stimulation (EMS) training is effective for increasing strength by inducing involuntary skeletal muscle contractions. Thus, this study aimed to examine changes in lumbar movement, muscle activity during walking, and maximum muscle strength of lower-limb joints based on an 8-week EMS exercise program for older adults with physical disabilities. Sixteen older adults (aged 56–78 years) with physical disabilities were selected and randomly assigned to either the exercise group (EG, n = 8) or the control group (CG, n = 8). EG participants were instructed to wear EMS suits and participate in an elastic band and bare-body exercise program, whereas CG participants performed the exercise program without the EMS suits. Lumbar range of motion (ROM), body circumference, partial volume, maximum muscle strength, and muscle activity were measured. Statistical analysis was performed using SPSS 28.0 for Windows, with the critical value of α = 0.05. Compared to CG participants, EG participants had a superior ROM, body volume, partial volume, maximum muscle strength (knee joints), and muscle activity while walking. These positive outcomes highlight the efficacy of combining EMS with an exercise program for strength and rehabilitation training in older adults with physical disabilities.

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References

Ada, L., Dorsch, S. & Canning, C. G. (2006). Strengthening interventions increase strength and improve activity after stroke: a systematic review. Aust J Physiother, 52(4), 241–248. https://doi.org/10.1016/s0004-9514(06)70003-4

An, K. Y., In Yang, H., Kang, D. W., et al. (2020). Development process of an evidence-based exercise program for post-operative colorectal cancer patients. Support Care Cancer, 28(2), 755–765. https://doi.org/10.1007/s00520-019-04864-4

Aruin, A. S. & Latash, M. L. (1995). Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Exp Brain Res, 103(2), 323–332. https://doi.org/10.1007/BF00231718

Arya, K. N., Pandian, S., Kumar, D., et al. (2015). Task-based mirror therapy augmenting motor recovery in poststroke hemiparesis: A randomized controlled trial. J Stroke Cerebrovasc Dis, 24(8), 1738–1748. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.026

Bache, C. E., Selber, P., & Graham, H. K. (2003). (ii) The management of spastic diplegia. Curr Orthop, 17, 88–104. https://doi.org/10.1054/cuor.2003.0328

Bang, J. S. (2016). Effects of Flexion and Extension Bias on the Cross-Sectional Area and Muscle Activity of Lumbar Muscles in Patients with Chronic Low Back Pain. Master’s Thesis, Hanseo University Graduate School, Korea.

Brown, L. P., Niehues, S. L., Harrah, A., et al. (1988). Upper extremity range of motion and isokinetic strength of the internal and external shoulder rotators in major league baseball players. Am J Sports Med, 16(6), 577–585.https://doi.org/10.1177/036354658801600604

Buonsenso, A., Centorbi, M., Di Martino, G., Della Valle, C., Di Claudio, G., Di Fonza, D., ... & Fiorilli, G. (2023). Acute Effects of Combining Whole-Body Electromyostimulation with Resistance Training in Active Women. Journal of Functional Morphology and Kinesiology, 9(1), 10.

Cramp, M. C., Greenwood, R. J., Gill, M., et al. (2006). Low intensity strength training for ambulatory stroke patients. Disabil Rehabil, 28(13-14), 883–889. https://doi.org/10.1080/09638280500535157

Delavier, F., & Gundill, M. (2003). Women’s Strength Training Anatomy paperback. 2nd ed. Champaign: Human Kinetics.

Doucet, B. M., Lam, A. & Griffin, L. (2012). Neuromuscular electrical stimulation for skeletal muscle function. Yale J Biol Med, 85(2), 201–215.

Downey, D. J., Drennan, J. C. & Garcia, J. F. (1992). Magnetic resonance image findings in congenital talipes equinovarus. J Pediatr Orthop, 12(2), 224–228 https://doi.org/10.1097/01241398-199203000-00013

Drouin, J. M., Valovich-mcLeod, T. C., Shultz, S. J., Gansneder, B. M., & Perrin, D. H. (2004). Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. European journal of applied physiology, 91, 22-29.

Fujita, E., Taaffe, D. R., Yoshitake, Y., et al. (2019). Repeated sit-to-stand exercise enhances muscle strength and reduces lower body muscular demands in physically frail elders. Exp Gerontol, 116, 86–92. https://doi.org/10.1016/j.exger.2018.12.016

Gilbey, H. J., Ackland, T. R., Wang, A. W., et al. (2003). Exercise improves early functional recovery after total hip arthroplasty. Clin Orthop Relat Res, (408), 193–200. https://doi.org/10.1097/00003086-200303000-00025

Gong H. (2008). The effect of elastic band training on daily living performance and joint ROM in stroke hemiplegia. Korean J Spec Phys Educ, 16, 117–134. https://doi.org/10.17006/kjapa.2008.16.1.117

Granat, M. H., Ferguson, A. C., Andrews, B. J., et al. (1993). The role of functional electrical stimulation in the rehabilitation of patients with incomplete spinal cord injury--observed benefits during gait studies. Paraplegia, 31(4), 207–215. https://doi.org/10.1038/sc.1993.39

Hachisuka, K., Umezu, Y. & Ogata, H. (1997). Disuse muscle atrophy of lower limbs in hemiplegic patients. Arch Phys Med Rehabil, 78(1), 13–18. https://doi.org/10.1016/s0003-9993(97)90003-4

Hah, C. K., & Yi, J. H. (2010). Comparison of pregnant women’s mechanical energy between the period of pregnancy and postpartum. Korean J Sport Biomech, 20, 387–393. https://doi.org/10.5103/KJSB2010.20.4.387

Hambali, R. H., Akmal, S., & Komaruddin, N. H. (2021). Muscle Activity and Gait Analysis of Assistive Device for Rehabilitation Gait Abnormalities Patient. In Journal of Physics: Conference Series (Vol. 2107, No. 1, p. 012063).

Hong, Y. J., & Cha, E. Y. (2000). A study on the attitudes of social sports instructors toward integrated physical education for people with disabilities. The 2000 Seoul International Sport Science Congress, 16, 1603–1612.

Huxley, R., Mendis, S., Zheleznyakov, E., et al. (2010). Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk--a review of the literature. Eur J Clin Nutr, 64(1), 16–22. https://doi.org/10.1038/ejcn.2009.68.

Jeon, S., Kim, M., Yoon, J., Lee, S., & Youm, S. (2023). Machine learning-based obesity classification considering 3D body scanner easurements. Scientific Reports, 13(1), 3299.

Kaplan, R. E., Czyrny, J. J., Fung, T. S., et al. (2002). Electrical foot stimulation and implications for the prevention of venous thromboembolic disease. Thromb Haemost, 88(2), 200–204.

Kemmler, W., Bebenek, M., Engelke, K., et al. (2014). Impact of whole-body electromyostimulation on body composition in elderly women at risk for sarcopenia: the Training and ElectroStimulation Trial (TEST-III). Age (Dordr), 36(1), 395–406. https://doi.org/10.1007/s11357-013-9575-2

Kim, B. H. (2021). Analysis of the effects of lumbar stabilization exercise and low-frequency EMS application on patients with chronic lower back pain. Korean J Sport Sci, 19, 571–578. https://doi.org/10.46669/kss.2021.19.1.051

Kim, J. H., Lee, C. K., & Jeong, G. T. (2023). A study on digital anthropometric items based on SLR techniques for spinal function evaluation and healthcare services. Journal of the Ergonomics Society of Korea, 42 (4), 345-356.

Kim, K. S., & Koo, K. M. (2017). Analysis of motivation for physical activity participation in individuals with disabilities: a systematic review. Korea J Sports Sci, 26, 285–295. https://doi.org/10.35159/kjss.2017.12.26.6.285

Kim, S. H., Kim, S. S., & Kim, M. K. (2007). Effect of 3D lumbar stabilization exercise according to exercise intensity on lumbar muscle strength and subjective pain index in patients with degenerative disc disease. Korean J Soc Sports, 31, 933–942. https://doi.org/10.51979/KSSLS.2007.11.31.933

Kim, T. H., Park, C. H., & Jekal, Y. (2015). The effect of customized training on the level of physical fitness among the disabled player. J Korean Soc Well, 10, 355–367.

Kim, Y. S. (2012). The Effect of Iliopsoas Myofascial Release on Reducing Chronic Low Back Pain and Increasing Lumbar Flexion ROM. PhD Thesis. Chosun University Graduate School, Korea.

Lamb, S. E., Ferrucci, L., Volapto, S., et al. (2003). Risk factors for falling in home-dwelling older women with stroke: the Women’s Health and Aging Study. Stroke, 34(2), 494–501.

Lau, K. W. & Mak, M. K. (2011). Speed-dependent treadmill training is effective to improve gait and balance performance in patients with sub-acute stroke. J Rehabil Med, 43(8), 709–713. https://doi.org/10.2340/16501977-0838

Laughlin, W. A., Weinhandl, J. T., Kernozek, T. W., et al. (2011). The effects of single-leg landing technique on ACL loading. J Biomech, 44(10), 1845–1851. https://doi.org/10.1016/j.jbiomech.2011.04.010

Lee, J. Y., & Choi, S. K. (2014). Sports injuries during training in Korean athletes at the 2012 London paralympic games. Korean J Spec Educ, 22, 111–125. https://doi.org/10.17006/kjapa.2014.22.1.111

Lee, M. C., Ho, C. S., Hsu, Y. J., Wu, M. F., & Huang, C. C. (2023). Effect of 8-week frequency-specific electrical muscle stimulation combined with resistance exercise training on muscle mass, strength, and body composition in men and women: A feasibility and safety study. PeerJ, 11, e16303.

Lee, Y. H., & Kang, S. J. (2009). The effects of aquatic rehabilitation exercises combined with land-based rehabilitation exercises on daily activity endurance and lower limb range of motion in individuals with chronic hemiparesis. Korean J Adapt Phys Act, 17, 121–141. https://doi.org/10.17006/kjapa.2009.17.2.121

Lin, Z. & Yan, T. (2011). Long-term effectiveness of neuromuscular electrical stimulation for promoting motor recovery of the upper extremity after stroke. J Rehabil Med, 43(6), 506–510. https://doi.org/10.2340/16501977-0807

Maguire, C., Sieben, J. M., Erzer, F., et al. (2012). How to improve walking, balance and social participation following stroke: a comparison of the long term effects of two walking aids--canes and an orthosis TheraTogs--on the recovery of gait following acute stroke. A study protocol for a multi-centre, single blind, randomised control trial. BMC Neurol, 12, 18. https://doi.org/10.1186/1471-2377-12-18

Mauritz, K. H. (2002). Gait training in hemiplegia. Eur J Neurol, 9 Suppl 1, 23-9; dicussion 53–61. https://doi.org/10.1046/j.1468-1331.2002.0090s1023.x

Mayer, T. G., Vanharanta, H., Gatchel, R. J., et al. (1989). Comparison of CT scan muscle measurements and isokinetic trunk strength in postoperative patients. Spine (Phila Pa 1976), 14(1), 33–36. https://doi.org/10.1097/00007632-198901000-00006

Ministry of Culture, Sports and Tourism. (2015). Survey on the Actual Status of Sports for the Disabled.

Moreland, J. D., Goldsmith, C. H., Huijbregts, M. P., et al. (2003). Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial. Arch Phys Med Rehabil, 84(10), 1433–1440. https://doi.org/10.1016/s0003-9993(03)00360-5

Nel, H. W., Mudzi, W., van Vuuren, E. C. J., & Musenge, E. (2020). Biodex© training post-stroke for postural stability in the upper trunk: A pilot study. The South African Journal of Physiotherapy, 76(1).

Oliveira, T. M. D., Felício, D. C., Filho, J. E., Durigan, J. L. Q., Fonseca, D. S., Jose, A., ... & Malaguti, C. (2021). Effects of whole-body electromyostimulation on function, muscle mass, strength, social participation, and falls-efficacy in older people: A randomized trial protocol. PLoS One, 16(1), e0245809

Orr, R. (2010). Contribution of muscle weakness to postural instability in the elderly. A systematic review. Eur J Phys Rehabil Med, 46(2), 183–220.

Ouellette, M. M., Bean, J., LeBrasseur, N. K., et al. (2003). Resistance exercise in the elderly after stroke. Med Sci Sports Exer, 35 (Suppl 1), https://doi.org/10.1097/00005768-200305001-01293

Park, J. J., Yoo, S. W., Kim, D. S., et al. (2001). A study on knee joint isokinetic strength and muscular endurance in visually impaired children. Korean J Spec Phys Educ, 9, 131–140.

Park, M. A., Lee, S. M., & Song, C. H. (2005). The effect of lumbar stabilization exercise on surface type of low back pain patients. Korean Sports Res, 16, 329–340.

Park, S. Y. (2015). Effects of functional ability and isokinetic strength on strength resistance exercise program of knee joint. Korean J Growth Dev, 23, 15–20.

Patten, C., Lexell, J. & Brown, H. E. (2004). Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy. J Rehabil Res Dev, 41(3A), 293–312. https://doi.org/10.1682/jrrd.2004.03.0293

Petersen, N. T., Taylor, J. L. & Gandevia, S. C. (2002). The effect of electrical stimulation of the corticospinal tract on motor units of the human biceps brachii. J Physiol, 544(Pt 1), 277–284. https://doi.org/10.1113/jphysiol.2002.024539

Popović, M. D., Kostić, M. D., Rodić, S. Z., et al. (2014). Feedback-mediated upper extremities exercise: increasing patient motivation in poststroke rehabilitation. Biomed Res Int, 2014, 520374. https://doi.org/10.1155/2014/520374

Regterschot, G. R., Folkersma, M., Zhang, W., et al. (2014). Sensitivity of sensor-based sit-to-stand peak power to the effects of training leg strength, leg power and balance in older adults. Gait Posture, 39(1), 303–307. https://doi.org/10.1016/j.gaitpost.2013.07.122

Schmitz, A., Gäbel, H., Weiss, H. R., et al. (2002). Anthropometric 3D-body scanning in idiopathic scoliosis (German). Z Orthop Ihre Grenzgeb, 140(6), 632–636. https://doi.org/10.1055/s-2002-36045

Shin, W. S. (2015). The impact of behavioral beliefs on exercise persistence and quality of life in individuals with physical disabilities participating in adapted physical activity. Korean J Sport Sci, 24, 239–253.

Sobhiyeh, S., Borel, N., Dechenaud, M., et al. (2020). Fully automated pipeline for body composition estimation from 3D optical scans using principal component analysis: A shape up study. Annu Int Conf IEEE Eng Med Biol Soc, 2020, 1853–1858. https://doi.org/10.1109/EMBC44109.2020.9175211

Song, J. E., Choi, G. H., & Park, H. (2016). Effects of the micro-training with EMS device on body composition, isokinetic muscular function, and physical fitness of healthy 20’s males. Korea J Sports Sci, 25, 1143–1154.

Stolze, H., Klebe, S., Zechlin, C., et al. (2004). Falls in frequent neurological diseases--prevalence, risk factors and aetiology. J Neurol, 251(1), 79–84. https://doi.org/10.1007/s00415-004-0276-8

Sun, J., & Park, D. S. (2022) The comparison of muscle contraction time and modulation ratio during reaching tasks in hemiparalysis, elderly and young adults. Phys Ther Rehabil Sci, 11, 145–153. https://doi.org/10.14474/ptrs.2022.11.2.145

Sunnerhagen, K. S. (2007). Circuit training in community-living "younger" men after stroke. J Stroke Cerebrovasc Dis, 16(3), 122-129. https://doi.org/10.1016/j.jstrokecerebrovasdis.2006.12.003

Teasell, R. W., Bhogal, S. K., Foley, N. C., et al. (2003). Gait retraining post stroke. Top Stroke Rehabil, 10(2), 34–65. https://doi.org/10.1310/UDXE-MJFF-53V2-EAP0

Thurston, M. (2021). Acute effects of a robotic ankle exosuit on the gait biomechanics, metabolic cost, and muscle activity during walking in patients with unilateral cerebral palsy (Master’s thesis).

Treleaven, P., & Wells, J. (2007). 3D body scanning and healthcare applications. Computer, 40, 28–34. https://doi.org/10.1109/MC.2007.225

Trombly, C. A. (1992). Deficits of reaching in subjects with left hemiparesis: a pilot study. Am J Occup Ther, 46(10), 887–897. https://doi.org/10.5014/ajot.46.10.887

Vanderthommen, M. & Duchateau, J. (2007). Electrical stimulation as a modality to improve performance of the neuromuscular system. Exerc Sport Sci Rev, 35(4), 180–185. https://doi.org/10.1097/jes.0b013e318156e785

Vanderthommen, M., Depresseux, J. C., Dauchat, L., et al. (2002). Blood flow variation in human muscle during electrically stimulated exercise bouts. Arch Phys Med Rehabil, 83(7), 936–941. https://doi.org/10.1053/apmr.2002.33226

von Stengel, S., Bebenek, M., Engelke, K., et al. (2015). Whole-body electromyostimulation to fight osteopenia in elderly females: The randomized controlled training and electrostimulation trial (TEST-III). J Osteoporos, 2015, 643520. https://doi.org/10.1155/2015/643520

Yang, Y. R., Wang, R. Y., Lin, K. H., et al. (2006). Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke. Clin Rehabil, 20(10), 860–870. https://doi.org/10.1177/0269215506070701

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