The effect of neuromuscular electrostimulation on muscle strenghthening of the m. quadriceps and on physical performance in frail elderly with poor physical performance on <= day 4 of hospital admission. Pilot study.

Elderly admitted to the geriatric ward of the hospital have got almost always a
acute medical problem in combination with other (chronic) illnesses and mental
and/or physical changes. This data makes them very vulnerable. Thereby they
have a large risk of complications on which one of them is the risk of function
loss. One of the most important causes of physical deterioration is sarcopenia.
This is defined as a syndrom characterised by progressive and generalised loss
of skeletal muscle mass and strenght with a risk of adverse outcomes such as
physical disability, poor quality of life and death. In elderly 70 years of age
the loss of skeletal muscle mass is 35% as a result of the proces of common
ageing. In addition to this information looses an acute ill geriatric patient
about >= than 1 kg of the muscle mass of his legs within 3 days after
admission. 10 days of immobility can be compared with the muscle loss of 15
years of common ageing. So it can be said that hospital admission will
accelerate the loss of muscle mass. In a important part of those elderly will
return to their own home appear to be a problem.

In recent studies physical training against resistance appeared to be the most
successfull to prevent sarcopenia. Because of the bad physical condition of the
elderly during a hospital admission resistancetraining can't be applied. A
Pilot study of the students physiotherapy earlier this year showed that in the
first days/week of a admission the physical load capacity is too low. That's
why resistance training is not an option. Therefore we are looking for an other
way to prevent functional loss during admission when training against
resistance isn't possible. Other recent studies have shown that the application
of neuromuscular electrostimulation (NMES) is a possibilty to prevent
functional loss. The aim of this researce is therefore to examine the effect of
NMES on prevention of progressive and generalised loss of muscle mass and
strenght and with that the prevention of functional loss.

The application of NMES in combination with the usual care on 15 frail elderly,
70 years and above, admitted to the geriatric ward of the Orbis Medisch Centrum
with different causes of disease with a SPPB <6 on day <=4 after admission. This
population will be compares with a control group. This group will only achieve
the usual care, exercise in guidance of the physiotherapist.

Application of NMES 5 days a week for 60 minutes a day during at least 1 week.

The burden and risks (shortterm muscle ache, fatigue and dermatitis in result
of the patch) associated with participation are limited. The outcome(s) of the
study, preservation of muscle strenght and mobility, may have major
consequences for the quality of life in frail elderly and a decrease in
comorbidity during and after hospital admission. In conclusion; the result(s)
of the intervention may have far-reaching consequences for the patient(s).