Pilot Study to Assess the Ability of a 4-Week, Home-Based, Electrical Muscle Stimulation Program to Improve Lower Extremity Function and Reduce Sarcopenia in Older Individuals With Cancer

Objective To assess the effectiveness of home-based self-rehabilitation using a portable electrical muscle stimulation (EMS) device for improving severe sarcopenia by improving lower extremity function. Design The effect of 4 weeks of EMS training on improving lower extremity function was compared between patients divided into 2 groups based on baseline lower extremity function. Self-rehabilitation was carried out with a portable EMS device, the SIXPAD Foot Fit, and each session lasted 15-23 minutes. Lower extremity function was assessed with the Short Physical Performance Battery (SPPB). Setting University hospital. Participants The study included 50 older outpatients (N=50) with a mean age of 75 years; 98% had hepatobiliary cancer, and 38% were men. Interventions Not applicable. Main Outcome Measures Patients were divided into 2 groups based on baseline SPPB value (SPPB ≤ 9 or SPPB >9). Lower extremity function was observed prospectively during 4 weeks of home-based self-rehabilitation. Results EMS was used consistently, with a median duration of use of 28 days. In the baseline SPPB>9 group, lower extremity function was not significantly improved (SPPB, 11.0-12.0; P =.290). In contrast, significant improvement was observed in the baseline SPPB ≤ 9 group, and the total score (SPPB score, 8.0-9.0; P =.001) and 2 of its 3 components, balance (balance score, 3.0-4.0; P =.009) and gait speed (gait speed score, 3.0-4.0; P =.002), improved significantly. Sit-to-stand ability did not improve (Sit-to-stand score, 1.0-2.0; P =.060). As a result, the proportion of patients with severe sarcopenia was initially 66.7% but decreased significantly to 36.4% ( P =.002). Conclusions A home-based, self-rehabilitation program using a portable EMS device may improve lower extremity function and attenuate sarcopenic status in older patients with cancer with reduced lower extremity function.