Feasibility and tolerability of electrical muscle stimulation during rehabilitation in older adults with osteoporotic vertebral fractures.

Objectives: In the context of Japan's rapidly aging population, osteoporotic vertebral fractures are becoming increasingly prevalent, creating greater demands for rehabilitation amid healthcare labor shortages. This study aimed to evaluate the feasibility and potential efficacy of abdominal electrical muscle stimulation (EMS) as an adjunct to rehabilitation in older adults with osteoporotic vertebral fractures, focusing on muscle thickness and bowel function. Methods: Thirty-four elderly patients (mean age: 85 years) hospitalized for osteoporotic vertebral fractures underwent conventional physical and occupational therapy combined with abdominal EMS four times per week. Rectus abdominis muscle thickness was assessed by ultrasound, and bowel function was evaluated using bowel movement frequency and laxative usage. Interrater reliability for ultrasound measurement was high (ICC = 0.97; 95% CI: 0.90-0.99). Results: Rectus abdominis muscle thickness increased significantly by 0.5 mm (P = 0.001). A non-significant trend toward increased spontaneous bowel movements was observed (5-6 times/week; P = 0.058), and laxative use decreased significantly (P = 0.0172). No EMS-related adverse events were reported, and all participants completed the intervention as scheduled. Conclusions: Abdominal EMS is a feasible, safe, and potentially effective adjunct to conventional rehabilitation for older adults with osteoporotic vertebral fractures, even during periods of bed rest. It may contribute to muscle maintenance and support bowel function. These findings support further investigation in larger prospective studies to confirm efficacy and explore long-term outcomes.