This study will employ a randomized controlled trial design with a pre-post design to investigate the combined effects of Neuromuscular Electrical Stimulation (NMES) and Low-Intensity Resistance Training (LIRT) on muscle strength, muscle girth, and physical endurance in the geriatric population. Participants will be randomly assigned to either an intervention group or a control group.
Both male and female will be added(29)
Patients with low calf muscle mass <31.5 cm for females and <33.5 cm for males will be included in this study(36).
Participants able to complete the Five Times Sit-to-Stand Test in ≤ 10 seconds (men) or ≤ 11 seconds (women)(37).
Participants must have ability to walk independently and absence of severe medical conditions(29).
Participants with a MoCA score of less than 26 will be excluded to ensure adequate cognitive ability to comprehend and follow the study protocol, including exercise and neuromuscular stimulation procedures (39).
Participants with any musculoskeletal issues will be excluded from this study(35).
Participants with neuromuscular disorders that may affect muscle strength or function(29).
Parallel
Neuromuscular electrical stimulation
Other interventionPrior to the initiation of resistance training, participants will receive 20 minutes of NMES targeting the gastrocnemius and calf muscles Frequency: 35 Hz Pulse duration: 300 µs Following NMES, participants will undergo a 20-minute LIRT session comprising the following exercises:
lOW intensity resistance training
Other interventionSeated Leg Press with Thera Band Resistance (Sole Support Position) Participants will be seated with a Thera Band looped around the soles of their feet and held in the hands to provide resistance during leg extension. Repetitions: 10 Sets: 3 Rest Interval: 30-60 seconds between sets
Manual muscle testing (MMT) for strength measurement
Muscle strength will be assessed using Manual Muscle Testing (MMT) of the plantar flexors and knee extensors based on the Medical Research Council (MRC) 0-5 grading scale. Each muscle group will be tested twice on the dominant side, and the higher grade will be recorded. Participants with grades ≤3 will be classified as having low muscle strength, while those with grades ≥4 will be considered to have sufficient strength for participation in low-intensity resistance training and neuromuscular electrical stimulation (NMES). MMT is a reliable and widely used clinical method for muscle strength assessment
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