Efficacy of Neuromuscular Electrical Stimulation in Mitigating Muscle Mass Loss: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
In brief
Neuromuscular electrical stimulation yields moderate muscle-mass increase in older adults
A meta-analysis of 18 randomized trials (676 participants) found that NMES raised muscle mass by a moderate amount (standardized effect ~0.66) compared with usual care, especially in community-dwelling seniors. Benefits were less clear in hemodialysis patients and varied with measurement technique. Evidence remains low-certainty, so standardized protocols and outcome studies are needed.
- Journal
- Muscle & nerve (Q1)
- Published
- 4 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Yang Jiang, Yemei Gao, Renxian Wang, Bowen Liu
- PMID
- 42698133
- DOI
- 10.1002/mus.70396
Why clinicians should know about it
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (top studies of the week, 6 September 2026): High-quality evidence in a top journal
Abstract
INTRODUCTION/AIMS: Evidence for the stand-alone effect of neuromuscular electrical stimulation (NMES) on muscle mass in adults with sarcopenia or secondary muscle loss remains fragmented. This systematic review and meta-analysis aimed to quantify this effect and explore whether population, stimulation parameters, and assessment methods modified treatment effects. METHODS: Six electronic databases, including PubMed, Embase, and the Cochrane Library, were systematically searched for randomized controlled trials (RCTs) published between January 2000 and June 2025. Pooled effect sizes (standardized mean difference, SMD) were calculated using random-effects models (PROSPERO: CRD420251114043). RESULTS: Eighteen RCTs involving 676 participants yielded 19 independent effect estimates. NMES improved muscle mass compared with control conditions (SMD = 0.66, 95% CI = 0.30-1.02), with substantial heterogeneity. Leave-one-out sensitivity analyses did not alter the direction of effect. Subgroup analyses suggested differences by population and assessment method: community-dwelling older adults showed the most consistent benefit, whereas hemodialysis patients showed no clear improvement. CT/DXA-based measures yielded larger estimates than ultrasound-based regional measures or indirect methods. Meta-regression suggested a potential positive association between pulse width and effect size, whereas stimulation site and intervention duration were not clearly associated with treatment effects. DISCUSSION: Low-certainty evidence suggests that NMES may improve muscle mass in selected adults with sarcopenia or secondary muscle loss. Future trials should use standardized NMES protocols, reliable muscle-mass assessments, and clinically meaningful outcomes.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.