Comparing rehabilitation with and without neuromuscular electrical stimulation in hospitalized older adults: Cognitive, functional, and acceptability outcomes from a pragmatic pilot study

Neuromuscular electrical stimulation (NMES) is a non-invasive therapeutic approach offering targeted muscle contraction without requiring voluntary effort. This pragmatic pilot study investigated the effects of integrating NMES into usual rehabilitation care on cognitive and mobility outcomes, as well as its acceptance among hospitalized older adults in rehabilitation settings. Twenty-nine older adults with a mean age of 81.7 years (SD = 9.0) participated in this study. Patients received either usual rehabilitation care alone (5 days/week) or NMES in addition to usual rehabilitation care (3 days/week) for three weeks. Cognitive function and mobility were assessed pre- and post-intervention, and NMES acceptability was measured using an 8-item questionnaire. Integrating NMES to usual rehabilitation care significantly improved cognitive flexibility, demonstrated by reduced task-switching errors (p = 0.03). No additional benefits were observed in other cognitive or mobility measures, although all participants showed mobility improvements over time. NMES was considered acceptable by older adults in the rehabilitation setting.Integrating NMES into usual rehabilitation is well accepted by hospitalized older adults, with preliminary evidence suggesting it may improve cognitive flexibility. © The Author(s), under exclusive licence to American Aging Association 2025.