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Updated: Sep 13, 2025

Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury
Published on: February 1, 2018
Neuromuscular electrical stimulation enhances glycemic control and carbohydrate utilization in sedentary,
Jehu N Apaflo1, Gabriel Narvaez1, Irene John Tomy1
1Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, Department of Kinesiology, The University of Texas at El Paso, 500 University Ave, El Paso, TX, USA.
Introduction:
Neuromuscular electrical stimulation (NMES) is used as a rehabilitation technique for individuals with physical function limitations and mobility impairments. However, the potential for NMES-induced muscle contraction to improve metabolic health is unclear. This study investigated the effect of NMES on glycemic control and energy expenditure in a predominantly Hispanic population.
Methods:
Overweight/obese participants with hyperglycemia (N = 56 [Males: 19; Females: 37] Age: 33.3 ± 11.8 years; BMI: 34.8 ± 5.6 kg/m2) underwent 30 min of NMES on both quadriceps muscles after an overnight fast. Glucose levels were continuously measured for over 48 h, encompassing the stimulation day and a control day, using a continuous glucose monitor. Standardized eucaloric diet was provided on both days. Energy expenditure and substrate utilization were measured by indirect calorimetry before and during the NMES application.
Results:
Thirty minutes of NMES treatment reduced glucose levels compared to baseline glucose (116.2 ± 2.7 mg/dL to 113.2 ± 2.5 mg/dL; p < 0.0001). Glycemic control determined by 24-h glucose variability/fluctuations was significantly lower on the day of NMES compared to the control day (18.0 ± 1.0 mg/dL vs 20.0 ± 1.2 mg/dL; p < 0.05). Energy expenditure (18.8 ± 0.3 kcal.Day-1.Kg-1 to 19.0 ± 0.3 kcal.Day-1.Kg-1; p < 0.05) and respiratory exchange ratio (0.79 ± 0.01 to 0.80 ± 0.01; p < 0.05) increased during stimulation compared to the baseline.
Conclusion:
Acute application of NMES results in improvement in glycemic control and energy expenditure in the short term. Future studies are needed to determine if chronic NMES-induced muscle contraction can provide an alternate strategy to manage hyperglycemia.
Clinical Trial Registration:
NCT03947697 May 2019.
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