Effects of Whole‐Body Electromyostimulation on the Thickness of Appendicular and Respiratory Muscles, Functionality, and Frailty in Patients From a Transitional Care Unit: A Randomized Clinical Trial Protocol

BACKGROUND: Frailty is highly prevalent among recently hospitalized adults and is associated with functional decline, dependency, and increased mortality. Although conventional physiotherapy is routinely applied in transitional care settings, its effectiveness may be limited in frail individuals with low tolerance to exercise. Whole-body electromyostimulation (WB-EMS) has emerged as a potential adjunct intervention to enhance muscle preservation and functional recovery in this population. The aim of this study was to evaluate the effects of WB-EMS combined with conventional physiotherapy on muscle thickness, functional capacity, and frailty in patients admitted to a transitional care unit. METHODS: This randomized, assessor-blinded clinical trial will include 62 frail adults (≥ 50 years; Tilburg Frailty Indicator ≥ 5), randomized to receive either WB-EMS plus physiotherapy or physiotherapy alone for 6 weeks. WB-EMS will be applied twice weekly (20 min/session), concurrently with standardized low-load exercises. The primary outcome is the change in rectus femoris muscle thickness assessed by B-mode ultrasonography. Secondary outcomes include diaphragm and forearm muscle thickness, functional capacity (Barthel Index), and frailty (Tilburg Frailty Indicator). Outcomes will be assessed at baseline and post-intervention. CONCLUSION: This trial will provide evidence on the feasibility and physiological effects of WB-EMS as an adjunct to physiotherapy in frail patients undergoing transitional care, with potential implications for rehabilitation strategies in post-hospitalization settings. TRIAL REGISTRATION: REBEC, RBR-6DQ3QGN. Registered on 01 November 2024.