L'électrostimulation neuromusculaire périphérique a-t-elle une place dans la prise en charge thérapeutique du patient obèse ?

Physical activity is a major therapeutic tool in the obese patient. It is however often difficult to promote due to the frequent physical limitations in these patients, and also to various psychosocial obstacles. Electrical neuromuscular stimulation (ENS), a technique of retraining, based on involuntary muscle contractions induced by an electric current applied by skin electrodes, is not currently used in obesity while it yet presents interesting potential for these patients. Indeed, studies in respiratory failure, heart failure or in the elderly, indicate that ENS has probably a place in the obese patient, not from a perspective of weight loss but rather to limit the loss of lean body mass associated with weight loss, to promote physical rehabilitation in the most sedentary subjects, and perhaps also to improve the metabolic status. Additional studies are however needed to clarify its actual clinical impact, its specific mechanisms of action and its indications. Technological improvements are also needed to facilitate its use by patients themselves and increase the effectiveness of stimulators in obese subjects.