**Table 7.**

*General overview of papers focused on electrostimulation and whole-body vibration as a sarcopenia rehabilitation tool.*

#### *Sarcopenia: Technological Advances in Measurement and Rehabilitation DOI: http://dx.doi.org/10.5772/intechopen.101278*

On the other hand, vibration therapy (VT) was considered a close relative of EMS and showed the potential to improve MS and PP in sarcopenic older adults [58].

Initially, whole-body vibration was tested both on Asiatic and European middleaged and older postmenopausal women [61]. Later, other studies tried to determine the optimal rate of frequency per time [62]; patients were enrolled if the diagnosis of sarcopenia was assessed by skeletal mass index. Therefore, there were some discrepancies due to the type of population and the criteria used to establish the diagnosis of sarcopenia, the point of stimulation, the type of exercises, and the measurements [58, 61]. It was compared [59] RT, WBV, and EMS and concluded that the combined use of the three techniques had the capability to improve MS and functional performance. However, more studies would be necessary to obtain more evidence that the combined use of EMS, RT, and WBV is effective in improving MS [59]. In the same year, Wu et al. [58] published a systematic review and meta-analysis showing the efficacy of WBV in improving sarcopenia and important results demonstrating an increase in MS, MQ, and PP after treatment.

Finally, Yamazaki et al. evaluated proprioception in pre-sarcopenia in a group of 64 patients [60]. However, a limitation of the study was the absence of the diagnosis of sarcopenia. Nevertheless, the results suggested that the proprioception could be linked to the decline of lower leg skeletal muscle spindles in older adults with lower muscle mass.

#### *3.1.3 New-born technologies (not yet been tested)*

Addante et al. [63] proposed new wearable devices incorporating the Arduino software to gain HGS, GS, and EMG data at the same time. Data acquisition was possible through the activation of a mobile application linked to the REST server, which was connected with the PostgreSQL database stored on a web application.

Concurrently, McGrath et al. [6] proposed a new dynamometer. It integrates the basic functionalities of any dynamometer with those of an accelerometer allowing a doubling of the features measured, obtaining a complete evaluation of the muscular capacities, integrating the parameters of MS, MQ, and PP, but only of the upper limbs.

Given the functional connection between brain activity and muscles driving the whole gait cycle, Gennaro et al. [64] proposed a mobile wireless recording device of brain activity combined with several other body behavioral variables [28, 64]. Through statistical methods based on blind source separation, they managed to segregate non-cerebral/artefactual sources from cerebral sources of activity: this system is called "*mobile brain/body imaging*" (MoBI) [64]. The obtained data were founded on coupled EEG-EMG analysis, in an interval from 0 to 1 named "*corticomuscular coherence*" (CMC) [28, 64].

Friedrich et al. [65] introduced the MyoRobot technology (a full description is available on the biomechatronic platform [66]) designed for assessing the pathophysiologic mechanisms of muscle biomechanics. Nowadays, the technology is still being tested.

### **4. Discussion and conclusions**

Sarcopenia is a disease that cannot be underestimated, given the impact it has on out-patient or hospitalized patients: complications, length of hospitalization, mortality, and possible problems that may occur in everyday life. In order to define target strategies or personalized therapies against sarcopenia, the diagnosis in older sarcopenic patients should be achieved through qualitative and quantitative measurements of muscle loss. Such measurements could be facilitated by the use, during hospitalization, of wearable devices capable of providing important data in a very short period of time.

In order to assess the reliability of the novel technologies proposed, a comparison on homogeneous populations should be made between the parameters obtained by using the second EWGSOP guidelines instructions and the parameters acquired through the technologies applied. Thereafter, it will be possible to define a diagnostic algorithm that would be able:


In conclusion, the proposed technologies are: (a) accelerometer and actigraph technology in wearable inertial sensors (**Table 1**), focused on sleep quality and loss of muscle strength, and physical activity in older adults related to PP assessment; (b) EMG for diagnostic purposes (**Table 2**); (c) JM (**Table 3**), (d) a short overview about the correlation between the PhA and muscle loss (**Table 4**); (e) a new frontier of virtual reality (**Table 6**) designed for rehabilitation programs for sarcopenic patients; (f) EMS and WBV (**Table 7**) technologies that are being studied for rehabilitation for pre-sarcopenia and sarcopenia; (g) IoT technologies, dynamometer, MoBI, and Myorobot Fiber System, which have not been yet evaluated on patients, and tools and software proposed and already tested (**Table 5**) (cfr. 3.1.3).

Devices promoting active aging could be used to design rehabilitation and prevention programs in severe sarcopenic and pre-sarcopenic patients, respectively. It would be desirable that these devices were available in hospitals, occupational medicine physicians' offices, or at general practitioner's surgeries.
