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The differentiation of muscle fibers regenerating in the absence of the nerve is remarkable in animal experiments and is also evident in muscle biopsies harvested from human patients. During the last 20 years, clinical studies have employed long impulse biphasic electrical stimulation as a first-step treatment for humans living with long-term denervated muscles subsequent to spinal cord injury (SCI). Trophic and functional recovery from severe atrophy/degeneration occurs in long-term denervated degenerating muscles (DDM) treated with h-bFES at between 1 and 5 years from SCI. This fact has sound foundations based on muscle biopsy analyses and on quantitative muscle color computed tomography (QMC-CT). If myogenesis in patients could be modulated during the many months needed to recover tetanic contractility of denervated muscles, then it should be possible to substantially abbreviate the time needed to achieve functional recovery of long-term denervated human muscle by h-bFES, using the commercial muscle stimulator and the large electrodes now available. The future will tell if induced muscle fiber regeneration and h-bFES will be useful even at 10 years after SCI, i.e., in the vast majority of the people in need of them.

All progressive muscle contractile impairments (including age-related muscle weakness) need permanent management. We discuss evidence that subclinical denervation contributes to atrophy and slowness of aged muscle, and we provide stimulation protocols for aged and denervated skeletal muscles. We describe in Sect. 11.1 the effects of home-based neuromuscular FES in elderly persons and then in Sect. 11.2 the diagnostics, training protocols, and clinical results of home-based functional electrical stimulation (h-b FES) for denervated–degenerated skeletal muscle tissue. Using molecular analyses, histological morphometry, and Muscle Color Computed Tomography, we evaluated muscles of elderly persons, showing that increased levels of muscle contractions induced by h-b FES reverse muscle weakness and atrophy both in sedentary seniors and in conus and cauda equina complete syndrome.