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Beier M, Schoene D, Kohl M, von Stengel S, Uder M, Kemmler W. Non-Athletic Cohorts Enrolled in Longitudinal Whole-Body Electromyostimulation Trials-An Evidence Map. SENSORS (BASEL, SWITZERLAND) 2024; 24:972. [PMID: 38339689 PMCID: PMC10857049 DOI: 10.3390/s24030972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Whole-body electromyostimulation (WB-EMS) can be considered as a time-efficient, joint-friendly, and highly customizable training technology that attracts a wide range of users. The present evidence map aims to provide an overview of different non-athletic cohorts addressed in WB-EMS research. Based on a comprehensive systematic search according to PRISMA, eighty-six eligible longitudinal trials were identified that correspond with our eligibility criteria. In summary, WB-EMS research sufficiently covers all adult age categories in males and females. Most cohorts addressed (58%) were predominately or exclusively overweight/obese, and in about 60% of them, diseases or conditions were inclusion criteria for the trials. Cohorts specifically enrolled in WB-EMS trials suffer from cancer/neoplasm (n = 7), obesity (n = 6), diabetes mellitus (n = 5), metabolic syndrome (n = 2), nervous system diseases (n = 2), chronic heart failure (n = 4), stroke (n = 1), peripheral arterial diseases (n = 2), knee arthrosis (n = 1), sarcopenia (n = 3), chronic unspecific low back pain (n = 4), and osteopenia (n = 3). Chronic kidney disease was an eligibility criterion in five WB-EMS trials. Finally, three studies included only critically ill patients, and two further studies considered frailty as an inclusion criterion. Of importance, no adverse effects of the WB-EMS intervention were reported. In summary, the evidence gaps in WB-EMS research were particular evident for cohorts with diseases of the nervous and cerebrovascular system.
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Affiliation(s)
- Miriam Beier
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Daniel Schoene
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, 78056 Villingen-Schwenningen, Germany;
| | - Simon von Stengel
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Wolfgang Kemmler
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany
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Chen YC, Chen WC, Liu CW, Huang WY, Lu IC, Lin CW, Huang RY, Chen JS, Huang CH. Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs. Eur Rev Aging Phys Act 2023; 20:22. [PMID: 38030985 PMCID: PMC10687931 DOI: 10.1186/s11556-023-00333-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Resistance training (RT) and nutritional supplementation are recommended for the management of sarcopenia in older adults. However, optimal RT intensity for the treatment of sarcopenia has not been well investigated. METHODS This network meta-analysis aims to determine the comparative effectiveness of interventions for sarcopenia, taking RT intensity into consideration. RT intensity was classified into light-to-moderate intensity RT(LMRT), moderate intensity RT(MRT), and moderate-to-vigorous intensity RT(MVRT) based on percentage of one repetition maximum (%1RM) and/or rating of perceived exertion. RESULTS A total of 50 RCTs (N = 4,085) were included after screening 3,485 articles. The results confirmed that RT with or without nutrition was positively associated with improved measures of muscle strength and physical performance. Regarding RT intensity, LMRT only demonstrated positive effects on hand grip (aerobic training + LMRT + nutrition: mean difference [MD] = 2.88; 95% credential intervals [CrI] = 0.43,5.32). MRT provided benefits on improvement in the 30-s chair stand test (repetitions) (MRT: MD = 2.98, 95% CrI = 0.35,5.59), timed up and go test (MRT: MD = -1.74, 95% CrI: = -3.34,-0.56), hand grip (MRT: MD = 2.44; 95% CrI = 0.03,5.70), and leg press (MRT: MD = 8.36; 95% CrI = 1.87,13.4). MVRT also improved chair stand test repetitions (MVRT: MD = 5.64, 95% CrI = 0.14,11.4), gait speed (MVRT + nutrition: MD = 0.21, 95% CrI = 0.003,0.48), appendicular skeletal muscle index (MVRT + nutrition: MD = 0.25, 95% CrI = 0.01,0.5), and leg press (MVRT: MD = 14.7, 95% CrI: 5.96,22.4; MVRT + nutrition: MD = 17.8, 95% CrI: 7.55,28.6). CONCLUSION MVRT had greater benefits on muscle mass, lower extremity strength, and physical performance compared to MRT. Increasing RT intensity may be recommended for sarcopenic older adults.
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Affiliation(s)
- Yu Chang Chen
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
| | - Wang-Chun Chen
- Department of Pharmacy, E-Da Hospital, I-Shou University, No. 1, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
- Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, No.8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
| | - Chia-Wei Liu
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
| | - Wei-Yu Huang
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
| | - ICheng Lu
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
| | - Chi Wei Lin
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
| | - Ru Yi Huang
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
- Data Science Degree Program, National Taiwan University and Academia sinica, No.1, Section 4, Roosevelt Rd, Da'an District, Taipei City, 10617, Taiwan (R.O.C.)
| | - Jung Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, No. 1, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan
| | - Chi Hsien Huang
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.
- School of Medicine for International Students, College of Medicine, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.
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Lee MC, Ho CS, Hsu YJ, Wu MF, Huang CC. Effect of 8-week frequency-specific electrical muscle stimulation combined with resistance exercise training on muscle mass, strength, and body composition in men and women: a feasibility and safety study. PeerJ 2023; 11:e16303. [PMID: 37868059 PMCID: PMC10586320 DOI: 10.7717/peerj.16303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023] Open
Abstract
In recent years, electrical muscle stimulation (EMS) devices have been developed as a complementary training technique that is novel, attractive, and time-saving for physical fitness and rehabilitation. While it is known that EMS training can improve muscle mass and strength, most studies have focused on the elderly or specific patient populations. The aim of this study was to investigate the effects of frequency-specific EMS combined with resistance exercise training for 8 weeks on muscle mass, strength, power, body composition, and parameters related to exercise fatigue. Additionally, we aimed to evaluate the feasibility and safety of EMS as an exercise aid to improve body composition. We recruited 14 male and 14 female subjects who were randomly assigned to two groups with gender parity (seven male and seven female/group): (1) no EMS group (age: 21.6 ± 1.7; height: 168.8 ± 11.8 cm; weight: 64.2 ± 14.4 kg) and (2) daily EMS group (age: 21.8 ± 2.0; height: 167.8 ± 9.9 cm; weight: 68.5 ± 15.5 kg). The two groups of subjects were very similar with no significant difference. Blood biochemical routine analysis was performed every 4 weeks from pre-intervention to post-intervention, and body composition, muscle strength, and explosive power were evaluated 8 weeks before and after the intervention. We also performed an exercise challenge analysis of fatigue biochemical indicators after 8 weeks of intervention. Our results showed that resistance exercise training combined with daily EMS significantly improved muscle mass (p = 0.002) and strength (left, p = 0.007; right, p = 0.002) and significantly reduced body fat (p < 0.001) than the no EMS group. However, there was no significant advantage for biochemical parameters of fatigue and lower body power. In summary, our study demonstrates that 8 weeks of continuous resistance training combined with daily upper body, lower body, and abdominal EMS training can significantly improve muscle mass and upper body muscle strength performance, as well as significantly reduce body fat percentage in healthy subjects.
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Affiliation(s)
- Mon-Chien Lee
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
- Center for General Education, Taipei Medical University, Taipei, Taiwan
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Yi-Ju Hsu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Ming-Fang Wu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
- Tajen University, Pingtung, Taiwan
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4
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Yin YH, Liu JYW, Välimäki M. Dietary behaviour change intervention for managing sarcopenic obesity among community-dwelling older people: a pilot randomised controlled trial. BMC Geriatr 2023; 23:597. [PMID: 37752447 PMCID: PMC10521482 DOI: 10.1186/s12877-023-04327-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The effects of dietary intervention in managing sarcopenic obesity are controversial, and behavior change techniques are lacking in previous studies which are important for the success of dietary intervention. This study aimed to evaluate the feasibility and preliminary effects of a dietary behaviour change (DBC) intervention on managing sarcopenic obesity among community-dwelling older people in the community. METHODS A two-armed, RCT was conducted. Sixty community-dwelling older adults (≥ 60 years old) with sarcopenic obesity were randomised into either the experimental group (n = 30), receiving a 15-week dietary intervention combined with behaviour change techniques guided by the Health Action Process Approach model, or the control group (n = 30), receiving regular health talks. Individual semi-structured interviews were conducted with 21 experimental group participants to determine the barriers and facilitators of dietary behaviour changes after the intervention. RESULTS The feasibility of the DBC intervention was confirmed by an acceptable recruitment rate (57.14%) and a good retention rate (83.33%). Compared with the control group, the experimental group significantly reduced their body weight (p = 0.027, d = 1.22) and improved their dietary quality (p < 0.001, d = 1.31). A positive improvement in handgrip strength (from 15.37 ± 1.08 kg to 18.21 ± 1.68 kg), waist circumference (from 99.28 ± 1.32 cm to 98.42 ± 1.39 cm), and gait speed (from 0.91 ± 0.02 m/s to 0.99 ± 0.03 m/s) was observed only in the experimental group. However, the skeletal muscle mass index in the experimental group decreased. The interview indicated that behaviour change techniques enhanced the partcipants' compliance with their dietary regimen, while cultural contextual factors (e.g., family dining style) led to some barriers. CONCLUSION The DBC intervention could reduce body weight, and has positive trends in managing handgrip strength, gait speed, and waist circumference. Interestingly, the subtle difference between the two groups in the change of muscle mass index warrants futures investigation. This study demonstrated the potential for employing dietary behaviour change interventions in community healthcare. TRIAL REGISTRATION Registered retrospectively on ClinicalTrailas.gov (31/12/2020, NCT04690985).
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Affiliation(s)
- Yue-Heng Yin
- School of Nursing, Nanjing Medical University, Nanjing, China.
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Maritta Välimäki
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland
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Hadjispyrou S, Giannopoulos A, Philippou A, Theos A. Mitochondrial Dysfunction and Sarcopenic Obesity: The Role of Exercise. J Clin Med 2023; 12:5628. [PMID: 37685695 PMCID: PMC10489005 DOI: 10.3390/jcm12175628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Sarcopenic obesity (SO) constitutes the coexistence of skeletal muscle mass loss (sarcopenia) and excess adiposity (obesity). It is mainly considered as a condition in the elderly with health-threatening impacts ranging from frailty to mortality. Mitochondrial dysfunction consists one of the basic pathophysiological mechanisms leading to the development of SO and its consequences. Indirect indicators of mitochondrial function, such as VO2max and exercise capacity, have been demonstrated to be negatively affected in individuals with SO, while the positive effect of exercise on mitochondrial function has been widely proved; thus, in this review, we aimed at investigating the effects of endurance, resistance, and concurrent exercise training on indexes of mitochondrial dysfunction in SO patients. The results of the clinical trials evaluated reveal positive effects of chronic exercise on VO2max and physical capacity, as well as mitochondrial biogenesis and activity. It has been concluded that utilizing a systematic exercise training program that includes both aerobic and strength exercises can be an effective strategy for managing SO and promoting overall health in these patients.
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Affiliation(s)
- Spyridon Hadjispyrou
- Section of Sports Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 901 87 Umeå, Sweden;
- Umeå School of Sports Sciences, Umeå University, 901 87 Umeå, Sweden;
| | - Antonios Giannopoulos
- Umeå School of Sports Sciences, Umeå University, 901 87 Umeå, Sweden;
- Department of Surgical & Perioperative Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 157 72 Athens, Greece;
| | - Apostolos Theos
- Section of Sports Medicine, Department of Community Medicine and Rehabilitation, Umeå University, 901 87 Umeå, Sweden;
- Umeå School of Sports Sciences, Umeå University, 901 87 Umeå, Sweden;
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6
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Xu J, Hu Q, Li J, Zhou Y, Chu T. Effects of non-pharmacological interventions on patients with sarcopenic obesity: A meta-analysis. PLoS One 2023; 18:e0290085. [PMID: 37566595 PMCID: PMC10420348 DOI: 10.1371/journal.pone.0290085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE Systematic evaluation of the improvement effect of non-pharmacological intervention on patients with sarcopenic obesity. METHODS Wanfang, VIP, China National Knowledge Infrastructure (CNKI), SinoMed, Web of Science, Cochrane Library, PubMed, and Embase databases were searched systematically for randomized controlled trials (RCTS) and experimental studies of non-pharmacological interventions on patients with sarcopenic obesity. The retrieval period was from the establishment of the databases to October 31, 2022. Meta-analysis was conducted using RevMan 5.4. RESULTS A total of 18 studies involving 1,109 patients were included. Meta-analysis results showed that non-pharmacological interventions improved patients' body weight [mean difference, MD = -2.74, 95% CI (-4.79, -0.70), P = 0.009], body fat percentage [MD = -0.67, 95% CI (-0.96, -0.38), P<0.00001], grip strength [MD = 1.29, 95% CI (0.81, 1.77), P<0.00001], gait speed [MD = 0.05, 95% CI (0.03, 0.07), P<0.00001], and knee extension strength [MD = 2.56, 95% CI (1.30, 3.82), P<0.0001]. CONCLUSIONS Non-pharmacological interventions can effectively improve the clinical symptoms and signs of patients with sarcopenic obesity. Dissemination of this information will be therapeutically useful. TRIAL REGISTRATION Registration. The PROSPERO No. is CRD42023403341.
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Affiliation(s)
- Jiajia Xu
- Nursing School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Qingqing Hu
- Nursing School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Jiaying Li
- Nursing School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Yixi Zhou
- Nursing School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Ting Chu
- Nursing School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
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Moyama S, Yamada Y, Makabe N, Fujita H, Araki A, Suzuki A, Seino Y, Shide K, Kimura K, Murotani K, Honda H, Kobayashi M, Fujita S, Yasuda K, Kuroe A, Tsukiyama K, Seino Y, Yabe D. Efficacy and Safety of 6-Month High Dietary Protein Intake in Hospitalized Adults Aged 75 or Older at Nutritional Risk: An Exploratory, Randomized, Controlled Study. Nutrients 2023; 15:2024. [PMID: 37432141 DOI: 10.3390/nu15092024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 07/12/2023] Open
Abstract
The aim of this study was to investigate the effects of increased dietary protein in daily-life settings in Japan for 6 months on the activities of daily living (ADL) in adults aged 75 or older at nutritional risk. The study was an open-label, exploratory, randomized controlled trial conducted at seven hospitals in Japan. The study participants were adults aged 75 or older who were hospitalized for treatable cancer, pneumonia, fractures, and/or urinary-tract infection at nutritional risk. The primary outcome was change in grip strength, skeletal muscle, and ADL indices (Barthel index, Lawton score). One hundred sixty-nine patients were randomly assigned to the intensive care (IC) or standard care (SC) group; the protein intake goals (g/kgw/day) were 1.5 for IC and 1.0 for SC. There was a significant improvement in grip strength only in the IC group (1.1 kg: 95% CI 0.1 to 2.1) (p = 0.02). While the skeletal muscle index and ADL indices were not significantly improved in either group, the improvement ratio tended to be greater in the IC group. There was no decrease in renal function in either group. Thus, intervention of increased dietary protein in daily-life settings for 6 months in adults aged 75 or older with treatable cancer, pneumonia, fractures, and/or urinary-tract infection and at nutritional risk may be effective in ameliorating loss of muscle strength.
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Affiliation(s)
- Shota Moyama
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka 553-0003, Japan
| | - Yuichiro Yamada
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka 553-0003, Japan
| | - Noboru Makabe
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka 553-0003, Japan
- Department of Human Life Sciences, Mimasaka University, Tsuyama 708-8511, Japan
| | - Hiroki Fujita
- Department of Endocrinology and Diabetes and Geriatric Medicine, Akita University School of Medicine, Akita 010-0852, Japan
| | - Atsushi Araki
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo 173-0015, Japan
| | - Atsushi Suzuki
- Department of Endocrinology and Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Yusuke Seino
- Department of Endocrinology and Metabolism, Fujita Health University, Toyoake 470-1192, Japan
| | - Kenichiro Shide
- Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto 606-8397, Japan
| | - Kyoko Kimura
- Department of Nutritional Sciences, Morioka University, Takizawa 020-0605, Japan
| | - Kenta Murotani
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Hiroto Honda
- Department of Physical Therapy, Faculty of Health Sciences, Aino University, Ibaraki 567-0012, Japan
| | - Mariko Kobayashi
- Department of Health and Welfare, Settsu City Hall, Settsu 566-8555, Japan
| | - Satoshi Fujita
- College of Sport and Health Sciences, Ritsumeikan University, Kusatsu 525-8577, Japan
| | - Koichiro Yasuda
- Department of Diabetes and Endocrinology, Saiseikai-Noe Hospital, Osaka 536-0001, Japan
| | - Akira Kuroe
- Department of Diabetes and Metabolism, Hikone Municipal Hospital, Hikone 522-0057, Japan
| | - Katsushi Tsukiyama
- Center for Diabetes, Kobayashi Memorial Hospital, Hekinan 447-0863, Japan
| | - Yutaka Seino
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka 553-0003, Japan
| | - Daisuke Yabe
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kyoto 604-8436, Japan
- Department of Diabetes, Endocrinology and Metabolism, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan
- Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
- Center for One Medicine Innovative Translational Research, Gifu University, Gifu 501-1194, Japan
- Center for Preemptive Food Research, Gifu University Institute for Advanced Study, Gifu 501-1194, Japan
- Center for Research, Education and Life Design, Gifu University, Gifu 501-1194, Japan
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Ikeda T, Katayama S, Kitagawa T. The combined intervention of neuromuscular electrical stimulation and nutrition therapy: A scoping review. Clin Nutr ESPEN 2023; 54:239-250. [PMID: 36963869 DOI: 10.1016/j.clnesp.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND & AIMS Neuromuscular electrical stimulation (NMES) is a safe and appropriate complement to voluntary resistance training for muscle weakness. However, its feasibility and effectiveness in combination with nutritional therapy remains unclear. This scoping review aimed to summarize the evidence on combined interventions for individuals with or at risk of sarcopenia for guiding future relevant research. METHODS A systematic electronic search was conducted using the following databases and registry: MEDLINE, CINAHL, Web of Science, PEDro, and ClinicalTrials. gov. Two independent reviewers summarized the characteristics, effectiveness, and feasibility of the combined intervention and the risk of bias in the literature. RESULTS Nine RCTs and four non-RCTs involving 802 participants were eligible. A diverse group of participants were included: older adults with sarcopenic obesity, patients in intensive care, and patients with cancer. Evidence-based interventions combining NMES and nutritional therapy were tailored to each patient's underlying disease. Although most studies were of low to moderate quality, it can be suggested that combined interventions may be feasible and effective for increasing skeletal muscle mass. CONCLUSION This scoping review demonstrates the potential of combined interventions as a new sarcopenia treatment strategy and highlights the need to examine the effects in high-quality RCTs with larger sample sizes.
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Affiliation(s)
- Tomohiro Ikeda
- Department of Rehabilitation Medicine, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Sho Katayama
- Department of Rehabilitation Medicine, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Takashi Kitagawa
- Department of Physical Therapy, School of Health Sciences, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
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Biss S, Teschler M, Heimer M, Thum T, Bär C, Mooren FC, Schmitz B. A single session of EMS training induces long-lasting changes in circulating muscle but not cardiovascular miRNA levels: a randomized crossover study. J Appl Physiol (1985) 2023; 134:799-809. [PMID: 36759165 DOI: 10.1152/japplphysiol.00557.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Electromyostimulation (EMS) is used to maintain or build skeletal muscle and to increase cardiopulmonary fitness. Only limited data on the molecular mechanisms induced by EMS are available and effects on circulating microRNAs (c-miRNAs) have not been reported. This study aimed to evaluate whether EMS induces long-term changes in muscle- and cardiovascular-specific c-miRNA levels. Twelve healthy participants (33.0 ± 12.0 yr, 7 women) performed a 20-min whole body EMS training and a time- and intensity-matched whole body circuit training (CT) in random order. Blood samples were drawn pre-/posttraining and at 1.5, 3, 24, 48, and 72 h to determine creatine kinase (CK) and miRNA-21-5p, -126-3p, -133a-3p, -146a-5p, -206-3p, -222-3p, and -499a-5p levels. Muscular exertion was determined using an isometric strength test, and muscle soreness/pain was assessed by questionnaire. EMS participants reported higher muscle soreness 48 and 72 h postexercise and mean CK levels after EMS increased compared with CT at 48 and 72 h (time × group P ≤ 0.01). The EMS session induced a significant elevation of myomiR-206 and -133a levels starting at 1.5 and 3 h after exercise. Both miRNAs remained elevated for 72 h with significant differences between 24 and 72 h (time × group P ≤ 0.0254). EMS did not induce changes in cardiovascular miRNAs and no elevation in any miRNA was detected following CT. Time-course analysis of muscle damage marker CK and c-miR-133a and -206 levels did not suggest a common scheme (P ≥ 0.277). We conclude that a single EMS session induces specific long-lasting changes of miR-206 and miR-133 involved in muscle proliferation and differentiation. A single EMS session does not affect primary cardiovascular miRNA-21-5p, -126-3p, -146a-5p, and -222-3p levels.NEW & NOTEWORTHY Our study describes the long-term effects of electromyostimulation (EMS) on circulating miRNA levels. The observed increase of functional myomiR-206 and -133a levels over 72 h suggests long-lasting effects on muscle proliferation and differentiation, whereas cardiovascular miRNAs appear unaffected. Our findings suggest that circulating miRNAs provide useful insight into muscle regeneration processes after EMS and may thus be used to optimize EMS training effects.
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Affiliation(s)
- Sinje Biss
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany
- REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Marc Teschler
- Faculty of Health, Department of Rehabilitation Sciences, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
| | - Melina Heimer
- Faculty of Health, Department of Rehabilitation Sciences, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany
- REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany
- REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover, Germany
| | - Frank C Mooren
- Faculty of Health, Department of Rehabilitation Sciences, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
| | - Boris Schmitz
- Faculty of Health, Department of Rehabilitation Sciences, University of Witten/Herdecke, Witten, Germany
- Center for Medical Rehabilitation, DRV Clinic Königsfeld, Ennepetal, Germany
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10
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Additional Active Movements Are Not Required for Strength Gains in the Untrained during Short-Term Whole-Body Electromyostimulation Training. Healthcare (Basel) 2023; 11:healthcare11050741. [PMID: 36900747 PMCID: PMC10000632 DOI: 10.3390/healthcare11050741] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Recommendations for conventional strength training are well described, and the volume of research on whole-body electromyostimulation training (WB-EMS) is growing. The aim of the present study was to investigate whether active exercise movements during stimulation have a positive effect on strength gains. A total of 30 inactive subjects (28 completed the study) were randomly allocated into two training groups, the upper body group (UBG) and the lower body group (LBG). In the UBG (n = 15; age: 32 (25-36); body mass: 78.3 kg (53.1-114.3 kg)), WB-EMS was accompanied by exercise movements of the upper body and in the LBG (n = 13; age: 26 (20-35); body mass: 67.2 kg (47.4-100.3 kg)) by exercise movements of the lower body. Therefore, UBG served as a control when lower body strength was considered, and LBG served as a control when upper body strength was considered. Trunk exercises were performed under the same conditions in both groups. During the 20-min sessions, 12 repetitions were performed per exercise. In both groups, stimulation was performed with 350 μs wide square pulses at 85 Hz in biphasic mode, and stimulation intensity was 6-8 (scale 1-10). Isometric maximum strength was measured before and after the training (6 weeks set; one session/week) on 6 exercises for the upper body and 4 for the lower body. Isometric maximum strength was significantly higher after the EMS training in both groups in most test positions (UBG p < 0.001-0.031, r = 0.88-0.56; LBG p = 0.001-0.039, r = 0.88-0.57). Only for the left leg extension in the UBG (p = 0.100, r = 0.43) and for the biceps curl in the LBG (p = 0.221, r = 0.34) no changes were observed. Both groups showed similar absolute strength changes after EMS training. Body mass adjusted strength for the left arm pull increased more in the LBG group (p = 0.040, r = 0.39). Based on our results we conclude that concurring exercise movements during a short-term WB-EMS training period have no substantial influence on strength gains. People with health restrictions, beginners with no experience in strength training and people returning to training might be particularly suitable target groups, due to the low training effort. Supposedly, exercise movements become more relevant when initial adaptations to training are exhausted.
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11
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Park W, Lee J, Hong K, Park HY, Park S, Kim N, Park J. Protein-Added Healthy Lunch-Boxes Combined with Exercise for Improving Physical Fitness and Vascular Function in Pre-Frail Older Women: A Community-Based Randomized Controlled Trial. Clin Interv Aging 2023; 18:13-27. [PMID: 36636457 PMCID: PMC9830714 DOI: 10.2147/cia.s391700] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Purpose Preventive or therapeutic interventions are key to maintaining independence in pre-frail and/or frail elderly. Therefore, we investigated whether multi-component interventions were effective in physical fitness levels and vascular functions in pre-frail older women. Patients and Methods Sixty participants aged ≥ 65 years (81.5 ± 4.3 yrs) were divided equally into control group, diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group. For 8 weeks, the participants received a set of protein-added meals twice daily on weekdays. The aerobic exercise groups performed 45 mins of stepping exercise at 50-70% of the maximal heart rate for 3 days/week, and the aerobic exercise with electromyostimulation was applied on each limb in 8 weeks. Blood pressure, physical fitness, cardiovascular biomarkers, pulse wave velocity, and flow-mediated dilation were measured before and after the 8-week. Results There were no group differences in age, height, weight, body mass index, free fat mass, and %body fat at baseline. The right grip strength significantly increased in the diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group (p < 0.05). Short physical performance battery, 6-min walking distance, and flow-mediated dilation significantly increased in the aerobic exercise and diet group and aerobic exercise with electromyostimulation and diet group (p < 0.05). Blood pressure and pulse wave velocity did not differ between interventions. High-density lipoprotein-cholesterol levels significantly increased after 8 weeks in all intervention groups (p < 0.05). There were no significant differences in glucose, HbA1c, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, Homeostatic Model Assessment for Insulin Resistance, nitric oxide, and C-reactive protein levels. Conclusion These results show that multi-component interventions appear to improve physical fitness and vascular function in pre-frail older women. Thus, possible strategies to prevent early frailty including proper nutrition and exercise may be needed.
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Affiliation(s)
- Wonil Park
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea,Physical Education Laboratory, Chung-Ang University, Seoul, South Korea
| | - Jaesung Lee
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea
| | - Kwangseok Hong
- Department of Physical Education, College of Education, Chung-Ang University, Seoul, South Korea
| | - Hun-Young Park
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea,Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, South Korea
| | - Saejong Park
- Department of Sports Science, Korea Institute of Sport Science, Seoul, South Korea
| | - Nahyun Kim
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea
| | - Jonghoon Park
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea,Correspondence: Jonghoon Park, Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea, Tel/Fax +82 (2) 3290-2315, Email
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12
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Hintze S, Baber L, Hofmeister F, Jarmusch S, Todorow V, Mehaffey S, Tanganelli F, Ferrari U, Neuerburg C, Teupser D, Bidlingmaier M, Marques JG, Koletzko B, Schoser B, Drey M, Meinke P. Exploration of mitochondrial defects in sarcopenic hip fracture patients. Heliyon 2022; 8:e11143. [PMID: 36303924 PMCID: PMC9593198 DOI: 10.1016/j.heliyon.2022.e11143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/05/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Severe cases of age-related loss of muscle function and mass are clinically unique to sarcopenia. Mitochondrial dysfunction has been associated with aging and sarcopenia, but the causal connection in this context is not well eluded. Here we investigated different aspects of mitochondrial respiration in sarcopenia. Open muscle biopsies were taken from a total of 31 hip fracture patients, older than 70 years. Patients were assigned a sarcopenia Z-score based on EWGSOP2 criteria. Primary myoblast cultures were generated from the muscle tissue samples and used for real time metabolic measurement. Muscle and serum samples showed correlation of high Z-scores with reduced mitochondrial complex I activity, increased tricarboxylic acid cycle (TCA) metabolites, reduced vitamin D3 levels, and signs of an altered iron metabolism. Primary myoblast cultures gained from the same muscle biopsies did not show significant mitochondrial defects. We hypothesize that a sum of external consequences, including vitamin D3 deficiency and iron deficiency caused by disturbances in the iron metabolism, result in complex I deficiency, which in turn affects the TCA and contributes to muscle weakness and loss.
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Affiliation(s)
- Stefan Hintze
- Friedrich-Baur-Institute at the Department of Neurology, LMU Klinikum, LMU Munich, Germany
| | - Lisa Baber
- Department of Medicine IV, Geriatrics, LMU Klinikum, LMU Munich, Germany
| | - Fabian Hofmeister
- Department of Medicine IV, Geriatrics, LMU Klinikum, LMU Munich, Germany
| | - Stefanie Jarmusch
- Department of Medicine IV, Geriatrics, LMU Klinikum, LMU Munich, Germany
| | - Vanessa Todorow
- Friedrich-Baur-Institute at the Department of Neurology, LMU Klinikum, LMU Munich, Germany
| | - Stefan Mehaffey
- Department of General-, Trauma- and Reconstructive Surgery, LMU Klinikum, LMU Munich, Germany
| | - Fabiana Tanganelli
- Department of Medicine IV, Geriatrics, LMU Klinikum, LMU Munich, Germany
| | - Uta Ferrari
- Department of Medicine IV, Geriatrics, LMU Klinikum, LMU Munich, Germany
| | - Carl Neuerburg
- Department of General-, Trauma- and Reconstructive Surgery, LMU Klinikum, LMU Munich, Germany
| | - Daniel Teupser
- Institute of Laboratory Medicine, LMU Klinikum, LMU Munich, Germany
| | | | - Jair Gonzalez Marques
- Department Pediatrics, Dr. von Hauner Children's Hospital, LMU Klinikum, LMU Munich, Germany
| | - Berthold Koletzko
- Department Pediatrics, Dr. von Hauner Children's Hospital, LMU Klinikum, LMU Munich, Germany
| | - Benedikt Schoser
- Friedrich-Baur-Institute at the Department of Neurology, LMU Klinikum, LMU Munich, Germany
| | - Michael Drey
- Department of Medicine IV, Geriatrics, LMU Klinikum, LMU Munich, Germany
| | - Peter Meinke
- Friedrich-Baur-Institute at the Department of Neurology, LMU Klinikum, LMU Munich, Germany
- Corresponding author.
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13
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Galicia Ernst I, Torbahn G, Schwingshackl L, Knüttel H, Kob R, Kemmler W, Sieber CC, Batsis JA, Villareal DT, Stroebele-Benschop N, Visser M, Volkert D, Kiesswetter E, Schoene D. Outcomes addressed in randomized controlled lifestyle intervention trials in community-dwelling older people with (sarcopenic) obesity-An evidence map. Obes Rev 2022; 23:e13497. [PMID: 35891613 DOI: 10.1111/obr.13497] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022]
Abstract
Obesity and sarcopenic obesity (SO) are characterized by excess body fat with or without low muscle mass affecting bio-psycho-social health, functioning, and subsequently quality of life in older adults. We mapped outcomes addressed in randomized controlled trials (RCTs) on lifestyle interventions in community-dwelling older people with (sarcopenic) obesity. Systematic searches in Medline, Embase, Cochrane Central, CINAHL, PsycInfo, Web of Science were conducted. Two reviewers independently performed screening and extracted data on outcomes, outcome domains, assessment methods, units, and measurement time. A bubble chart and heat maps were generated to visually display results. Fifty-four RCTs (7 in SO) reporting 464 outcomes in the outcome domains: physical function (n = 42), body composition/anthropometry (n = 120), biomarkers (n = 190), physiological (n = 30), psychological (n = 47), quality of life (n = 14), pain (n = 4), sleep (n = 2), medications (n = 3), and risk of adverse health events (n = 5) were included. Heterogeneity in terms of outcome definition, assessment methods, measurement units, and measurement times was found. Psychological and quality of life domains were investigated in a minority of studies. There is almost no information beyond 52 weeks. This evidence map is the first step of a harmonization process to improve comparability of RCTs in older people with (sarcopenic) obesity and facilitate the derivation of evidence-based clinical decisions.
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Affiliation(s)
- Isabel Galicia Ernst
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Gabriel Torbahn
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.,Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, Regensburg, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Cornel C Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.,Department of Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - John A Batsis
- Division of Geriatric Medicine, School of Medicine and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dennis T Villareal
- Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston, Texas, USA
| | - Nanette Stroebele-Benschop
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.,Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Institute for Exercise and Public Health, University of Leipzig, Leipzig, Germany
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14
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Qin Y, Chen H, Liu X, Wu J, Zhang Y. Effects of whole-body electromyostimulation training on upper limb muscles strength and body composition in moderately trained males: A randomized controlled study. Front Public Health 2022; 10:982062. [PMID: 36159315 PMCID: PMC9501974 DOI: 10.3389/fpubh.2022.982062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/22/2022] [Indexed: 01/25/2023] Open
Abstract
Resistance training has been known to have a positive effect on muscle performance in exercisers. Whole-body electromyostimulation (WB-EMS) is advertised as a smooth, time-efficient, and highly individualized resistance training technology. The purpose of this study is to evaluate the effects of WB-EMS training on maximum isometric elbow muscle strength and body composition in moderately trained males in comparison to traditional resistance training. The study was a randomized controlled single-blind trial. Twenty, moderately trained, male participants (25.15 ± 3.84, years) were randomly assigned to the following groups: a WB-EMS training group (n = 11) and a traditional resistance training group (the control group [CG]: n = 9). Both training intervention programs consisted of 18 training sessions for six consecutive weeks. All subjects performed dynamic movements with the WB-EMS or external weights (CG). The primary outcome variables included maximum isometric elbow flexor strength (MIEFS), maximum isometric elbow extensor strength (MIEES) and surface electromyography amplitude (sEMGRMS). Secondary outcomes involved lean body mass, body fat content, arm fat mass, and arm lean mass. ANOVAs, Friedman test and post hoc t-tests were used (P = 0.05) to analyze the variables development after the 6-week intervention between the groups. Significant time × group interactions for MIEFS (η2 = 0.296, P Bonferroni = 0.013) were observed, the increase in the WB-EMS group were significantly superior to the CG [23.49 ± 6.48% vs. 17.01 ± 4.36%; MD (95% CI) = 6.48 (1.16, 11.80); d = 1.173, P = 0.020]. There were no significant differences were observed between interventions regarding MIEES, sEMGRMS and body composition. These findings indicate that in moderately trained males the effects of WB-EMS were similar to a traditional resistance training, with the only exception of a significantly greater increase in elbow flexor strength. WB-EMS can be considered as an effective exercise addition for moderately trained males.
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Affiliation(s)
- Yin Qin
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China,Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China,*Correspondence: Yin Qin
| | - Hui Chen
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China,Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiaoying Liu
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China,Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jiwei Wu
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China,Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yinxin Zhang
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China,Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
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15
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Bibliometric Analysis of Studies on Whole Body Electromyostimulation. BIOLOGY 2022; 11:biology11081205. [PMID: 36009832 PMCID: PMC9405447 DOI: 10.3390/biology11081205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Simple Summary This work consists of a review with bibliometric analysis on WB-EMS. One hundred and two articles were analyzed in the period from 2010 to 2022 to find out which country, author and institutions produce the most knowledge on this topic. The results of this work are important to know to determine publication growth trend as well as the most relevant clusters and authors. Abstract Whole Body Electromyostimulation [WB-EMS] is a training methodology that applies electrostimulation in the main muscle groups of the human body superimposed with active training exercises. This study aims to carry out a bibliometric analysis on WB-EMS to provide an overview of the state of research and provide new insights for research in the field. Method: One hundred and two citations extracted were examined using a bibliometric approach based on data stored in the Web of Science Core Collection, applying traditional bibliometric laws, and using VOSviewer and excel for data and metadata processing. Results: Among the results, this study points out that Germany is the country that produces more scientific knowledge on WB-EMS. Wolfgang Kemmler is the most relevant author in this field. Moreover, Frontier of Physiology is the journal where the authors publish the most. Conclusion: Research on WB-EMS has been growing in recent years. German and Spanish researchers lead two clusters where most studies and collaborations in this field are carried out. These findings will provide a better understanding of the state of WB-EMS research and may guide the emergence of new lines of investigation and research ideas.
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16
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Ghiotto L, Muollo V, Tatangelo T, Schena F, Rossi AP. Exercise and physical performance in older adults with sarcopenic obesity: A systematic review. Front Endocrinol (Lausanne) 2022; 13:913953. [PMID: 35966077 PMCID: PMC9366852 DOI: 10.3389/fendo.2022.913953] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sarcopenic obesity is characterized by low muscle mass and high body fat; prevalence increases with age, particularly after age 65 years. For this systematic literature review we searched scientific databases for studies on exercise interventions for improving physical performance in adults with sarcopenic obesity; also, we identified potential gaps in clinical practice guidelines that need to be addressed. Methods We followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases were searched for studies published through November 2021 that measured physical performance in adults with sarcopenic obesity. Results Most of the studies applied a strength training protocol in which improvement was noted post-treatment on the Time Chair Rise (TCR), 30-s Chair Stand, and Single Leg Stance (SLS) tests. Discrepancies between the studies were observed when resistance training was combined with or without elastic bands or electromyostimulation, as measured with the Short Physical Performance Battery (SPPB), Physical Performance Test (PPT), Gait Speed, and Timed Up & Go (TUG) test. Post-intervention SPPB, PPT, and gait speed scores showed an increase or maintenance of performance, while TUG test scores were higher according to one study but lower according to another. Conclusions Engagement in physical exercise, and resistance training in particular, can improve or maintain physical performance in adults with sarcopenic obesity. Study samples should include more men. A future area of focus should be the impact of different types of training (aerobic, power training, combined modalities). Finally, studies with longer intervention periods and follow-up periods are needed to gain a better understanding of the effectiveness of exercise on physical function in adults with sarcopenic obesity.
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Affiliation(s)
- Laura Ghiotto
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | - Toni Tatangelo
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Andrea P. Rossi
- Geriatrics Division, Department of Medicine, Ospedale Cà Foncello ULSS2, Treviso, Italy
- Healthy Aging Center, Department of Medicine, Division of Geriatrics, University of Verona, Verona, Italy
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17
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Yang JM, Luo Y, Zhang JH, Liu QQ, Zhu Q, Ye H, Niu YL, Huang H, Xie HY, Long Y, Wang MY. Effects of WB-EMS and protein supplementation on body composition, physical function, metabolism and inflammatory biomarkers in middle-aged and elderly patients with sarcopenic obesity: A meta-analysis of randomized controlled trials. Exp Gerontol 2022; 166:111886. [DOI: 10.1016/j.exger.2022.111886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/04/2022]
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18
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New Trend of Physical Activity and Exercise for Health Promotion and Functional Ability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137939. [PMID: 35805597 PMCID: PMC9265872 DOI: 10.3390/ijerph19137939] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
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19
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Bloeckl J, Raps S, Weineck M, Kob R, Bertsch T, Kemmler W, Schoene D. Feasibility and Safety of Whole-Body Electromyostimulation in Frail Older People—A Pilot Trial. Front Physiol 2022; 13:856681. [PMID: 35812334 PMCID: PMC9263209 DOI: 10.3389/fphys.2022.856681] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/30/2022] [Indexed: 01/04/2023] Open
Abstract
Whole-body electromyostimulation (WB-EMS) induces high-intense stimuli to skeletal muscles with low strain on joints and the autonomic nervous system and may thus be suitable for frail, older people. However, if trained at very high intensities, WB-EMS may damage muscles and kidneys (rhabdomyolysis). This study aimed at investigating the feasibility, safety and preliminary efficacy of WB-EMS in frail, older people. Seven frail (81.3 ± 3.5 years), 11 robust (79.5 ± 3.6 years), 10 young (29.1 ± 6.4 years) participants completed an eight-week WB-EMS training (week 1–4: 1x/week; week 5–8: 1.5x/week) consisting of functional exercises addressing lower extremity strength and balance. Feasibility was assessed using recruitment, adherence, retention, and dropout rates. The satisfaction with WB-EMS was measured using the Physical Activity Enjoyment Scale for older adults (PACES-8). In week 1, 3, and 8 creatine kinase (CK) was assessed immediately before, 48 and 72 h after WB-EMS. Symptoms of rhabdomyolysis (muscle pain, muscle weakness, myoglobinuria) and adverse events were recorded. Functional capacity was assessed at baseline and after 8 weeks using the Short Physical Performance Battery (SPPB), Timed Up-and-Go Test (TUG), Choice Stepping Reaction Time Test (CSRT), 30-second Chair-Stand Test (30-STS), maximum isometric leg strength and handgrip strength. The recruitment rate of frail individuals was 46.2%, adherence 88.3% and the dropout rate 16.7%. All groups indicated a high satisfaction with WB-EMS. CK activity was more pronounced in young individuals with significant changes over time. Within older people CK increased borderline-significantly in the frail group from baseline to week 1 but not afterwards. In robust individuals CK increased significantly from baseline to week 1 and 3. No participant reached CK elevations close to the threshold of ≥5,000 U/l and no symptoms of rhabdomyolysis were observed. With the exception of the TUG (p = 0.173), frail individuals improved in all tests of functional capacity. Compared to the young and robust groups, frail individuals showed the greater improvements in the SPPB, handgrip strength, maximum isokinetic hip-/knee extension and flexion strength. WB-EMS is feasible for frail older people. There were no clinical signs of exertional rhabdomyolysis. WB-EMS proved to be sufficiently intense to induce meaningful changes in functional capacity with frail individuals showing greater improvements for several measures.
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Affiliation(s)
- Joerg Bloeckl
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- *Correspondence: Joerg Bloeckl,
| | - Sebastian Raps
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Weineck
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander University Erlangen-Nürnberg, Nuremberg, Germany
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Wolfgang Kemmler
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Institute of Exercise and Public Health, University of Leipzig, Leipzig, Germany
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20
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Balke M, Teschler M, Schäfer H, Pape P, Mooren FC, Schmitz B. Therapeutic Potential of Electromyostimulation (EMS) in Critically Ill Patients—A Systematic Review. Front Physiol 2022; 13:865437. [PMID: 35615672 PMCID: PMC9124773 DOI: 10.3389/fphys.2022.865437] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/01/2022] [Indexed: 12/15/2022] Open
Abstract
Ample evidence exists that intensive care unit (ICU) treatment and invasive ventilation induce a transient or permanent decline in muscle mass and function. The functional deficit is often called ICU-acquired weakness with critical illness polyneuropathy (CIP) and/or myopathy (CIM) being the major underlying causes. Histopathological studies in ICU patients indicate loss of myosin filaments, muscle fiber necrosis, atrophy of both muscle fiber types as well as axonal degeneration. Besides medical prevention of risk factors such as sepsis, hyperglycemia and pneumonia, treatment is limited to early passive and active mobilization and one third of CIP/CIM patients discharged from ICU never regain their pre-hospitalization constitution. Electromyostimulation [EMS, also termed neuromuscular electrical stimulation (NMES)] is known to improve strength and function of healthy and already atrophied muscle, and may increase muscle blood flow and induce angiogenesis as well as beneficial systemic vascular adaptations. This systematic review aimed to investigate evidence from randomized controlled trails (RCTs) on the efficacy of EMS to improve the condition of critically ill patients treated on ICU. A systematic search of the literature was conducted using PubMed (Medline), CENTRAL (including Embase and CINAHL), and Google Scholar. Out of 1,917 identified records, 26 articles (1,312 patients) fulfilled the eligibility criteria of investigating at least one functional measure including muscle function, functional independence, or weaning outcomes using a RCT design in critically ill ICU patients. A qualitative approach was used, and results were structured by 1) stimulated muscles/muscle area (quadriceps muscle only; two to four leg muscle groups; legs and arms; chest and abdomen) and 2) treatment duration (≤10 days, >10 days). Stimulation parameters (impulse frequency, pulse width, intensity, duty cycle) were also collected and the net EMS treatment time was calculated. A high grade of heterogeneity between studies was detected with major cofactors being the analyzed patient group and selected outcome variable. The overall efficacy of EMS was inconclusive and neither treatment duration, stimulation site or net EMS treatment time had clear effects on study outcomes. Based on our findings, we provide practical recommendations and suggestions for future studies investigating the therapeutic efficacy of EMS in critically ill patients. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021262287].
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Affiliation(s)
- Maryam Balke
- St. Marien Hospital Cologne, Department of Early Rehabilitation, Cologne, Germany
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- *Correspondence: Maryam Balke,
| | - Marc Teschler
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Hendrik Schäfer
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Pantea Pape
- St. Marien Hospital Cologne, Department of Early Rehabilitation, Cologne, Germany
| | - Frank C. Mooren
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Boris Schmitz
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
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21
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Li L, He Y, Jin N, Li H, Liu X. Effects of protein supplementation and exercise on delaying sarcopenia in healthy older individuals in Asian and non-Asian countries: A systematic review and meta-analysis. Food Chem X 2022; 13:100210. [PMID: 35128383 PMCID: PMC8808080 DOI: 10.1016/j.fochx.2022.100210] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 12/28/2022] Open
Abstract
The cultural and ethnic differences were taken into consideration in the study design. It is the first meta-analysis to evaluate whether protein supplementation exerts additional benefits on sarcopenia in Asian and non-Asian countries. Protein supplementation combined with exercise exerts superior benefit on lower-extremity strength in healthy older adults with sarcopenia in Asian countries.
While there is growing research interest in the effects of nutrition and exercise on delaying sarcopenia, the results are inconclusive and there is scarce information on regional patterns. This review evaluated the effects of the combination of protein supplementation and exercise on muscle strength, mass and physical performance, compared to exercise alone or with a placebo, in healthy older adults in Asian and non-Asian countries. Fourteen studies were included in the analysis, involving a total of 888 healthy older adults (>60 years). A significant increase in the lower-extremity strength was observed in the combined intervention group compared to the exercise group in Asian countries (SMD: 0.24, 95% CI [0.00, 0.47], p = 0.048, I2 = 0.0%). No statistical differences were found relating to upper-extremity strength, muscle mass and physical performance. Protein supplementation combined with exercise provides additional benefit on lower-extremity strength in healthy older adults with sarcopenia in Asian countries.
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Affiliation(s)
- Lu Li
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - Yueyue He
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - Nini Jin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - He Li
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - Xinqi Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
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22
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The effect of 6 weeks electrical muscle stimulation training and aerobic exercise on body composition of overweight women: a randomized controlled study. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00910-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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de Oliveira TM, Felício DC, Filho JE, Fonseca DS, Durigan JLQ, Malaguti C. Effects of whole-body electromyostimulation on health indicators of older people: Systematic review and meta-analysis of randomized trials. J Bodyw Mov Ther 2022; 31:134-145. [DOI: 10.1016/j.jbmt.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 02/08/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
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24
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Tannir H, Itani L, Kreidieh D, El Masri D, El Ghoch M. Can Intentional Weight Loss Ameliorate Sarcopenia in Individuals with Obesity? A Longitudinal Interventional Study. Clin Pract 2022; 12:106-112. [PMID: 35200265 PMCID: PMC8870980 DOI: 10.3390/clinpract12010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 12/04/2022] Open
Abstract
Little remains known regarding the impact of weight loss on sarcopenic obesity (SO), and for this reason we aimed to assess the relationship between the two during a weight management program. Body composition was measured at baseline and six-month follow-up using the Tanita BC-418, and step measurements were obtained daily over a period of six months using an Omron HJ-320 pedometer, in 41 adults of both genders with obesity. The participants were then categorized according to the presence or absence of SO. After a significant weight loss, an improvement in the appendicular skeletal mass (ASM) to weight ratio (24.5 ± 3.5 vs. 26.2 ± 3.6, p < 0.01), indicated a decrease in the prevalence of SO by 12.2%. Moreover, these findings were confirmed by logistic regression analysis revealing a significant WL% ≥ 5% combined with an active lifestyle (i.e., ≥8000 steps/day), decreased the risk of SO by 91% (OR = 0.09; 95% CI: 0.02–0.56), after adjusting for age and gender. In conclusion, in a weight management setting, a personalized program for individuals with SO that incorporates new strategies in terms of weight loss and physical activity targets may be adopted to improve the sarcopenia-related index and reduce the prevalence of SO in this population.
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Affiliation(s)
- Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (H.T.); (L.I.); (D.K.); (D.E.M.)
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (H.T.); (L.I.); (D.K.); (D.E.M.)
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (H.T.); (L.I.); (D.K.); (D.E.M.)
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (H.T.); (L.I.); (D.K.); (D.E.M.)
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut 11072809, Lebanon; (H.T.); (L.I.); (D.K.); (D.E.M.)
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Correspondence: or
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25
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Negm AM, Lee J, Hamidian R, Jones CA, Khadaroo RG. Management of Sarcopenia: A Network Meta-analysis of Randomized Controlled Trials. J Am Med Dir Assoc 2022; 23:707-714. [DOI: 10.1016/j.jamda.2022.01.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
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26
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Kiuchi Y, Makizako H, Nakai Y, Taniguchi Y, Tomioka K, Sato N, Wada A, Doi T, Kiyama R, Takenaka T. Associations of alpha-actinin-3 genotype with thigh muscle volume and physical performance in older adults with sarcopenia or pre-sarcopenia. Exp Gerontol 2021; 154:111525. [PMID: 34425205 DOI: 10.1016/j.exger.2021.111525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND This cross-sectional study aimed to investigate the relationship of the ACTN3 genotype with thigh muscle volume and physical performance in older adults with sarcopenia or pre-sarcopenia. METHODS Data from 64 older Japanese adults (mean age 74.4 ± 6.9 years, women 71.9%) with sarcopenia or pre-sarcopenia were analyzed. Sarcopenia and pre-sarcopenia were defined using the Asian Working Group for Sarcopenia. We collected oral mucosa samples to determine the ACTN3 genotype. Thigh muscle volumes were measured using magnetic resonance imaging. Physical performance was assessed using the usual and maximum gait speed, timed up and go test, and five-repetition sit-to-stand test. Muscle strength was assessed using grip strength. RESULT The ACTN3 genotype proportions were 20.3% for RR, 51.6% for RX, and 28.1% for XX. Participants with the RR genotype showed greater thigh muscle volume/ht2 compared to those with the RX and XX ACTN3 genotypes (p < 0.05). The multiple linear regression analysis revealed that RX (p < 0.01) and XX (p < 0.01) ACTN3 genotypes, compared to RR, were associated with lower thigh muscle volume/ht2 and with age, sex (reference; men), weight and maximum walking speed. There was no significant difference between physical performance and muscle strength between the ACTN3 genotypes. CONCLUSION The ACTN3 genotype of the X allele was associated with decreased thigh muscle volume compared to the ACTN3 genotype of RR in older adults with sarcopenia or pre-sarcopenia.
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Affiliation(s)
- Yuto Kiuchi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan; Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Yuki Nakai
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Yoshiaki Taniguchi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan; Department of Physical Therapy, Kagoshima Medical Professional College, Kagoshima 891-0133, Japan.
| | - Kazutoshi Tomioka
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan; Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima 891-2124, Japan.
| | - Nana Sato
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Ayumi Wada
- Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Takehiko Doi
- Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan.
| | - Toshihiro Takenaka
- Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima 891-2124, Japan.
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27
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Teschler M, Heimer M, Schmitz B, Kemmler W, Mooren FC. Four weeks of electromyostimulation improves muscle function and strength in sarcopenic patients: a three-arm parallel randomized trial. J Cachexia Sarcopenia Muscle 2021; 12:843-854. [PMID: 34105256 PMCID: PMC8350212 DOI: 10.1002/jcsm.12717] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/24/2021] [Accepted: 04/30/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Sarcopenia, defined as loss of muscle mass, quality, and function, is associated with reduced quality of life and adverse health outcomes including disability and mortality. Electromyostimulation (EMS) has been suggested to attenuate the loss of muscle mass and function in elderly, sedentary individuals. This study aimed to investigate the effects of EMS on muscle strength and function during 4 weeks of inpatient medical rehabilitation. METHODS Patients receiving 4 weeks of inpatient medical rehabilitation diagnosed with sarcopenia using bioimpedance analysis were eligible to participate. One hundred and thirty-four patients (55.7 ± 7.9 years, 25.4% female) were randomly assigned to three groups: whole-body (WB) EMS (n = 48): stimulation of major muscle groups (pectoral muscles, latissimus, trapezius, abdominals, upper arm and leg, lower back muscles, gluteal muscles, and thighs); part-body (PB) EMS (n = 42): stimulation of leg muscles including gluteal muscles and thighs; and control group (CG, n = 44). All participants performed six 20 min training sessions including dynamic movements (squats, lunges, biceps curl, chest press, butterfly reverse, reverse lunges, standing diagonal crunches, etc.) with superimposed (WB-, PB-) EMS or without EMS (CG) in addition to the standard rehabilitation programme. Primary outcome variables included muscle function assessed by chair rise test and 6 min walking test as well as muscle strength (isometric grip strength, leg, arm, and back extension). RESULTS Primary outcome variables chair rise test and leg extension improved significantly (P = 0.001, η2 = 0.06 and P = 0.008, η2 = 0.06; EMS vs. CG) in that chair rise test results increased in WB-EMS from 5 (4; 7) to 7 (5; 9), in PB-EMS from 5 (5; 7) to 7 (6; 8), and in CG from 6 (4; 7) to 7 (5; 8) repetitions. Knee extension increased in WB-EMS from 692.3 ± 248.6 to 831.7 ± 298.7 N, in PB-EMS from 682.8 ± 257.8 to 790.2 ± 270.2 N, and in CG from 638.5 ± 236.9 to 703.2 ± 218.6 N. No adverse events or side effects occurred. CONCLUSIONS We conclude that EMS might be an additional training option to improve muscle function and strength in sarcopenic patients during a 4 week rehabilitation programme. EMS provides greater functional and strength improvements compared with standard treatment with additional potential health benefits for sarcopenic cardiac and orthopaedic patients.
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Affiliation(s)
- Marc Teschler
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany.,Klinik Königsfeld der DRV, Department of Cardiology and Orthopedics Clinic, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Melina Heimer
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany.,Klinik Königsfeld der DRV, Department of Cardiology and Orthopedics Clinic, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Boris Schmitz
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany.,Klinik Königsfeld der DRV, Department of Cardiology and Orthopedics Clinic, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Frank C Mooren
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany.,Klinik Königsfeld der DRV, Department of Cardiology and Orthopedics Clinic, Center for Medical Rehabilitation, Ennepetal, Germany
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28
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Zink-Rückel C, Chaudry O, Engelke K, Ghasemikaram M, Kohl M, Uder M, Kemmler W. Once Weekly Whole-Body Electromyostimulation Enhances Muscle Quality in Men: Data of the Randomized Controlled Franconian Electromyostimulation and Golf Study. Front Physiol 2021; 12:700423. [PMID: 34366890 PMCID: PMC8335588 DOI: 10.3389/fphys.2021.700423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/02/2021] [Indexed: 12/29/2022] Open
Abstract
Whole-body electromyostimulation (WB-EMS) is commercially advertised as a time-efficient resistance-type exercise technology. Indeed, the commercial, non-medical setting applies 20 min of WB-EMS only once a week. However, this setting conflicts with the approved scientific approach of higher training frequencies. Using data from an ongoing study on WB-EMS and golf performance as a vehicle, we evaluate the effect of once weekly WB-EMS on changes of fatty muscle infiltration, as a crucial parameter of muscle quality. Fifty-four moderately physically active male amateur golfers 18-70 years old were randomly allocated to a WB-EMS (n = 27) with a standard setting of once weekly 20 min and a non-WB-EMS control group (CG, n = 27). Intermuscular adipose tissue (IMAT) volume and intrafascial muscle tissue (MT) volume per unit of intrafascial volume as determined by magnetic resonance imaging were used to characterize muscle quality. Intention to treat analysis with multiple imputation was applied. WB-EMS was conducted at the participants' homes; thus, the attendance rate was close to 100%. After 16 weeks of intervention, we observed increases in volume-adjusted IMAT (p = 0.040) and decreases in MT (p = 0.206) in the CG. IMAT decreased in the WB-EMS group (p = 0.215), while MT increased significantly (p = 0.032). Of importance, group difference (i.e., "effects") for intra-group changes in volume-adjusted IMAT (effect size: d´ = 0.66; p = 0.028) and MT (d´ = 0.70; p = 0.020) was significant for both parameters. Once weekly WB-EMS application significantly affects muscle quality of the mid-thigh in moderately active, healthy men 18-70 years old.
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Affiliation(s)
- Carina Zink-Rückel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Oliver Chaudry
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Medizinische Klinik III, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Medizinische Klinik III, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Mansour Ghasemikaram
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
| | - Michael Uder
- Institute of Radiology, FAU Erlangen-Nürnberg and University Hospital, Erlangen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Institute of Radiology, FAU Erlangen-Nürnberg and University Hospital, Erlangen, Germany
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29
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Keicher C, Pyrkosch L, Wolfarth B, Ströhle A. Psychological Effects of Whole-body Electromyostimulation Training: a Controlled Pilot Study in Healthy Volunteers. SPORTS MEDICINE-OPEN 2021; 7:40. [PMID: 34106377 PMCID: PMC8190409 DOI: 10.1186/s40798-021-00325-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Whole-body electromyostimulation (WB-EMS) training is used in popular and health sports to improve muscular performance. Little is known about the possible psychological effects of WB-EMS training. The aim of the study is therefore to investigate the possible psychological effects of WB-EMS training on subjective well-being, relaxation, mood, and perceived stress. MATERIALS AND METHODS Twenty-five healthy subjects underwent conventional WB-EMS training and Sham training (without the application of electrical stimulation) as part of a randomized, controlled pilot study in a crossover design. Subjective well-being and subjective relaxation were assessed using visual analog scales, the current state of mood was assessed with Multidimensional Mood State Questionnaires (MDBF), and the current level of stress was assessed with Recovery-Stress Questionnaires/Erholungs-Belastungs-Fragebögen (RESTQEBF) before and after training. RESULTS WB-EMS training has a statistically significant positive effect on subjective well-being and subjective relaxation, as well as on the awake subscale of the MDBF. No significant main effect of sequence and no interaction effects were found. Also, compared to a Sham training session, a single WB-EMS training session had no significant effect on mood, nervousness, or the current level of stress. CONCLUSION Besides physiological effects, WB-EMS might also have a strong psychological impact. WB-EMS could be beneficial for people who, due to their limitations, have problems training on a regular basis and with adequate training intensity. TRIAL REGISTRATION German Clinical Trials Register, DRKS00012583 , 22 June 2017.
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Affiliation(s)
- Christian Keicher
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Psychiatrie und Psychotherapie, Charitéplatz 1, Berlin, 10117, Germany.,Charité Research Organisation GmbH, Charitéplatz 1, Berlin, 10117, Germany
| | - Lena Pyrkosch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Psychiatrie und Psychotherapie, Charitéplatz 1, Berlin, 10117, Germany.
| | - Bernd Wolfarth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Abteilung Sportmedizin, Philippstraße 13, 10115, Berlin, Germany
| | - Andreas Ströhle
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Psychiatrie und Psychotherapie, Charitéplatz 1, Berlin, 10117, Germany
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Tu DY, Kao FM, Tsai ST, Tung TH. Sarcopenia among the Elderly Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Healthcare (Basel) 2021; 9:healthcare9060650. [PMID: 34072617 PMCID: PMC8228648 DOI: 10.3390/healthcare9060650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023] Open
Abstract
Purpose. This systematic review and meta-analysis was conducted to explore the effect of protein intake on the prevention and improvement of sarcopenia. Methods. We searched the Cochrane Library, PubMed, and EMBASE from inception to 20 May 2021. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Results. There were 12 studies that met the selection criteria among 53 eligible publications. The results of the study show that the protein intake has no significant effect on the physical performance—4 m gait speed, chair rise test, short physical performance battery, muscle mass—skeletal muscle mass index, and muscle strength—hand grip strength. Conclusion. Protein supplementation had no significant effect on 4 m gait speed and on improving skeletal muscle mass index, hand grip strength, chair rise test, and short physical performance battery. Additional randomized controlled trials are warranted to adequately assess the effect of protein supplementation on elderly sarcopenia.
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Affiliation(s)
- Di-Ya Tu
- Department of Nutrition Therapy, Cheng-Hsin General Hospital, Taipei 112, Taiwan; (D.-Y.T.); (F.-M.K.); (S.-T.T.)
| | - Fa-Min Kao
- Department of Nutrition Therapy, Cheng-Hsin General Hospital, Taipei 112, Taiwan; (D.-Y.T.); (F.-M.K.); (S.-T.T.)
| | - Shih-Tzer Tsai
- Department of Nutrition Therapy, Cheng-Hsin General Hospital, Taipei 112, Taiwan; (D.-Y.T.); (F.-M.K.); (S.-T.T.)
- Department of Internal Medicine, Cheng-Hsin General Hospital, Taipei 112, Taiwan
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
- Correspondence: ; Tel.: +86-576-8512-0120
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Zink-Rückel C, Kohl M, Willert S, von Stengel S, Kemmler W. Once-Weekly Whole-Body Electromyostimulation Increases Strength, Stability and Body Composition in Amateur Golfers. A Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115628. [PMID: 34070315 PMCID: PMC8197524 DOI: 10.3390/ijerph18115628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 12/12/2022]
Abstract
Whole-body electromyostimulation (WB-EMS), an innovative training technology, is considered as a joint-friendly, highly customizable and particularly time-effective option for improving muscle strength and stability, body composition and pain relief. The aim of the present study was to determine the effect of 16 weeks of once-weekly WB-EMS on maximum isometric trunk (MITS), leg extensor strength (MILES), lean body mass (LBM) and body-fat content. A cohort of 54 male amateur golfers, 18 to 70 years old and largely representative for healthy adults, were randomly assigned to a WB-EMS (n = 27) or a control group (CG: n = 27). Bipolar low-frequency WB-EMS combined with low-intensity movements was conducted once per week for 20 min at the participants’ locations, while the CG maintained their habitual activity. The intention to treat analysis with multiple imputation was applied. After 16 weeks of once-weekly WB-EMS application with an attendance rate close to 100%, we observed significant WB-EMS effects on MITS (p < 0.001), MILES (p = 0.001), LBM (p = 0.034), but not body-fat content (p = 0.080) and low-back pain (LBP: p ≥ 0.078). In summary, the commercial setting of once-weekly WB-EMS application is effective to enhance stability, maximum strength, body composition and, to a lower extent, LBP in amateur golfers widely representative for a healthy male cohort.
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Affiliation(s)
- Carina Zink-Rückel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, 78056 Villingen-Schwenningen, Germany;
| | - Sebastian Willert
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany; (C.Z.-R.); (S.W.); (S.v.S.)
- Correspondence: ; Tel.: +49-9131-8523999
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Fiorilli G, Quinzi F, Buonsenso A, Casazza G, Manni L, Parisi A, Di Costanzo A, Calcagno G, Soligo M, di Cagno A. A Single Session of Whole-Body Electromyostimulation Increases Muscle Strength, Endurance and proNGF in Early Parkinson Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5499. [PMID: 34065571 PMCID: PMC8161270 DOI: 10.3390/ijerph18105499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 12/19/2022]
Abstract
Parkinson's disease (PD) patients lead a sedentary lifestyle, being unable or unwilling to exercise conventionally, due to physical and mental limitations. The aim of this study was to assess the acute effects of a single session of whole-body electromyostimulation (WB-EMS) on the physical performances and serum levels of the neurotrophic factors in PD patients. Ten subjects (aged 72.60 ± 6.82) underwent 20 min of physical activity with superimposed WB-EMS and, after four weeks, the same protocol with no WB-EMS. WB-EMS was conducted with intermittent stimulation, with 4 s WB-EMS/4 s rest, at 85 Hz, 350 μs. A physical fitness assessment and blood samples collection, to evaluate neurotrophic factors' levels (BDNF, FGF21, proNGF, mNGF), were collected before and after the intervention. The RM-ANOVA showed significant improvements in sit-to-stand (p < 0.01), arm curl (p < 0.01), handgrip (p < 0.01) and soda pop test (p < 0.01) after the WB-EMS intervention. Higher proNFG serum levels were observed in the WB-EMS condition compared to the no WB-EMS after 60 min post-intervention (p = 0.0163). The effect of WB-EMS confirmed the electrostimulation ability to modulate the proNGF quantity. The positive impact of the WB-EMS protocol on physical functioning, and eye-hand coordination, makes this intervention a promising strategy to improve motor and non-motor symptoms in PD patients.
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Affiliation(s)
- Giovanni Fiorilli
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.C.); (A.D.C.)
| | - Federico Quinzi
- Department of Motor, Human and Health Sciences, University of Rome “Foro Italico”, 00197 Rome, Italy; (F.Q.); (A.P.); (A.d.C.)
| | - Andrea Buonsenso
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.C.); (A.D.C.)
| | - Giusy Casazza
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.C.); (A.D.C.)
| | - Luigi Manni
- Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy; (L.M.); (M.S.)
| | - Attilio Parisi
- Department of Motor, Human and Health Sciences, University of Rome “Foro Italico”, 00197 Rome, Italy; (F.Q.); (A.P.); (A.d.C.)
| | - Alfonso Di Costanzo
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.C.); (A.D.C.)
| | - Giuseppe Calcagno
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.C.); (A.D.C.)
| | - Marzia Soligo
- Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy; (L.M.); (M.S.)
| | - Alessandra di Cagno
- Department of Motor, Human and Health Sciences, University of Rome “Foro Italico”, 00197 Rome, Italy; (F.Q.); (A.P.); (A.d.C.)
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Reljic D, Herrmann HJ, Neurath MF, Zopf Y. Iron Beats Electricity: Resistance Training but Not Whole-Body Electromyostimulation Improves Cardiometabolic Health in Obese Metabolic Syndrome Patients during Caloric Restriction-A Randomized-Controlled Study. Nutrients 2021; 13:nu13051640. [PMID: 34068089 PMCID: PMC8152778 DOI: 10.3390/nu13051640] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/01/2021] [Accepted: 05/11/2021] [Indexed: 01/09/2023] Open
Abstract
Caloric restriction (CR) and exercise are cornerstones in the treatment of obesity and cardiometabolic disorders. Recently, whole body electromyostimulation (WB-EMS) has emerged as a more time-efficient alternative to traditional resistance training (RT). However, the effects of WB-EMS compared to RT on cardiometabolic health in obese metabolic syndrome (MetS) patients performed during CR are still unclear. In total, 118 obese MetS patients (52.7 ± 11.8 years, BMI: 38.1 ± 6.9 kg/m2) undergoing CR over 12 weeks (aim: −500 kcal deficit/day) were randomly allocated to either WB-EMS, single-set RT (1-RT), 3-set RT (3-RT) or an inactive control group (CON). Primary outcome was MetS severity (MetS z-score). Secondary outcomes were body composition, muscle strength and quality of life (QoL). All groups significantly reduced body weight (~3%) and fat mass (~2.6 kg) but only 1-RT and 3-RT preserved skeletal muscle mass (SMM). All exercise groups increased muscle strength in major muscle groups (20–103%). However, only the two RT-groups improved MetS z-score (1-RT: −1.34, p = 0.003; 3-RT: −2.06, p < 0.001) and QoL (1-RT: +6%, p = 0.027; 3-RT: +12%, p < 0.001), while WB-EMS and CON had no impact on these outcomes. We conclude that traditional RT has superior effects on cardiometabolic health, SMM and QoL in obese MetS patients undergoing CR than WB-EMS.
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Affiliation(s)
- Dejan Reljic
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (Y.Z.)
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany;
- Correspondence: ; Tel.: +49-9131-85-45220
| | - Hans J. Herrmann
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (Y.Z.)
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Markus F. Neurath
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany;
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Yurdagül Zopf
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (Y.Z.)
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany;
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Kemmler W, Shojaa M, Steele J, Berger J, Fröhlich M, Schoene D, von Stengel S, Kleinöder H, Kohl M. Efficacy of Whole-Body Electromyostimulation (WB-EMS) on Body Composition and Muscle Strength in Non-athletic Adults. A Systematic Review and Meta-Analysis. Front Physiol 2021; 12:640657. [PMID: 33716787 PMCID: PMC7952886 DOI: 10.3389/fphys.2021.640657] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/19/2021] [Indexed: 12/12/2022] Open
Abstract
This systematic review and meta-analysis set out to determine the efficacy on whole-body electromyostimulation (WB-EMS) on body composition and strength parameters in non-athletic cohorts. A systematic review of the literature according to the PRISMA statement included (a) controlled trials, (b) WB-EMS trials with at least one exercise and one control group, (c) WB-EMS as primary physical intervention, (d) WB-EMS with at least six electrodes covering most muscle groups, (e) non-athletic cohorts. We searched eight electronic databases up to June 30, 2020, without language restrictions. Standardized mean differences (SMD) for muscle mass parameters, total body fat mass, maximum leg extension, and trunk extension strength were defined as outcome measures. In summary, 16 studies with 19 individual WB-EMS groups representing 897 participants were included. Studies vary considerably with respect to age, BMI, and physical conditions. Impulse protocols of the studies were roughly comparable, but training frequency (1-5 sessions/week) and intervention length (6-54 weeks) differed between the studies. SMD average was 1.23 (95%-CI: 0.71-1.76) for muscle mass, 0.98 (0.74-1.22) for maximum leg, and 1.08 (0.78-1.39) for maximum trunk extension strength changes (all p < 0.001). SMD for body fat changes (-0.40, [-0.98 to 0.17]), however, did not reach significance. I 2 and Q-statistics revealed substantial heterogeneity of muscle and fat mass changes between the trials. However, rank and regression tests did not indicate positive evidence for small-study bias and funnel plot asymmetries. This work provided further evidence for significant, large-sized effects of WB-EMS on muscle mass and strength parameters, but not on body fat mass. Clinical Trial Registration: ClinicalTrials.gov, PROSPERO; ID: CRD42020183059.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Mahdieh Shojaa
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - James Steele
- Ukactive Research Institute, London, United Kingdom.,Faculty of Sport, Health, and Social Sciences, Solent University, Southampton, United Kingdom
| | - Joshua Berger
- Department of Sports Science, Technische Universität Kaiserslauter, Kaiserslautern, Germany
| | - Michael Fröhlich
- Department of Sports Science, Technische Universität Kaiserslauter, Kaiserslautern, Germany
| | - Daniel Schoene
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | | | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
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Wu PY, Huang KS, Chen KM, Chou CP, Tu YK. Exercise, Nutrition, and Combined Exercise and Nutrition in Older Adults with Sarcopenia: A Systematic Review and Network Meta-analysis. Maturitas 2020; 145:38-48. [PMID: 33541561 DOI: 10.1016/j.maturitas.2020.12.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/07/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
It is unclear whether the combined effects of exercise and nutrition are better than those of exercise alone or nutrition alone in older adults with sarcopenia. This paper assesses the comparative effects of exercise, nutrition, and the combination of exercise and nutrition on muscle mass, muscle strength, and physical performance in older adults with sarcopenia. In this systematic review and network meta-analysis, 11 electronic databases were searched up to November 2020. Inclusion criteria were: (1) adults aged 65 years and older with sarcopenia; (2) interventions of exercise, nutrition, or the combination of both; (3) the outcomes include at least one of the following: muscle mass, muscle strength (hand grip and knee extension strength), or physical performance (gait speed and dynamic balance); and (4) randomized control trials. For each outcome measurement, a network meta-analysis was conducted to determine the direct and indirect effects of each intervention compared with each of the other interventions. A total of 26 studies were included in the network meta-analysis. Compared with the control group, exercise alone and the combination of exercise and nutrition significantly increased handgrip strength (1.12 kg, 95% CI: 0.12, 2.11; 2.03 kg, 95% CI: 1.10, 2.97) and improved dynamic balance (-1.76 seconds, 95% CI: -2.24, -1.28; -1.02 seconds, 95% CI: -1.64, -0.39). Both exercise alone and the combination of exercise and nutrition have beneficial effects on muscle strength and physical performance in older adults with sarcopenia.
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Affiliation(s)
- Pei-Yu Wu
- Center for Long-Term Care Research, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, 80708, Taiwan.
| | - Kun-Siang Huang
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan; College of Medicine, Chang Gung University, Taiwan.
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, 100 Shih-Chuan 1(st)Rd., Sanmin District, Kaohsiung, 80708, Taiwan; Center for Long-Term Care Research, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
| | - Chia-Pei Chou
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Dapi Rd., Niaosong District, Kaohsiung, 83301, Taiwan; College of Medicine, Chang Gung University, Taiwan
| | - Yu-Kang Tu
- College of Public Health, National Taiwan University, 17 Xu-Zhou Rd., Zhongzheng District, Taipei, 10055, Taiwan; Department of Medical Research, National Taiwan University Hospital, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taiwan.
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Resistance Exercise, Electrical Muscle Stimulation, and Whole-Body Vibration in Older Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2020; 9:jcm9092902. [PMID: 32911822 PMCID: PMC7563530 DOI: 10.3390/jcm9092902] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022] Open
Abstract
It has been shown that resistance exercise (RT) is one of the most effective approaches to counteract the physical and functional changes associated with aging. This systematic review with meta-analysis compared the effects of RT, whole-body vibration (WBV), and electrical muscle stimulation (EMS) on muscle strength, body composition, and functional performance in older adults. A thorough literature review was conducted, and the analyses were limited to randomized controlled trials. In total, 63 studies were included in the meta-analysis (48 RT, 11 WBV, and 4 EMS). The results showed that RT and WBV are comparably effective for improving muscle strength, while the effects of EMS remains debated. RT interventions also improved some outcome measures related to functional performance, as well as the cross-sectional area of the quadriceps. Muscle mass was not significantly affected by RT. A limitation of the review is the smaller number of WBV and particularly EMS studies. For this reason, the effects of WBV and EMS could not be comprehensively compared to the effect of RT for all outcome measures. For the moment, RT or combinations of RT and WBV or EMS, is probably the most reliable way to improve muscle strength and functional performance, while the best approach to increase muscle mass in older adults remains open to further studies.
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Konrad KL, Baeyens JP, Birkenmaier C, Ranker AH, Widmann J, Leukert J, Wenisch L, Kraft E, Jansson V, Wegener B. The effects of whole-body electromyostimulation (WB-EMS) in comparison to a multimodal treatment concept in patients with non-specific chronic back pain-A prospective clinical intervention study. PLoS One 2020; 15:e0236780. [PMID: 32822361 PMCID: PMC7446884 DOI: 10.1371/journal.pone.0236780] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/12/2020] [Indexed: 11/26/2022] Open
Abstract
Background According to present guidelines, active exercise is one key component in the comprehensive treatment of nonspecific chronic back pain (NSCBP). Whole body electromyostimulation (WB-EMS) is a safe, and time-effective training method, that may be effective in NSCBP-patients. Methods In this prospective and controlled nonrandomized clinical study, two therapeutic approaches were compared. One group received 20 minutes WB-EMS per week. An active control group (ACG) received a multimodal therapy program. A third group included subjects without back pain. To all groups, the following measurement instruments were applied: Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), North American Spine Society Instrument (NASS); SF 36 survey and measurements for muscular function and postural stability. In the EMS-group: T0: baseline; T1: at 6 weeks; T2: at 12 weeks and T3: at 24 weeks. In the ACG: T0 baseline and T1 after 4 weeks. Results In the intervention group, 128 patients with low back pain were enrolled, 85 in the WB-EMS group and 43 in the ACG. 34 subjects were allocated to the passive control group. The average age was 58.6 years (18–86 years). In the EMS group, the NRS (1–10) improved statistically and clinically significantly by 2 points. The ODI was reduced by 19.7 points. The NASS and most of the SF 36 items improved significantly. In the multimodal treatment group, only the muscular function improved slightly. Conclusion Our data support the hypothesis that WB-EMS is at least as effective as a multimodal treatment, which is often referred to as being the golden standard. Therefore WB-EMS may be an effective and, with 20 min./week training time, very time-efficient alternative to established multimodal treatment models.
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Affiliation(s)
- Karl Lorenz Konrad
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Jean-Pierre Baeyens
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Christof Birkenmaier
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Anna Helena Ranker
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Jonas Widmann
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Johannes Leukert
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Lisa Wenisch
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Eduard Kraft
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Volkmar Jansson
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Bernd Wegener
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
- * E-mail:
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Kemmler W, Kohl M, Jakob F, Engelke K, von Stengel S. Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study. Nutrients 2020; 12:E2341. [PMID: 32764397 PMCID: PMC7468852 DOI: 10.3390/nu12082341] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
The present study aimed to evaluate the effect of high intensity dynamic resistance exercise (HIT-DRT) and whey protein supplementation (WPS) on bone mineral density (BMD) and sarcopenia parameters in osteosarcopenic men. Men ≥ 72 years with osteosarcopenia (n = 43) were randomly assigned to a HIT-RT (HIT-RT: n = 21) or a non-training control group (n = 22). Supervised HIT-RT twice/week was applied for 18 months, while the control group maintained their habitual lifestyle. Supplying WPS, total protein intake amounted to 1.5-1.6 (HIT-RT) and 1.2 g/kg/body mass/d (control). Both groups were supplied with calcium and vitamin D. Primary study outcomes were BMD and the sarcopenia Z-score. After adjusting for multiplicity, we observed significant positive effects for sarcopenia Z-score (standardized mean difference (SMD): 1.40), BMD at lumbar spine (SMD: 0.72) and total hip (SMD: 0.72). In detail, effect sizes for skeletal muscle mass changes were very pronounced (1.97, p < 0.001), while effects for functional sarcopenia parameters were moderate (0.87, p = 0.008; handgrip strength) or low (0.39, p = 0.209; gait velocity). Apart from one man who reported short periods of temporary worsening of existing joint pain, no HIT-RT/WPS-related adverse effects or injuries were reported. We consider HIT-RT supported by whey protein supplementation as a feasible, attractive, safe and highly effective option to fight osteosarcopenia in older men.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91053 Erlangen, Germany; (K.E.); (S.v.S.)
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Neckarstrasse 1, 78054 Villingen-Schwenningen, Germany;
| | - Franz Jakob
- Bernhard-Heine-Center for Locomotion Research, University of Würzburg, Brettreichstrasse 11, 97074 Würzburg, Germany;
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91053 Erlangen, Germany; (K.E.); (S.v.S.)
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91053 Erlangen, Germany; (K.E.); (S.v.S.)
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Pano-Rodriguez A, Beltran-Garrido JV, Hernandez-Gonzalez V, Reverter-Masia J. Effects of Whole Body Electromyostimulation on Physical Fitness and Health in Postmenopausal Women: A Study Protocol for a Randomized Controlled Trial. Front Public Health 2020; 8:313. [PMID: 32793536 PMCID: PMC7391420 DOI: 10.3389/fpubh.2020.00313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Age-related problems such as chronic diseases, functional limitation and dependence, reduce the quality of life in the elderly, and increase public spending in health. It has been established that physical activity plays a fundamental role in the health of the elderly. The whole body electromyostimulation (WB-EMS) could be a successful methodology as high-intensity training to improve the physical fitness of older people. Methods: A minimum of 13 women between 55 and 70 years old will be randomized in two groups. The exercise with WB-EMS group (EX + WB-EMS) will conduct a resistance strength training program with superimposed WB-EMS while the exercise group (EX) will perform only resistance strength and aerobic training. Balance, strength, flexibility, agility, speed, and aerobic performance (EXERNET battery and progressive resistance test), as well as body composition, blood parameters and physical activity reporting (IPAQ-E) will be assessed to analyze the effects of whole body electromyostimulation in the physical fitness and the health in postmenopausal women. Discussion: Innovative and scientifically well-designed protocols are needed to enhance the knowledge of the body's responses within this training methodology which is being used by a big quantity of population. This trial will provide evidence on the effectiveness of whole-body electromyostimulation in physical fitness and health in elderly women. Trial Registration: ISRCTN15558857 registration data: 27/11/2019 (retrospectively registered).
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Pano-Rodriguez A, Beltran-Garrido JV, Hernandez-Gonzalez V, Nasarre-Nacenta N, Reverter-Masia J. Impact of Whole Body Electromyostimulation on Velocity, Power and Body Composition in Postmenopausal Women: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4982. [PMID: 32664361 PMCID: PMC7400631 DOI: 10.3390/ijerph17144982] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 02/08/2023]
Abstract
Menopause is associated with losses in strength and power along with weight and fat mass gains, which may result from menopause-related hormonal changes, aging-associated diseases, and decreased physical activity time. The objective of this study is to analyze if whole-body electromyostimulation (WB-EMS) is suitable for the prevention and treatment of postmenopausal physical deterioration. Thirty-four healthy sedentary women between 55 and 69 years followed an experimental design pre-post test. Both groups conducted 10 weeks of aerobic and strength training program. The experimental group conducted the training with superimposed WB-EMS during exercise. At the end of the intervention, the experimental group obtained better power (Squat: mean difference (MD) = 38.69 W [1.75,75.62], d = 0.81; Bench press: MD = 25.64 W [17.48, 33.82], d = 2.39) and velocity (Squat: MD = 0.04 m·s-1 [0.01, 0.08], d = 0.98; Bench press: MD = 0.10 m·s-1 [0.06, 0.14], d = 1.90) score improvements than the other group (pBonferroni < 0.05). Furthermore, trivial to small effects were found in the body composition of the participants of both groups (p > 0.050). WB-EMS showed a favorable isolated effect on the development of power and velocity, but it induced negligible effects on the body composition of postmenopausal women.
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Affiliation(s)
| | - Jose Vicente Beltran-Garrido
- EUSES Escola Universitària de la Salut i l’Esport, Rovira i Virgili University, 43870 Tarragona, Spain; (J.V.B.-G.); (J.R.-M.)
| | | | | | - Joaquin Reverter-Masia
- EUSES Escola Universitària de la Salut i l’Esport, Rovira i Virgili University, 43870 Tarragona, Spain; (J.V.B.-G.); (J.R.-M.)
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Kemmler W, von Stengel S, Kohl M, Rohleder N, Bertsch T, Sieber CC, Freiberger E, Kob R. Safety of a Combined WB-EMS and High-Protein Diet Intervention in Sarcopenic Obese Elderly Men. Clin Interv Aging 2020; 15:953-967. [PMID: 32612355 PMCID: PMC7322975 DOI: 10.2147/cia.s248868] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
Purpose Whole-body electromyostimulation (WB-EMS) especially in combination with a high-protein supplementation has been established as an efficient treatment against sarcopenia. However, there are several case reports of rhabdomyolysis after WB-EMS application. Thus, we asked if this training could potentially lead to deteriorations of the cardiac as well as the renal function. Materials and Methods One hundred sarcopenic obese men aged 70 years and older were randomly balanced (1-1-1) and allocated to one of the three study arms. During 16 weeks of intervention, these groups either performed WB-EMS and took a protein supplement (WB-EMS&P), solely received the protein supplement (Protein) or served as control group (CG). WB-EMS consisted of 1.5×20 min (85 Hz, 350 μs, 4 s of strain to 4 s of rest) applied with moderate-to-high intensity while moving. We further generated a daily protein intake of 1.7-1.8 g/kg/body mass per day. At baseline and 8-10 days after completion of the intervention, blood was drawn and biomarkers of muscle, cardiac and renal health were assessed. Results Hereby, we found slight but significant elevations of creatine kinase (CK) levels in the WB-EMS group pointing to minor damages of the skeletal muscle (140 U/l [81-210], p < 0.001). This was accompanied by a significant, low-grade increase of creatine kinase-muscle brain (CK-MB, 0.43 ng/mL [-0.29-0.96], p < 0.01) and high-sensitivity troponin T (hsTnT, 0.001 ng/mL. [0.000-0.003], p < 0.001) but without a higher risk of developing heart failure according to N-terminal prohormone of brain natriuretic peptide (NT-proBNP, -5.7 pg/mL [-38.8-24.6], p = 0.17). Estimated glomerular filtration rate (eGFR) was impaired neither by the high-protein supplementation alone nor in combination with WB-EMS (CG 76.0 mL/min/1.73 m2 [71.9-82.2] vs Protein 73.2 mL/min/1.73 m2 [63.0-78.9] vs WB-EMS&P 74.6 mL/min/1.73 m2 [62.8-84.1], p = 0.478). Conclusion In conclusion, even in the vulnerable group of sarcopenic obese seniors, the combination of WB-EMS with a high-protein intake revealed no short-term, negative impact on the eGFR, but potential consequences for the cardiovascular system need to be addressed in future studies.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Faculty of Medical and Life Science, University of Furtwangen, Schwenningen, Germany
| | - Nicolas Rohleder
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany
| | - Cornel C Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
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Effectiveness of non-pharmacological interventions on the management of sarcopenic obesity: A systematic review and meta-analysis. Exp Gerontol 2020; 135:110937. [DOI: 10.1016/j.exger.2020.110937] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/19/2020] [Accepted: 03/26/2020] [Indexed: 01/26/2023]
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Pano-Rodriguez A, Beltran-Garrido JV, Hernandez-Gonzalez V, Reverter-Masia J. Effects of Whole-Body Electromyostimulation on Physical Fitness in Postmenopausal Women: A Randomized Controlled Trial. SENSORS 2020; 20:s20051482. [PMID: 32182674 PMCID: PMC7085547 DOI: 10.3390/s20051482] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022]
Abstract
Whole-body electromyostiulation (WB-EMS) has experienced a boom in recent years, even though its effectiveness is controversial. A sedentary lifestyle is deeply rooted in the European population, mainly in the elderly. This experimental study analyzed the impact of WB-EMS on the physical fitness of postmenopausal women. Thirty-four healthy sedentary women between 55 and 69 years followed an experimental design pre–post-test. Both groups conducted a ten-week aerobic and strength training program. The experimental group overlaid the WB-EMS during exercise. At the end of the intervention, both groups improved upper and lower body strength, lower extremity flexibility, agility, and speed levels (pBonferroni < 0.05). Significant interactions were observed at upper and lower body strength, agility, speed, and cardiovascular endurance (p < 0.05). The WB-EMS group scored better agility than the control group at the end of the intervention (pBonferroni < 0.05) and was the only group that improved cardiovascular endurance. WB-EMS shows a favorable isolate effect on the development of dynamic leg strength, agility, and cardiovascular endurance but did not in dynamic arm strength, gait speed, balance, or flexibility of postmenopausal women.
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Affiliation(s)
- Alvaro Pano-Rodriguez
- Research Group Human Movement, University of Lleida, Av. de l’Estudi General, n.4 E-25001 Lleida, Spain; (V.H.-G.); (J.R.-M.)
- Correspondence: ; Tel.: +346-4954-6894
| | - Jose Vicente Beltran-Garrido
- EUSES Health and Sport Sciences School, Rovira i Virgili University, C/Sebastià Joan Arbó, 2, 43870 Amposta, Spain;
| | - Vicenç Hernandez-Gonzalez
- Research Group Human Movement, University of Lleida, Av. de l’Estudi General, n.4 E-25001 Lleida, Spain; (V.H.-G.); (J.R.-M.)
| | - Joaquín Reverter-Masia
- Research Group Human Movement, University of Lleida, Av. de l’Estudi General, n.4 E-25001 Lleida, Spain; (V.H.-G.); (J.R.-M.)
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Amaro-Gahete FJ, De-la-O A, Jurado-Fasoli L, Sanchez-Delgado G, Ruiz JR, Castillo MJ. Metabolic rate in sedentary adults, following different exercise training interventions: The FIT-AGEING randomized controlled trial. Clin Nutr 2020; 39:3230-3240. [PMID: 32089371 DOI: 10.1016/j.clnu.2020.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/06/2020] [Accepted: 02/01/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND & AIMS This study compares the influence of different exercise training programs on basal metabolic rate (BMR) and fat oxidation, in basal conditions (BFox) and during exercise (MFO), in sedentary, middle-aged adults. METHODS The study subjects of this 12 week-long, randomised controlled trial, were 71 middle-aged adults (age 53.5 ± 4.9 years; 52% women). Subjects were randomly assigned to one of the following groups: (1) no exercise, (2) concurrent training based on international physical activity recommendations (PAR group), (3) high intensity interval training (HIIT group), and (4) high intensity interval training plus whole-body electromyostimulation (HIIT + EMS group). Subject BMR, BFox and MFO were determined by indirect calorimetry before and after the intervention. RESULTS The HIIT + EMS subjects showed significant increases in BFox following the intervention compared with the control group (all P = 0.043); no such differences were seen in the PAR and HIIT compared with the control group (all P ≥ 0.1). A significant increase in post-intervention MFO was noted for the HIIT and HIIT + EMS group compared to the non-exercise control group (P < 0.05); no such difference was seen in the PAR group compared to the control group (all P ≥ 0.05). CONCLUSIONS Twelve weeks of high intensity interval training plus whole-body electromyostimulation may increase the BFox and MFO of middle-aged sedentary adults. These findings have important clinical implications; a well-designed high-intensity interval training program plus whole-body electromyostimulation might be followed to help combat the appearance of chronic metabolic diseases characterized by metabolic inflexibility in middle-aged sedentary adults, though it will be necessary to determine how long the effects last.
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Affiliation(s)
- Francisco J Amaro-Gahete
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, Spain; PROmoting FITness and Health Through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain.
| | - Alejandro De-la-O
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, Spain
| | - Lucas Jurado-Fasoli
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, Spain
| | - Guillermo Sanchez-Delgado
- PROmoting FITness and Health Through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Pennington Biomedical Research Center, LA USA
| | - Jonatan R Ruiz
- PROmoting FITness and Health Through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Manuel J Castillo
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, Spain
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Stöllberger C, Finsterer J. Side effects of and contraindications for whole-body electro-myo-stimulation: a viewpoint. BMJ Open Sport Exerc Med 2019; 5:e000619. [PMID: 31908835 PMCID: PMC6937082 DOI: 10.1136/bmjsem-2019-000619] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Whole-body electro-myo-stimulation (WB-EMS) has been introduced as an alternative to physical training. Data about side effects and contraindications of WB-EMS are summarised. From healthy subjects, elevation of creatine-kinase (CK) activity with inter-individual variability was reported after WB-EMS. No data about applied current types, stimulation frequency and risk factors were given. In randomised trials investigating WB-EMS, CK activity was not measured. Seven cases of rhabdomyolysis after WB-EMS were found, and it remains open whether WB-EMS was the only risk factor. In healthy subjects, WB-EMS does not seem to affect blood pressure, heart rate and oxygen uptake. The lists of exclusion criteria are, in part, contradictory between different studies, especially regarding malignancy and heart failure. Risk factors for rhabdomyolysis are not mentioned as contraindications for WB-EMS. Scientific research should concentrate on muscle damage as a side effect of WB-EMS considering current types applied, stimulation frequency and risk factors for rhabdomyolysis. Research about WB-EMS should include longitudinal muscle force measurements and MRI. Subjects, intending to perform WB-EMS, should undergo investigations by a physician comprising a screen for risk factors for rhabdomyolysis. The education of operators working in gyms with WB-EMS should be regulated and improved. Regulatory authorities should become aware of the problem. Those working in the field should start an initiative on an international level to increase the safety of WB-EMS.
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Teschler M, Mooren FC. (Whole-Body) Electromyostimulation, Muscle Damage, and Immune System: A Mini Review. Front Physiol 2019; 10:1461. [PMID: 31849709 PMCID: PMC6895567 DOI: 10.3389/fphys.2019.01461] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/12/2019] [Indexed: 01/01/2023] Open
Abstract
Exercise-induced muscular damage (EIMD) is a well-known phenomenon in exercise medicine that is closely related to the type and intensity of training, with especially eccentric training content providing various physiological irritations, including mechanical as well as metabolic. Besides the increase in markers of muscular damage, such as creatine kinase (CK) and myoglobin (Mb), several physiological shifts trigger a kind of stepwise repair chain reactions lasting over a time course from several hours to days. Subsequent inflammatory processes are closely related to muscular damage with decisive influence on physiological repair mechanisms, as indicated by an increased invasion of immune cells and typical patterns of pro- and anti-inflammatory cytokines. Previously, whole-body electromyostimulation (WB-EMS) showed significant, partly extreme distractions in markers of muscular damage lasting over several days. Because of the large area of stimulated muscle mass and a relatively high proportion of eccentric movements, initially too intense WB-EMS is predisposed to produce serious changes on several physiological levels due to its unfamiliar muscular strain. Therefore, it is the aim of this short review to focus on the possible immunological side effects of this aspiring training technology. As the number of original investigations in this field is rather small, we will include data from other studies about the relation of exercise-induced muscle damage and immune regulation.
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Affiliation(s)
- Marc Teschler
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany.,Klinik Königsfeld der DRV, Department of Cardiology and Orthopedics Clinic, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Frank C Mooren
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany.,Klinik Königsfeld der DRV, Department of Cardiology and Orthopedics Clinic, Center for Medical Rehabilitation, Ennepetal, Germany
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Schuhbeck E, Birkenmaier C, Schulte-Göcking H, Pronnet A, Jansson V, Wegener B. The Influence of WB-EMS-Training on the Performance of Ice Hockey Players of Different Competitive Status. Front Physiol 2019; 10:1136. [PMID: 31551812 PMCID: PMC6746827 DOI: 10.3389/fphys.2019.01136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was to examine the influence of long-term whole-body electromyostimulation (WB-EMS) training in addition to standard ice hockey training in the following areas: shot speed, counter-movement-jump (CMJ) height and power, 10 m-sprint, isokinetic maximum force at 60 and 300°/s of the knee extensor muscle and subjective performance. The purpose was further to check, whether competitive status influenced the extent of response to WB-EMS and whether WB-EMS would hypothetically be a suitable method to reduce injury rate. Methods Thirty male amateur ice hockey players participated in this study. They were divided into two cross-over groups (Group A and Group B). EMS sessions were carried out once a week for 12 weeks for each group with a subsequent 4 week EMS pause. The sessions consisted of 20 min electromyostimulation with 150 contractions (4 s duration, 85 Hz). Shot speed of slap shot was measured with Sportradar 1503. Jumping ability was determined with a ground reaction force platform (GRFP). Sprint time for 10 m skate was recorded using an infrared photo sensor. Isokinetic force of the knee extensor muscle was detected with Isomed 2000 at two different angular velocities (60 and 300°/s) and the subjective performance was collected using a questionnaire. Results After 12 weeks of WB-EMS training jumping power increased significantly for the WB-EMS groups by 5.15%, 10 m skating time decreased significantly by 5%, and maximum isokinetic force at 300°/s increased significantly by 7% (all p < 0.05). In contrast post training shot speed showed no significant change. Isokinetic torque at 60°/s and vertical jump height were collected as secondary variables and showed increases of 5.45 and 15.15%, respectively. After finishing the WB-EMS and continuing the normal training, it was shown that the training effect regressed. Conclusion This study demonstrated that WB-EMS training significantly decreased 10 m skating time and increased jumping power and maximum isokinetic force at 300°/s. We conclude that with additional WB-EMS training, an increase in performance might also be achieved for athletes in lower leagues. Due to the higher training potential of leisure athletes, the effect is probably even more pronounced than would be expected for competitive athletes.
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Affiliation(s)
- Elisabeth Schuhbeck
- Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, Ludwig Maximilian University of Munich, Munich, Germany
| | - Christof Birkenmaier
- Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, Ludwig Maximilian University of Munich, Munich, Germany
| | - Heike Schulte-Göcking
- Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, Ludwig Maximilian University of Munich, Munich, Germany
| | - Andreas Pronnet
- Aktiva Medici Rehabilitation Center, Prien am Chiemsee, Germany
| | - Volkmar Jansson
- Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, Ludwig Maximilian University of Munich, Munich, Germany
| | - Bernd Wegener
- Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, Ludwig Maximilian University of Munich, Munich, Germany
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Ströhle A. Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders. Eur Arch Psychiatry Clin Neurosci 2019; 269:485-498. [PMID: 29564546 DOI: 10.1007/s00406-018-0891-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/19/2018] [Indexed: 12/11/2022]
Abstract
Sports psychiatry has developed for the past 3 decades as an emerging field within psychiatry and sports medicine. An International society has been established in 1994 and also national interest groups were implemented, mostly within the national organizations for psychiatry, some also containing the topic of exercise treatment of mental disorders. Where are we now 30 years later? We systematically but also selectively review the medical literature on exercise, sport, psychiatry, mental health and mental disorders and related topics. The number of publications in the field has increased exponentially. Most topics keep remaining on the agenda, e.g., head trauma and concussion, drug abuse and doping, performance enhancement, overtraining, ADHD or eating disorders. Supported by the growing literature, evidence-based recommendations have become available now in many clinical areas. A relatively new phenomenon is muscle dysmorphia, observed in weightlifters, bodybuilders but also in college students and gym users. Further, sports therapy of mental disorders has been studied by more and more high-quality randomized controlled clinical trials. Mostly as a complementary treatment, however, for some disorders already with a 1a evidence level, e.g., depression, dementia or MCI but also post-traumatic stress disorder. Being grown up and accepted nowadays, sports psychiatry still represents a fast-developing field. The reverse side of the coin, sport therapy of mental disorders has received a scientific basis now. Who else than sports psychiatry could advance sport therapy of mental disorders? We need this enthusiasm for sports and psychiatry for our patients with mental disorders and it is time now for a broadening of the scope. Optimized psychiatric prevention and treatment of athletes and ideal sport-related support for individuals with mental disorders should be our main purpose and goal.
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Affiliation(s)
- Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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Berger J, Becker S, Backfisch M, Eifler C, Kemmler W, Fröhlich M. Adjustment Effects of Maximum Intensity Tolerance During Whole-Body Electromyostimulation Training. Front Physiol 2019; 10:920. [PMID: 31396098 PMCID: PMC6668421 DOI: 10.3389/fphys.2019.00920] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/08/2019] [Indexed: 01/10/2023] Open
Abstract
Intensity regulation during whole-body electromyostimulation (WB-EMS) training is mostly controlled by subjective scales such as CR-10 Borg scale. To determine objective training intensities derived from a maximum as it is used in conventional strength training using the one-repetition-maximum (1-RM), a comparable maximum in WB-EMS is necessary. Therefore, the aim of this study was to examine, if there is an individual maximum intensity tolerance plateau after multiple consecutive EMS application sessions. A total of 52 subjects (24.1 ± 3.2 years; 76.8 ± 11.1 kg; 1.77 ± 0.09 m) participated in the longitudinal, observational study (38 males, 14 females). Each participant carried out four consecutive maximal EMS applications (T1-T4) separated by 1 week. All muscle groups were stimulated successively until their individual maximum and combined to a whole-body stimulation index to carry out a possible statement for the development of the maximum intensity tolerance of the whole body. There was a significant main effect between the measurement times for all participants (p < 0.001; 𝜂2 = 0.39) as well as gender specific for males (p = 0.001; 𝜂2 = 0.18) and females (p < 0.001; 𝜂2 = 0.57). There were no interaction effects of gender × measurement time (p = 0.394). The maximum intensity tolerance increased significantly from T1 to T2 (p = 0.001) and T2 to T3 (p < 0.001). There was no significant difference between T3 and T4 (p = 1.0). These results indicate that there is an adjustment of the individual maximum intensity tolerance to a WB-EMS training after three consecutive tests. Therefore, there is a need of several habituation units comparable to the identification of the individual 1-RM in conventional strength training. Further research should focus on an objective intensity-specific regulation of the WB-EMS based on the individual maximum intensity tolerance to characterize different training areas and therefore generate specific adaptations to a WB-EMS training compared to conventional strength training methods.
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Affiliation(s)
- Joshua Berger
- Department of Sports Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Stephan Becker
- Department of Sports Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Marco Backfisch
- Department of Sports Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Christoph Eifler
- Department of Applied Training Science, German University of Applied Sciences for Prevention and Health Management (DHfPG), Saarbrücken, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Fröhlich
- Department of Sports Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
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Petroni ML, Caletti MT, Dalle Grave R, Bazzocchi A, Aparisi Gómez MP, Marchesini G. Prevention and Treatment of Sarcopenic Obesity in Women. Nutrients 2019; 11:E1302. [PMID: 31181771 PMCID: PMC6627872 DOI: 10.3390/nu11061302] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/30/2019] [Accepted: 06/04/2019] [Indexed: 02/06/2023] Open
Abstract
Sarcopenic obesity (SO) is referred to as the combination of obesity with low skeletal muscle mass and function. However, its definition and diagnosis is debated. SO represents a sizable risk factor for the development of disability, possibly with a worse prognosis in women. The present narrative review summarizes the current evidence on pharmacological, nutrition and exercise strategies on the prevention and/or treatment of SO in middle-aged and older-aged women. A literature search was carried out in Medline and Google Scholar between 29th January and 14th March 2019. Only controlled intervention studies on mid-age and older women whose focus was on the prevention and/or treatment of sarcopenia associated with obesity were included. Resistance training (RT) appears effective in the prevention of all components of SO in women, resulting in significant improvements in muscular mass, strength, and functional capacity plus loss of fat mass, especially when coupled with hypocaloric diets containing at least 0.8 g/kg body weight protein. Correction of vitamin D deficit has a favorable effect on muscle mass. Treatment of SO already established is yet unsatisfactory, although intense and prolonged RT, diets with higher (1.2 g/kg body weight) protein content, and soy isoflavones all look promising. However, further confirmatory research and trials combining different approaches are required.
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Affiliation(s)
- Maria L Petroni
- Unit of Metabolic Diseases and Clinical Dietetics, Sant'Orsola-Malpighi Hospital, "Alma Mater" University, via G. Massarenti 9, 40138 Bologna, Italy.
| | - Maria T Caletti
- Unit of Metabolic Diseases and Clinical Dietetics, Sant'Orsola-Malpighi Hospital, "Alma Mater" University, via G. Massarenti 9, 40138 Bologna, Italy.
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, via Monte Baldo 89, 37016 Garda (VR), Italy.
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy.
| | - Maria P Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Park Road, Grafton, 1023 Auckland, New Zealand.
| | - Giulio Marchesini
- Unit of Metabolic Diseases and Clinical Dietetics, Sant'Orsola-Malpighi Hospital, "Alma Mater" University, via G. Massarenti 9, 40138 Bologna, Italy.
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