1
|
Sanchez MJ, Mossayebi A, Sigaroodi S, Apaflo JN, Galvan MJ, Min K, Agullo FJ, Wagler A, Bajpeyi S. Effects of neuromuscular electrical stimulation on glycemic control: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1222532. [PMID: 37583429 PMCID: PMC10424918 DOI: 10.3389/fendo.2023.1222532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
Background Physical inactivity increases the risk for metabolic diseases such as obesity and type 2 diabetes. Neuromuscular electrical stimulation (NMES) is an effective method to induce muscle contraction, particularly for populations with physical impairments and/or metabolic diseases. However, its effectiveness to improve glycemic control is unclear. This review aimed to determine the effectiveness of NMES on glycemic control. Methods Electronic search consisted of MEDLINE (PubMed), EMBASE, Cochrane Library, Google Scholar, and Web of Science to identify studies that investigated the effects of NMES on glycemic control for this systematic review. The meta-analysis consists of the studies designed as randomized controlled trials. Effect sizes were calculated as the standardized mean difference (SMD) and meta-analysis was conducted using a random-effects model. Results Thirty-five studies met the inclusion criteria for systematic review and of those, nine qualified for the meta-analysis. Existing evidence suggested that NMES effectively improves glycemic control predominantly in middle-aged and elderly population with type 2 diabetes, obesity, and spinal cord injury. The meta-analysis is comprised of 180 participants and reported that NMES intervention lowered fasting blood glucose (SMD: 0.48; 95% CI: 0.17 to 0.78; p=0.002; I²=0%). Additional analysis using the primary measures reported by each study to indicate glycemic control (i.e., OGTT, HOMA-IR, and fasting glucose) also confirmed a significant effect of NMES on improving glycemic control (SMD: 0.41; 95% CI, 0.09 to 0.72; p=0.01; I²=11%). NMES protocol varied across studies and requires standardization. Conclusion NMES could be considered as a therapeutic strategy to improve glycemic control in populations with physical impairments and/or metabolic disorders. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42020192491.
Collapse
Affiliation(s)
- Michael J. Sanchez
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Ali Mossayebi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Solmaz Sigaroodi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Jehu N. Apaflo
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Michelle J. Galvan
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Kisuk Min
- Muscle Molecular Physiology Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | | | - Amy Wagler
- Department of Mathematical Sciences, The University of Texas at El Paso, El Paso, TX, United States
| | - Sudip Bajpeyi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| |
Collapse
|
2
|
Bellini A, Nicolò A, Rocchi JE, Bazzucchi I, Sacchetti M. Walking Attenuates Postprandial Glycemic Response: What Else Can We Do without Leaving Home or the Office? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:253. [PMID: 36612575 PMCID: PMC9819328 DOI: 10.3390/ijerph20010253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
We evaluated the effects of different exercise types suitable for a home/work setting on the postprandial glucose response. Twenty-three healthy, active, young individuals performed one of two studies (12 in Study 1 and 11 in Study 2), with four randomized protocols each. After a meal high in carbohydrate content (1 g of carbohydrate per kg of body weight), in Study 1, participants performed 30 min of either walking (WALK), bench stepping exercise (STEP) or isometric wall squat (SQUAT); in Study 2, participants performed 30 min of either walking (WALK), neuromuscular electrical stimulation alone (P_NMES) or superimposed on voluntary muscle contraction (VC_NMES). In both studies, participants performed a prolonged sitting condition (CON) that was compared to the exercise sessions. In Study 1, WALK and STEP significantly reduced the glucose peak compared to CON (p < 0.011). In Study 2, the peak was significantly reduced in WALK compared to CON, P_NMES and VC_NMES (p < 0.011) and in VC_NMES compared to CON and P_NMES (p < 0.011). A significant reduction of 3 h glucose iAUC was found for WALK and VC_NMES compared to CON and P_NMES (p < 0.033). In conclusion, WALK is the most effective strategy for improving the postprandial glycemic response. However, STEP and VC_NMES can also be used for reducing postprandial glycemia.
Collapse
Affiliation(s)
| | | | | | | | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
| |
Collapse
|
3
|
Cohen JN, Kuikman MA, Politis-Barber V, Stairs BE, Coates AM, Millar PJ, Burr JF. Blood flow restriction and stimulated muscle contractions do not improve metabolic or vascular outcomes following glucose ingestion in young, active individuals. J Appl Physiol (1985) 2022; 133:75-86. [DOI: 10.1152/japplphysiol.00178.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Glucose ingestion and absorption into the blood stream can challenge glycemic regulation and vascular endothelial function. Muscular contractions in exercise promote a return to homeostasis by increasing glucose uptake and blood flow. Similarly, muscle hypoxia supports glycemic regulation by increasing glucose oxidation. Blood flow restriction (BFR) induces muscle hypoxia during occlusion and reactive hyperemia upon release. Thus, in the absence of exercise, electric muscle stimulation (EMS) and BFR may offer circulatory and glucoregulatory improvements. In 13 healthy, active participants (27±3yr, 7 female) we tracked post-glucose (oral 100g) glycemic, cardiometabolic and vascular function measures over 120min following four interventions: 1) BFR, 2) EMS, 3) BFR+EMS or 4) Control. BFR was applied at 2min intervals for 30min (70% occlusion), EMS was continuous for 30min (maximum-tolerable intensity). Glycemic and insulinemic responses did not differ between interventions (partial η2=0.11-0.15, P=0.2); however, only BFR+EMS demonstrated cyclic effects on oxygen consumption, carbohydrate oxidation, muscle oxygenation, heart rate, and blood pressure (all P<0.01). Endothelial function was reduced 60min post-glucose ingestion across interventions and recovered by 120min (5.9±2.6% vs 8.4±2.7%; P<0.001). Estimated microvascular function was not meaningfully different. Leg blood flow increased during EMS and BFR+EMS (+656±519mL•min-1, +433±510mL•min-1; P<0.001); however, only remained elevated following BFR intervention 90min post-glucose (+94±94mL•min-1; P=0.02). Superimposition of EMS onto cyclic BFR did not preferentially improve post-glucose metabolic or vascular function amongst young, active participants. Cyclic BFR increased blood flow delivery 60min beyond intervention, and BFR+EMS selectively increased carbohydrate usage and reduced muscle oxygenation warranting future clinical assessments.
Collapse
Affiliation(s)
- Jeremy N. Cohen
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Megan A. Kuikman
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Valerie Politis-Barber
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Brienne E. Stairs
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Alexandra M. Coates
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Philip J. Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Jamie F. Burr
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| |
Collapse
|
4
|
Galvan MJ, Sanchez MJ, McAinch AJ, Covington JD, Boyle JB, Bajpeyi S. Four weeks of electrical stimulation improves glucose tolerance in a sedentary overweight or obese Hispanic population. Endocr Connect 2022; 11:e210533. [PMID: 35007207 PMCID: PMC8859936 DOI: 10.1530/ec-21-0533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 11/08/2022]
Abstract
Introduction/purpose Most US adults (54%) do not meet the minimum exercise recommendations by the American College of Sports Medicine. Neuromuscular electrical stimulation (NMES) is a novel alternate strategy to induce muscle contraction. However, the effectiveness of NMES to improve insulin sensitivity and energy expenditure is unclear. The purpose of this study was to investigate the effects of 4 weeks of NMES on glucose tolerance in a sedentary overweight or obese population. Methods Participants (n = 10; age: 36.8 ± 3.8 years; BMI = 32 ± 1.3 kg/m2) were randomized into either control or NMES group. All participants received bilateral quadriceps stimulation (12 sessions; 30 min/session; three times/week at 50 Hz and 300 µs pulse width) altering pulse amplitude to either provide low-intensity sensory level (control; tingling sensation) or at high-intensity neuromuscular level (NMES; maximum tolerable levels with visible muscle contraction). Glucose tolerance was assessed by a 3-h oral glucose tolerance test (OGTT), and substrate utilization was measured by indirect calorimetry and body composition via dual X-ray absorptiometry at baseline and after 4 weeks of NMES intervention. Results Control and NMES groups had comparable fasting blood glucose, glucose tolerance, substrate utilization, and muscle mass at baseline. Four weeks of NMES resulted in a significant improvement in glucose tolerance measured by OGTT, whereas no change was observed in the control group. There was no change in substrate utilization and muscle mass in both control and NMES groups. Conclusion NMES is a novel and effective strategy to improve glucose tolerance in an at-risk overweight or obese sedentary population.
Collapse
Affiliation(s)
- Michelle J Galvan
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
| | - Michael J Sanchez
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
| | - Andrew J McAinch
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, Victoria, Australia
| | - Jeffrey D Covington
- Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Jason B Boyle
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
| | - Sudip Bajpeyi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
| |
Collapse
|