Effects of Whole-Body Electromyostimulation on Low Back Pain in People with Chronic Unspecific Dorsal Pain: A Meta-Analysis of Individual Patient Data from Randomized Controlled WB-EMS Trials

Acute Compartment Syndrome and Rhabdomyolysis Caused by a Single Electrical Muscle Stimulation in a 46-Year-Old Female Professional Athlete With Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Disorder: A Case Report

ABSTRACT

Electrical muscle stimulation (EMS) training has been recognized as an effective modality for improving body composition, enhancing body strength, and facilitating injury recovery. However, individuals who are new to EMS training and those with certain chronic diseases should exercise caution due to the increased risk of rhabdomyolysis. This case report describes the occurrence of rhabdomyolysis and gluteal compartment syndrome following a single session of EMS training in a 46-year-old Caucasian female professional athlete. The patient was successfully managed with intensive intravenous fluid therapy and sodium bicarbonate supplementation, along with close monitoring of electrolytes and renal function. Electrical muscle stimulation training poses an increased risk of severe complications in individuals with chronic diseases and myopathy. Therefore, careful subject selection is required for EMS training in individuals with chronic diseases and myopathy to prevent common side effects. For individuals trying EMS training for the first time, it is recommended to avoid high-frequency EMS exercises.

Effects of 12 weeks of neuromuscular electrical stimulation of the quadriceps muscles on the function and physio-biochemical traits in functionally fit female nursing-home residents aged 75 + years: a pilot study

PURPOSE

Muscular changes induced by neuromuscular electrical stimulation (NMES) are well recognized, but knowledge of how NMES influences the physio-biochemical traits of the oldest old is still limited. This study investigated the effect of NMES applied for 12 weeks to the quadriceps muscles of female nursing-home residents aged 75 + on their functional capability and inflammatory, bone metabolism, and cardiovascular traits.

METHODS

Nineteen women regularly taking part in two body conditioning sessions per week were randomized into an electrical stimulation group (ES; n = 10; 30 min sessions, 3 times per week) or a control group (CON; n = 9). At baseline and study week 12, all women performed the 30 s chair stand test (30sCST), the 6-minute walk test (6MWT), and the instrumented timed up and go test (iTUG). Resting heart rates, blood pressure, and the blood concentrations of inflammatory and bone metabolism markers were also measured twice.

RESULTS

NMES increased the strength of participants' quadriceps muscles and their performance on the 30sCST and 6MWT while lowering resting arterial blood pressure and inflammatory marker levels; osteoclast activity showed a tendency to decrease. Changes in the iTUG results were not observed. A multiple regression analysis found that the results of functional tests in the ES group were best correlated with pulse pressure (the 30sCST and iTUG tests) and diastolic blood pressure (the 6MWT test).

CONCLUSION

Twelve weeks of NMES treatment improved participants' functional capacity and inflammatory, bone metabolism, and cardiovascular traits. The ES group participants' performance on functional tests was best predicted by hemodynamic parameters.

Acute Effects of Whole-Body Electrostimulation Combined with Stretching on Lower Back Pain

Data from recent studies suggest that whole-body electromyostimulation (WB-EMS) is a time-effective and tailored intervention for chronic lower back pain (CLBP). The aim of this non-randomized controlled study was to compare the efficacy of a WB-EMS training and the association between WB-EMS specific training with passive stretching (Well Back System, [WBS]) on CLBP. Forty patients with CLBP, 43-81 years old, were assigned to one of the two groups: WB-EMS (n=20) and WB-EMS+WBS (n=20). Both groups completed 12 sessions (8 weeks) of the WB-EMS protocol (2×20 minutes/week). The second group performed core-specific exercises with WB-EMS plus 6 extra stretching sessions (30 minutes each). Primary study endpoints were based on changes on the visual analogue scale (VAS) and changes on the Oswestry Low Back Disability Questionnaire (ODI). Secondary study endpoints were percentage changes of maximum trunk flexion (Sit & Reach, [SR]) and changes in consumption of painkillers. Both interventions significantly improved VAS, ODI, and SR values (p range: 0.04;<0.001). However, the change of VAS (-46% vs. -17%, p<0.001), ODI (-53% vs. -17%, p<0.001), and SR (+ 7 vs.+3 cm, p=0.001) were significantly higher in the WB-EMS+WBS group compared to the WB-EMS group. The working method with WB-EMS+WBS can be a joint-friendly, individualized form to decrease CLBP.

Profile of Whole Body Electromyostimulation Training Users-A Pilot Study

(1) Introduction: Whole Body Electromyostimulation is a technological and time efficient personal training practiced all over the world. With the increase of practitioners in the last 10 years, the need to study more about practitioners has arisen, so this pilot study aims to trace a user profile of this method through the analysis of socio-demographic data for a better understand of the profile of people looking for this type of training to improve the effectiveness of the intervention and develop programs that are in accordance with the motivation of practitioners. (2) Methods: 270 users from 5 countries answered an online questionnaire with socio-demographic questions. Data were treated using descriptive statistics. Possible differences between sexes and between groups were analyzed by means of non-parametric statistical tests: Mann−Whitney U-test (continuous variables); in addition to studying possible dependence relationships and differences between proportions, using the Chi-square statistic with pairwise z-test using the Bonferroni correction (categorical variables). (3) Results: Middle-aged women are the main user of this type of training. The majority of WB-EMS users do another type of physical activity with significant difference between men and woman (p < 0.05) men are more active than women. Weight loss, health and wellness and muscle mass increase are the main goals of the WB-EMS users. There are significant differences in weight loss and rehabilitation between genders (p < 0.05). Women look much more than men to lose weight and men look more than women to rehabilitation. (4) Conclusions: The user profile is a physically active woman, aged 35−49 years, with normal weight and high educational level, who carries out twice weekly full body electrostimulation training with the goals of weight loss, health and/or wellness and muscle mass gain.

Psychological Effects of Whole-body Electromyostimulation Training: a Controlled Pilot Study in Healthy Volunteers

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.

Once-Weekly Whole-Body Electromyostimulation Increases Strength, Stability and Body Composition in Amateur Golfers. A Randomized Controlled Study

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.

Similar Pain Intensity Reductions and Trunk Strength Improvements Following Whole-Body Electromyostimulation vs. Whole-Body Vibration vs. Conventional Back-Strengthening Training in Chronic Non-specific Low Back Pain Patients: A Three-Armed Randomized Controlled Trial

The aim of this multicenter trial was to compare the effects of whole-body electromyostimulation (WB-EMS) and whole-body vibration (WBV) with conventional back-strengthening training (CT) on changes in mean back pain intensity (MPI) and trunk strength in patients suffering from chronic non-specific low back pain (CNLBP). Two-hundred and forty CNLBP patients (40–70 years; 62% female) were randomly assigned to three intervention arms (WB-EMS: n = 80 vs. WBV: n = 80 vs. CT: n = 80). All training intervention programs were performed for 12 weeks in their usual commercial training setting. Before and during the last 4 weeks of the intervention, MPI was recorded using a 4-week pain diary. Additionally, maximal isometric trunk extension and -flexion strength was assessed on the BackCheck® machine. A moderate but significant decrease of MPI was observed in all groups (WB-EMS: 29.7 ± 39.1% (SMD 0.50) vs. WBV: 30.3 ± 39.3% (SMD 0.57) vs. CT: 30.5 ± 39.6% (SMD 0.59); p < 0.001). Similar findings were observed for maximal isometric strength parameters with a significant increase in all groups (extension: WB-EMS: 17.1 ± 25.5% vs. WBV: 16.2 ± 23.6% vs. CT: 21.6 ± 27.5%; p < 0.001; flexion: WB-EMS: 13.3 ± 25.6% vs. WBV: 13.9 ± 24.0% vs. CT: 13.9 ± 25.4%; p < 0.001). No significant interaction effects for MPI (p = 0.920) and strength parameters (extension: p = 0.436; flexion: p = 0.937) were observed. WB-EMS, WBV, and CT are comparably effective in improving MPI and trunk strength. However, training volume of WB-EMS was 43 or 62% lower, compared with CT and WBV.

Effects of Whole Body Electrostimulation Associated With Body Weight Training on Functional Capacity and Body Composition in Inactive Older People

Objective: To analyze the effects of whole body electrostimulation (WB-EMS) with body weight training on functional fitness and body composition of older men.

Methods: Twenty physically inactive older men were randomized into: Control group (control), performed the body weight exercise training wearing electrostimulation clothing, but without receiving electrical current stimuli (n = 10), and body weight associated with whole body electrostimulation group (BW+WB-EMS), performed the body weight exercise training wearing electrostimulation clothing plus whole body electrostimulation (n = 10). The training sessions were performed twice a week for 6 weeks and included eight exercises using body weight, performed in two sets of eight repetitions. Physical function was assessed using a battery composed of seven tests, six derived from the Senior fitness test and a handgrip strength test. We also measured the muscle thickness (MT) of the biceps and triceps brachii and vastus lateralis.

Results: The BW+WB-EMS group presented increased (p < 0.05) performance in the 30-s chair stand test (10.2 ± 3.3 vs. 13.8 ± 5.0 reps), arm curl (16.6 ± 3.9 vs. 19.9 ± 6.1 reps), 6-min walk test (402 ± 96 vs. 500 ± 104 m), and handgrip strength test (30 ± 11 vs. 32 ± 11 kgf). The BW+WB-EMS group also presented increased MT (p < 0.05) in the biceps brachii (17.7 ± 3.0 vs. 21.4 ± 3.4 mm), triceps brachial (14.7 ± 3.6 vs. 17.5 ± 4.1 mm), and vastus lateralis muscles (15.1 ± 2.6 vs. 18.6 ± 4.3 mm). Moderate correlations were found in arm curl (p = 0.011, r = 0.552) but not handgrip strength (p = 0.053, r = 0.439) with changes in the biceps MT. Moderate changes in the 6-min walk distance were significantly correlated with changes in vastus lateralis MT (p = 0.036, r = 0.471). There was a moderate correlation between the changes in the 30-s chair stand test (p = 0.006, r = 0.589) and changes in the vastus lateralis MT. Furthermore, although a moderate correlation (r = 0.438) was found between triceps MT and handgrip strength no significant difference (p = 0.053) was reported. Additionally, there were no statistical differences in any parameters for the control group.

Conclusion: WB-EMS with body weight training increased functional fitness and MT in physically inactive older men.

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

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.

Comparison of Whole-Body Electromyostimulation versus Recognized Back-Strengthening Exercise Training on Chronic Nonspecific Low Back Pain: A Randomized Controlled Study

Background

Low back pain (LBP) affects almost everyone at least once in their lifetime. Various meta-analyses show promising effects on pain reduction for conventional exercise. However, the lack of time and, especially for pain patients, a fear of movement (“kinesiophobia”) as well as functional limitations often oppose participation in such activities. In contrast, the advantage of novel training technologies like whole-body electromyostimulation (WB-EMS) lies particularly in a joint-friendly, time-effective, and highly customized training protocol and might be an alternative option for LBP patients. A meta-analysis of individual patient data and a comparison of WB-EMS against a passive control group confirmed the proof principle. Thus, the aim of this randomized controlled trial is to compare WB-EMS with a recognized back-strengthening exercise protocol to determine the corresponding effects on chronic, nonspecific LBP in people suffering from this.

Methods and Findings

This randomized, controlled multicenter study is focused on novel and time-effective training technologies and LBP. In this contribution, the focus is primarily on the comparison of WB-EMS against a comparable conventional exercise training (CT). One hundred ten nonspecific chronic LBP patients, 40–70 years old, were randomly allocated to the intervention arms (WB-EMS: 55 vs. CT: 55). Both groups completed a 12-week program (WB-EMS: 1 × 20 min/week vs. CT: 1 × 45 min/week) specifically dedicated to LBP. The selection of the content of the active control group was based on the principles of WB-EMS training, which uses electrical stimulation to train mainly strength and stabilization in a very short time. Exercises were similar in all groups, with the focus on strengthening and stabilizing the trunk. Outcome measures were assessed by a four-week pain diary (before and during the last four weeks of intervention) as well as an isometric maximum strength measurement of the trunk muscles at baseline and after 12 weeks of intervention. Primary study endpoint was average pain intensity at the lumbar spine. Secondary study endpoints were maximum isometric strength of the back and the abdominals. The mean pain intensity of LBP decreased significantly in both groups (WB-EMS: −22.3 ± 20.9% vs. CT: −30.2 ± 43.9%; p < 0.001), however, without significant intergroup difference (p=0.160). A similar result was observed for “maximum isometric strength of trunk muscles.” The increase in back strength (WB-EMS: 15.6 ± 24.9% vs. CT: 23.0 ± 30.9%) was highly significant in both groups (p=0.001), and similar changes were observed for the trunk flexors (WB-EMS: 17.6 ± 24.8% vs. CT: 18.1 ± 24.8%). Also, at the secondary endpoint, no significant difference in pairwise comparison was observed in both cases (extension: p=0.297; flexion: p=0.707).

Conclusion

In summary, both, WB-EMS and conventional back-strengthening protocol are comparably effective in reducing nonspecific chronic LBP in this dedicated cohort. The result is particularly positive in terms of time effectiveness and offers an adequate alternative for people with limited time resources or other barriers to conventional training methods.

The Influence of WB-EMS-Training on the Performance of Ice Hockey Players of Different Competitive Status

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.

The Impact of Whole-Body Electromyostimulation on Body Posture and Trunk Muscle Strength in Untrained Persons

Muscular imbalances of the trunk muscles are held responsible for changes in body posture. At the same time, whole-body electromyostimulation (WB-EMS) has been established as a new training method that enables simultaneous stimulation of many muscle groups. This study was aiming to analyze if a 10 weeks WB-EMS training changes posture-relevant parameters and/or improves isometric strength of the trunk extensors and flexors, and if there are differences based on stimulation at 20 Hz and 85 Hz. Fifty eight untrained adult test persons were divided into three groups (control, CON; training with 20 Hz stimulation, TR20; training with 85 Hz, TR85). Anthropometric parameters, trunk extension and flexion forces and torques, and posture parameters were determined before (n = 58) and after (n = 53: CON: n = 15, TR20: n = 19, TR85: n = 19) a 10 weeks WB-EMS training program (15 applications, 9 exercises). Differences between the groups were calculated for pre- and post-tests using univariate ANOVA and between the test times using repeated (2 × 3) ANOVA. Comparisons of pairs were calculated post hoc based on Fisher (LSD). No differences between the groups were found for the posture parameters. The post hoc analysis of both trunk flexion and trunk extension forces and torques showed a significant difference between the groups TR85 and CON but no difference between the other group pairs. A 10 weeks whole-body electrostimulation training with a stimulation frequency of 85 Hz in contrast to training with a stimulation frequency of 20 Hz improves the trunk muscle strength of an untrained group but does not significantly change posture parameters.

Effects of whole-body ELECTROMYOSTIMULATION on health and performance: a systematic review

BACKGROUND

Whole-body electrical myostimulation (WB-EMS) is a relatively recent training methodology that has been extraordinarily used in recent years. However, there is a lack of consensus on the effectiveness of WB-EMS in the situations in which its use has been largely popularized. The objective of this systematic review was to determine the effects produced by WB-EMS.

METHODS

A search of PubMed, Web of Science, Scopus and Cochrane was performed to identify all the studies that have applied electrical stimulation in lower and upper limbs simultaneously and that have clearly presented their protocols for the training and application of the stimulation. The last search was performed on September 9, 2018. Studies written in English or German were included.

RESULTS

A total of 21 articles met the inclusion criteria and were analyzed following the guidelines of the Cochrane Guide for Systematic Reviews. Nineteen studies analyzed the chronic effects of WB-EMS, and 2 analyzed acute effects with a total of 505 subjects (310 men and 195 women). In total, 35% were moderately trained, and 65% were sedentary subjects. Different dependent variables were studied, such as anthropometric parameters, strength parameters, energy expenditure, psychophysiological parameters and blood parameters. There is a lack of randomized controlled studies, and the studies included exhibit a moderate to high level of risk of bias.

CONCLUSIONS

Given the limited number of available studies on WB-EMS, the scarce amount of scientific evidence found does not allow definitive conclusions about its effects; therefore, future studies about WB-EMS are necessary.

Effects of whole-body electromyostimulation on chronic nonspecific low back pain in adults: a randomized controlled study

Purpose

Low back pain (LBP) is one of the most frequent chronic conditions worldwide. Data from a recent meta-analysis indicated that whole-body electromyostimulation (WB-EMS), a time-effective, joint-friendly, and highly individualized training technology, demonstrated promising effects on LBP; however, methodologic limitations prevent definitive evidence for this result. Thus, the aim of this study was to conduct a randomized controlled WB-EMS trial to determine the corresponding effect on chronic, nonspecific LBP in people with chronic LBP.

Patients and methods

Thirty LBP patients, 40-70 years old, were randomly assigned into two groups (WB-EMS: 15; control [CG]: 15). While the nonactive CG maintained their lifestyle, the WB-EMS group completed a 12-week WB-EMS protocol (1×20 min/week) with slight movements, specifically dedicated to LBP. Pain intensity and frequency were determined by a 4-week pain diary before and during the last 4 weeks of intervention. Primary study endpoint was average pain intensity at the lumbar spine.

Results

At baseline, no group differences apart from nonregular exercise were observed. Mean intensity of LBP decreased significantly in the WB-EMS group (P=0.002) and remained unchanged in the CG (P=0.730), with a significant difference between both groups (P=0.027). Maximum isometric trunk extensors improved significantly in the WB-EMS group (P=0.005), while no significant difference was seen in the CG (P=0.683). In contrast to the significant difference between WB-EMS group and CG for the latter parameter (P=0.038), no intergroup difference was determined for maximum isometric trunk flexors (P=0.091). The WB-EMS group showed a significant increase of this parameter (P=0.003), while no significant change was determined in the CG (P=0.563).

Conclusion

WB-EMS is a time-effective training method for reducing chronic nonspecific LBP and increasing maximum trunk strength in people with such complaints. After this promising comparison with a nonactive CG, research needs to be extended to include comparisons with active groups (WB-Vibration, conventional back strengthening).

Efficacy and Safety of Low Frequency Whole-Body Electromyostimulation (WB-EMS) to Improve Health-Related Outcomes in Non-athletic Adults. A Systematic Review

Exercise positively affects most risk factors, diseases and disabling conditions of middle to advanced age, however the majority of middle-aged to older people fall short of the exercise doses recommended for positively affecting cardio-metabolic, musculoskeletal and neurophysiological fitness or disabling conditions. Whole-Body Electromyostimulation (WB-EMS) may be a promising exercise technology for people unable or unmotivated to exercise conventionally. However, until recently there has been a dearth of evidence with respect to WB-EMS-induced effects on health-related outcomes. The aim of this systematic review is to summarize the effects, limitations and risks of WB-EMS as a preventive or therapeutic tool for non-athletic adults. Electronic searches in PubMed, Scopus, Web of Science, PsycINFO, Cochrane and Eric were run to identify randomized controlled trials, non-randomized controlled trials, meta-analyses of individual patient data and peer reviewed scientific theses that examined (1) WB-EMS-induced changes of musculoskeletal risk factors and diseases (2) WB-EMS-induced changes of functional capacity and physical fitness (3) WB-EMS-induced changes of cardio-metabolic risk factors and diseases (4) Risk factors of WB-EMS application and adverse effects during WB-EMS interventions. Two researchers independently reviewed articles for eligibility and methodological quality. Twenty-three eligible research articles generated by fourteen research projects were finally included. In summary, thirteen projects were WB-EMS trials and one study was a meta-analysis of individual patient data. WB-EMS significantly improves muscle mass and function while reducing fat mass and low back pain. Although there is some evidence of a positive effect of WB-EMS on cardio-metabolic risk factors, this aspect requires further detailed study. Properly applied and supervised, WB-EMS appears to be a safe training technology. In summary, WB-EMS represents a safe and reasonable option for cohorts unable or unwilling to join conventional exercise programs. However, much like all other types of exercise, WB-EMS does not affect every aspect of physical performance and health.