1
|
Hasan A, Moustafa I, Shousha T. Effect of Russian current expert modes on quadriceps muscle torque in healthy adults: A single-blinded randomized controlled trial. PLoS One 2024; 19:e0297136. [PMID: 38271360 PMCID: PMC10810422 DOI: 10.1371/journal.pone.0297136] [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: 10/11/2023] [Accepted: 12/25/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Russian current (RC), a well-known neuromuscular electrical stimulation operating at 2500 Hz, has demonstrated significant strength improvement over traditional exercises due to its high tolerance and low pain provocation. Despite extensive NMES parameter research, the specific effects of expert modes, particularly ON2 and Rest, remain unexplored. This study investigates the direct effect of these expert modes on quadriceps muscle strength in healthy adults. METHODS This is a single-blind, randomization-controlled trial. Forty-eight healthy university students (31 females, 17 males) were assigned in two randomized experimental groups either the ON2 or Rest mode for a 15-minute electrical stimulation session. Quadriceps maximum voluntary isokinetic contraction measurements were taken before and directly after RC application using Biodex Medical Systems 4 pro isokinetic dynamometer. RESULTS Both RC modes significantly increased the quadriceps muscle torque in healthy adults compared to baseline (p<0.05). Baseline mean torque was 123.28 (SD = 38.8), and post- RC mean torque was 136.67 (SD = 45.76). Deviation from normality was observed at baseline (p = 0.034) and persisted post-RC application (p = 0.017). The Wilcoxon test reported significant increases in quadriceps muscle knee torque for both ON2 and Rest groups (p < 0.001). The lack of ties in ranks and negative Z-values highlight the robustness of the observed effects. CONCLUSION The findings of this study align with previous research on NMES and RC supporting the idea that electrical stimulation enhances muscle strength, selecting the appropriate RC expert modes can assist physiotherapist in tailoring rehabilitation program to achieve their specific strength goals.
Collapse
Affiliation(s)
- Ansam Hasan
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
| | - Ibrahim Moustafa
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
- Neuromusculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Tamer Shousha
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
- Neuromusculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- University of Sharjah Center of Excellence for Healthy Aging, Sharjah, UAE
- Healthy Aging, Longevity and Sustainability Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Uwamahoro R, Sundaraj K, Feroz FS. Effect of Forearm Postures and Elbow Joint Angles on Elbow Flexion Torque and Mechanomyography in Neuromuscular Electrical Stimulation of the Biceps Brachii. SENSORS (BASEL, SWITZERLAND) 2023; 23:8165. [PMID: 37836995 PMCID: PMC10575078 DOI: 10.3390/s23198165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 10/15/2023]
Abstract
Neuromuscular electrical stimulation plays a pivotal role in rehabilitating muscle function among individuals with neurological impairment. However, there remains uncertainty regarding whether the muscle's response to electrical excitation is affected by forearm posture, joint angle, or a combination of both factors. This study aimed to investigate the effects of forearm postures and elbow joint angles on the muscle torque and MMG signals. Measurements of the torque around the elbow and MMG of the biceps brachii (BB) muscle were conducted in 36 healthy subjects (age, 22.24 ± 2.94 years; height, 172 ± 0.5 cm; and weight, 67.01 ± 7.22 kg) using an in-house elbow flexion testbed and neuromuscular electrical stimulation (NMES) of the BB muscle. The BB muscle was stimulated while the forearm was positioned in the neutral, pronation, or supination positions. The elbow was flexed at angles of 10°, 30°, 60°, and 90°. The study analyzed the impact of the forearm posture(s) and elbow joint angle(s) on the root-mean-square value of the torque (TQRMS). Subsequently, various MMG parameters, such as the root-mean-square value (MMGRMS), the mean power frequency (MMGMPF), and the median frequency (MMGMDF), were analyzed along the longitudinal, lateral, and transverse axes of the BB muscle fibers. The test-retest interclass correlation coefficient (ICC21) for the torque and MMG ranged from 0.522 to 0.828. Repeated-measure ANOVAs showed that the forearm posture and elbow flexion angle significantly influenced the TQRMS (p < 0.05). Similarly, the MMGRMS, MMGMPF, and MMGMDF showed significant differences among all the postures and angles (p < 0.05). However, the combined main effect of the forearm posture and elbow joint angle was insignificant along the longitudinal axis (p > 0.05). The study also found that the MMGRMS and TQRMS increased with increases in the joint angle from 10° to 60° and decreased at greater angles. However, during this investigation, the MMGMPF and MMGMDF exhibited a consistent decrease in response to increases in the joint angle for the lateral and transverse axes of the BB muscle. These findings suggest that the muscle contraction evoked by NMES may be influenced by the interplay between actin and myosin filaments, which are responsible for muscle contraction and are, in turn, influenced by the muscle length. Because restoring the function of limbs is a common goal in rehabilitation services, the use of MMG in the development of methods that may enable the real-time tracking of exact muscle dimensional changes and activation levels is imperative.
Collapse
Affiliation(s)
- Raphael Uwamahoro
- Fakulti Kejuruteraan Elektronik dan Kejuruteraan Komputer, Universiti Teknikal Malaysia Melaka, Durian Tunggal 76100, Melaka, Malaysia; (R.U.); (F.S.F.)
- Regional Centre of Excellence in Biomedical Engineering and e-Health, University of Rwanda, Kigali P.O. Box 4285, Rwanda
| | - Kenneth Sundaraj
- Fakulti Kejuruteraan Elektronik dan Kejuruteraan Komputer, Universiti Teknikal Malaysia Melaka, Durian Tunggal 76100, Melaka, Malaysia; (R.U.); (F.S.F.)
| | - Farah Shahnaz Feroz
- Fakulti Kejuruteraan Elektronik dan Kejuruteraan Komputer, Universiti Teknikal Malaysia Melaka, Durian Tunggal 76100, Melaka, Malaysia; (R.U.); (F.S.F.)
| |
Collapse
|
4
|
Borzuola R, Nuccio S, Scalia M, Parrella M, Del Vecchio A, Bazzucchi I, Felici F, Macaluso A. Adjustments in the motor unit discharge behavior following neuromuscular electrical stimulation compared to voluntary contractions. Front Physiol 2023; 14:1212453. [PMID: 37324379 PMCID: PMC10267458 DOI: 10.3389/fphys.2023.1212453] [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: 04/26/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction: The application of neuromuscular electrical stimulation superimposed on voluntary muscle contractions (NMES+) has demonstrated a considerable potential to enhance or restore muscle function in both healthy and individuals with neurological or orthopedic disorders. Improvements in muscle strength and power have been commonly associated with specific neural adaptations. In this study, we investigated changes in the discharge characteristics of the tibialis anterior motor units, following three acute exercises consisting of NMES+, passive NMES and voluntary isometric contractions alone. Methods: Seventeen young participants participated in the study. High-density surface electromyography was used to record myoelectric activity in the tibialis anterior muscle during trapezoidal force trajectories involving isometric contractions of ankle dorsi flexors with target forces set at 35, 50% and 70% of maximal voluntary isometric contraction (MVIC). From decomposition of the electromyographic signal, motor unit discharge rate, recruitment and derecruitment thresholds were extracted and the input-output gain of the motoneuron pool was estimated. Results: Global discharge rate increased following the isometric condition compared to baseline at 35% MVIC while it increased after all experimental conditions at 50% MVIC target force. Interestingly, at 70% MVIC target force, only NMES + led to greater discharge rate compared to baseline. Recruitment threshold decreased after the isometric condition, although only at 50% MVIC. Input-output gain of the motoneurons of the tibialis anterior muscle was unaltered after the experimental conditions. Discussion: These results indicated that acute exercise involving NMES + induces an increase in motor unit discharge rate, particularly when higher forces are required. This reflects an enhanced neural drive to the muscle and might be strongly related to the distinctive motor fiber recruitment characterizing NMES+.
Collapse
Affiliation(s)
- Riccardo Borzuola
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Stefano Nuccio
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Martina Scalia
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Martina Parrella
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Alessandro Del Vecchio
- Department Artificial Intelligence in Biomedical Engineering, Faculty of Engineering, Zentralinstitut für Medizintechnik (ZIMT), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Ilenia Bazzucchi
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Francesco Felici
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| |
Collapse
|
5
|
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.
Collapse
|
6
|
Sumin AN, Oleinik PA, Bezdenezhnykh AV, Bezdenezhnykh NA. Prehabilitation in Cardiovascular Surgery: The Effect of Neuromuscular Electrical Stimulation (Randomized Clinical Trial). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2678. [PMID: 36768044 PMCID: PMC9916173 DOI: 10.3390/ijerph20032678] [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: 11/08/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE We aimed to determine the effects of prehabilitation with neuromuscular electrical stimulation (NMES) on muscle status and exercise capacity in patients before cardiac surgery. METHODS Preoperative elective cardiac surgery patients were randomly assigned to the NMES group or control group. Intervention in the NMES group was 7-10 sessions, whereas the control group carried out breathing exercises and an educational program. The outcome measures included a six-minute walk test (6MWT) and a muscle status assessment (knee extensor strength (KES), knee flexor strength (KFS), and handgrip strength (HS)) after the course of prehabilitation. RESULTS A total of 122 patients (NMES, n = 62; control, n = 60) completed the study. During the NMES course, no complications occurred. After the course prehabilitation KES, KFS, and 6MWT distance were significantly increased (all p < 0.001) in the NMES group compared to the control. There was no significant difference in HS before surgery. CONCLUSIONS A short-term NMES course before cardiac surgery is feasible, safe, and effective to improve preoperative functional capacity (six-minute walk distance) and the strength of stimulated muscles.
Collapse
Affiliation(s)
- Alexey N. Sumin
- Correspondence: ; Tel.: +7-(3842)-64-33-08 or +7-9039-40-86-68; Fax: (3842)-64-34-10
| | | | | | | |
Collapse
|
7
|
Effect of Superimposed Russian Current on Quadriceps Strength and Lower-Extremity Endurance in Healthy Males and Females. J Sport Rehabil 2023; 32:46-52. [PMID: 35894893 DOI: 10.1123/jsr.2021-0437] [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: 12/08/2021] [Revised: 05/12/2022] [Accepted: 05/28/2022] [Indexed: 01/03/2023]
Abstract
CONTEXT More studies are needed to compare the effect of voluntary contraction, electrical stimulation, and electrical stimulation superimposed onto voluntary contraction in improving trained and untrained homolog muscle strength and lower-extremity endurance. DESIGN Seventy-six healthy young adults (age = 20.41 [3.07] y, 61 females and 15 males) were included in the study. Subjects were randomly divided into 3 groups as voluntary isometric contraction (IC) group, Russian current (RC) group, and superimposed Russian current (SRC) group. METHODS All training regimens were performed under physiotherapist supervision for a total of 18 sessions (3 times per week for 6 wk). In each session, 10 ICs were achieved with voluntary isometric exercise only, RC only, or RC superimposed onto ICs. Main outcome measures were trained and untrained quadriceps strength (maximal voluntary isometric contraction [MVIC]) and lower-extremity endurance (sit-to-stand test). RESULTS After 6 weeks of training, all outcome measures improved in all groups (P < .05), except the untrained quadriceps MVIC score of RC group (P = .562). The trained quadriceps MVIC score (P < .001, η2 = .478), untrained quadriceps MVIC score (P = .011, η2 = .115), and sit-to-stand test score (P < .001, η2 = .357) differed significantly among the 3 groups; post hoc analysis revealed that the trained quadriceps MVIC score was higher in SRC and RC groups than in the IC group, untrained quadriceps MVIC score was higher in SRC group than in the RC group, and sit-to-stand test score was higher in SRC group than in the RC group and IC group. CONCLUSIONS RC and RC superimposed onto IC are superior to IC in improving quadriceps muscle strength, and RC superimposed onto IC is superior to RC and IC in improving lower-extremity endurance. RC superimposed onto IC and voluntary IC created cross-education effect on untrained quadriceps.
Collapse
|
8
|
Happ KA, Behringer M. Neuromuscular Electrical Stimulation Training vs. Conventional Strength Training: A Systematic Review and Meta-Analysis of the Effect on Strength Development. J Strength Cond Res 2022; 36:3527-3540. [PMID: 34417404 DOI: 10.1519/jsc.0000000000004119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Happ, KA, and Behringer, M. Neuromuscular electrical stimulation Training vs. conventional strength training: a systematic review and meta-analysis of the effect on strength development. J Strength Cond Res 36(12): 3527-3540, 2022-A systematic review of the current state of literature and a meta-analysis were conducted to compare the strength development between neuromuscular electrical stimulation (NMES) and conventional strength training when training volume is matched. Searches of PubMed and several other databases were conducted for studies that met the following primary inclusion criteria: randomized studies of >20 days duration with a sample size of >4 subjects in each group ("voluntary contraction" [VC] and "electrically stimulated" [ES]) conducted with percutaneous stimulation only in healthy individuals at equal training volume. Finally, a total of 19 studies were included in the analysis. When comparing strength gains between groups (ES-VC), no favorable effect toward a training method could be observed (0.023 hg [95% CI: -0.198 to 0.246, p = 0.836]). Subgroup analyses were performed based on the application type (NMES evoked and NMES onto voluntary contractions) and stimulation frequency. Both analyses revealed no favorable effect and significant difference of groups (significance level set at 0.05). A meta-regression evaluated the relationship between stimulation frequency and effect size difference. The regression showed a tendency of higher stimulation frequencies being associated with higher study effect size differences (predicted effect size = -0.599 + 0.008 (Hz) ( p = 0.176)). The findings indicate that training with NMES results in virtually identical strength gains compared with conventional strength training when training volume is matched. If training with NMES is preferred, the stimulation frequency type (regular or Burst Mode Alternating Current) can be chosen according to preference without loss of effectiveness.
Collapse
Affiliation(s)
- Kevin A Happ
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
| | | |
Collapse
|
9
|
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.
Collapse
|
10
|
Micke F, Held S, Lindenthal J, Donath L. Effects of electromyostimulation on performance parameters in sportive and trained athletes: A systematic review and network meta-analysis. Eur J Sport Sci 2022:1-11. [PMID: 35913269 DOI: 10.1080/17461391.2022.2107437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This systematic review and network meta-analysis aimed to evaluate the effectiveness of different electromyostimulation (EMS) training interventions on performance parameters in trained athletes. The research was conducted until may 2021 using the online databases PubMed, Web of Science, Cochrane and SPORTDiscus for studies with the following inclusion criteria: (a) controlled trials, (b) EMS trials with at least one exercise and/or control group, (c) strength and/or jump and/or sprint and/or aerobic capacity parameter as outcome (d) sportive/trained subjects. Standardized mean differences (SMD) with 95% confidence interval (CI) and random effects models were calculated. Thirty-six studies with 1.092 participants were selected and 4 different networks (strength, jump, sprint, aerobic capacity) were built. A ranking of different exercise methods was achieved. The highest effects for pairwise comparisons against the reference control "active control" were found for a combination of resistance training with superimposed EMS and additional jump training (outcome strength: 4.43 SMD [2.15; 6.70 CI]; outcome jump: 3.14 SMD [1.80;4.49]), jump training with superimposed whole-body electromyostimulation (WB-EMS) (outcome sprint: 1.65 SMD [0.67; 2.63 CI] and high intensity bodyweight resistance training with superimposed WB-EMS (outcome aerobic capacity: 0.83 SMD [-0.49; 2.16 CI]. These findings indicate that the choice of EMS-specific factors such as the EMS application mode, the combination with voluntary activation, and the selection of stimulation protocols has an impact on the magnitude of the effects and should therefore be carefully considered, especially in athletes. Superimposed EMS with relatively low volume, high intensity and outcome-specific movement pattern appeared to positively influence adaptations in athletes.
Collapse
Affiliation(s)
- Florian Micke
- German Sport University Cologne, Department of Intervention Research in Exercise Training
| | - Steffen Held
- German Sport University Cologne, Department of Intervention Research in Exercise Training
| | - Jessica Lindenthal
- German Sport University Cologne, Department of Intervention Research in Exercise Training
| | - Lars Donath
- German Sport University Cologne, Department of Intervention Research in Exercise Training
| |
Collapse
|
11
|
Borzuola R, Laudani L, Labanca L, Macaluso A. Superimposing neuromuscular electrical stimulation onto voluntary contractions to improve muscle strength and mass: a systematic review. Eur J Sport Sci 2022:1-13. [PMID: 35856620 DOI: 10.1080/17461391.2022.2104656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Training and rehabilitation programs involving neuromuscular electrical stimulation superimposed onto voluntary contractions (NMES+) have gained popularity in the last decades. Yet, there is no clear consensus on the effectiveness of such intervention. The aim of this review was to evaluate the effect of chronic exposure to NMES+ on muscle strength and mass compared to conventional volitional training or passive electrical stimulation alone. Two authors conducted an electronic search to identify randomized controlled trials that investigated the effect of NMES+ training, involved healthy participants or orthopaedic patients, detailed a well-defined NMES training protocol, and provided outcomes related to skeletal-muscle strength and/or mass. The authors extracted data on participants, intervention characteristics, muscle-related outcomes, and assessed the methodological quality of the studies.A total of twenty-four studies were included in the review. The majority of these reported an increase in muscle strength following training with NMES+ compared to an equivalent voluntary training or passive NMES training. The highest improvements were found when NMES was superimposed on sub-maximal exercises involving both concentric and eccentric contractions. Only two studies reported an increase in muscle mass after NMES+ intervention, while no significant improvements were found in two other studies.This review indicated that chronic exposure to NMES+ determines muscle strength improvements greater or equal compared to volitional training alone. However, differences in the methodological characteristics of the stimulation and the type of exercise associated with NMES+, revealed significant discrepancies in the results. A deeper understanding of the neurophysiological adaptations to NMES+ is crucial to fully explain the muscle-related enhancement resulting from such intervention.
Collapse
Affiliation(s)
- Riccardo Borzuola
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luca Laudani
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Luciana Labanca
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| |
Collapse
|
12
|
Hasan S, Kandasamy G, Alyahya D, Alonazi A, Jamal A, Iqbal A, Unnikrishnan R, Muthusamy H. Effect of plyometric training and neuromuscular electrical stimulation assisted strength training on muscular, sprint, and functional performances in collegiate male football players. PeerJ 2022; 10:e13588. [PMID: 35782092 PMCID: PMC9245565 DOI: 10.7717/peerj.13588] [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: 01/10/2022] [Accepted: 05/24/2022] [Indexed: 01/17/2023] Open
Abstract
Background The study's objective was to analyze the influence of an 8-week neuromuscular electrical stimulation (NMES) with a plyometric (PT) and strength training (ST) program on muscular, sprint, and functional performances in collegiate male football players. Methods Sixty collegiate male football players participated in this randomized controlled trial single-blind study. All the participants were randomly divided into two groups: (1) NMES group (Experimental, n = 30) who received NMES assisted ST and (2) sham NMES group (Control, n = 30) who received sham NMES assisted ST. In addition, participants from both groups received a PT program; both groups received intervention on three days a week for 8-weeks. The study's outcomes, such as muscular, sprint, and functional performances, were assessed using a strength test (STN) for quadriceps muscle, sprint test (ST), and single-leg triple hop test (SLTHT), respectively, at baseline pre-intervention and 8-week post-intervention. The interaction between group and time was identified using a mixed design (2 × 2) ANOVA. Results Significant difference found across the two time points for the scores of STN: F (1.58) = 5,479.70, p < 0.05; SLTHT: F (1.58) = 118.17, p < 0.05; and ST: F (1.58) = 201.63, p < 0.05. Similarly, the significant differences were found between groups averaged across time for the scores of STN: F (1.58) = 759.62, p < 0.05 and ST: F (1.58) = 10.08, p < 0.05. In addition, after 8-week of training, Cohen's d observed between two groups a large to medium treatment's effect size for the outcome STN (d = 10.84) and ST (d = 1.31). However, a small effect size was observed only for the SLTHT (d = 0.613). Conclusions Findings suggest that the effect of PT and ST with either NMES or sham NMES are equally capable of enhancing muscular, sprint, and functional performances in collegiate male football players. However, PT and ST with NMES have shown an advantage over PT and ST with sham NMES in improving muscular performance and sprint performance among the same participants.
Collapse
Affiliation(s)
- Shahnaz Hasan
- Physical Therapy Department, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | | | - Danah Alyahya
- Physical Therapy Department, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Asma Alonazi
- Physical Therapy Department, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Azfar Jamal
- Department of Biology, College of Science, Al-Zulfi-, Majmaah University, Al Majmaah, Riyadh Region, Saudi Arabia,Health and Basic Science Research Centre, Majmaah University, Al Majmaah, Saudi Arabia
| | - Amir Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Radhakrishnan Unnikrishnan
- Physical Therapy Department, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Hariraja Muthusamy
- Physical Therapy Department, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| |
Collapse
|
13
|
Rodrigues-Santana L, Louro H, Denche-Zamorano Á, Vega-Muñoz A, Contreras-Barraza N, Adsuar JC. Profile of Whole Body Electromyostimulation Training Users-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084711. [PMID: 35457575 PMCID: PMC9029882 DOI: 10.3390/ijerph19084711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 12/18/2022]
Abstract
(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.
Collapse
Affiliation(s)
- Luiz Rodrigues-Santana
- Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
- Correspondence:
| | - Hugo Louro
- Sport Sciences School of Rio Maior, Research Center in Sport Science, Health and Human Development, 5000-801 Vila Real, Portugal;
- Life Quality Research Center, 2040-413 Santarém, Portugal
| | - Ángel Denche-Zamorano
- Promoting a Healthy Society (PHeSo), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (Á.D.-Z.); (J.C.A.)
| | - Alejandro Vega-Muñoz
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile;
| | | | - Jose Carmelo Adsuar
- Promoting a Healthy Society (PHeSo), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain; (Á.D.-Z.); (J.C.A.)
| |
Collapse
|
14
|
Changes in Muscle Thickness after 8 Weeks of Strength Training, Electromyostimulation, and Both Combined in Healthy Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063184. [PMID: 35328871 PMCID: PMC8955636 DOI: 10.3390/ijerph19063184] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/03/2022] [Accepted: 03/05/2022] [Indexed: 11/17/2022]
Abstract
The aim of this study was to verify and compare the effects of electromyostimulation training (EMS), strength training (ST), and both combined (STEMS), through the analysis of the elbow flexors muscle thickness. Forty subjects (24.45 ± 3.53 years), were randomly divided equally in 4 groups: 3 experimental groups and 1 control group. Each experimental group was submitted to one of three interventions, either an ST protocol, an EMS protocol, or a STEMS protocol. The control group (CG) did not perform any type of physical activity. Ultrasonography (US) was used to measure muscle thickness (MT) at 50 and 60% of the distance between the acromion and the olecranon. The results showed a significant difference in the elbow flexors muscle thickness after 8 weeks, both in the STG, EMSG, and STEMSG, but not in the CG. However, no significant differences were observed between the intervention protocols. It seems that an increase in MT can be obtained using either with ST, EMS, or both combined, however, the results doesn’t support the overlap of one method in relation to the others. EMS can be another interesting tool to induce muscle hypertrophy, but not necessarily better.
Collapse
|
15
|
Padilha JF, Passos KKA, Silva JBD, Driusso P. Electrostimulation and pelvic floor muscle training: immediate effect after one single session. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.35603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract Introduction: Pelvic floor muscle training (PFMT) and neuromuscular electrical stimulation (NMES) are physiotherapeutic conservative treatments to prevent and to treat pelvic floor dysfunctions. Objective: To investigate the immediate effect of one session of PFMT versus NMES associated to pelvic floor muscle (PFM) contraction on the PFM function in nulliparous women. Methods: This is a cross-sectional experimental study. Twenty women were randomized into the “PFMT Group” and “NMES Group”. PFM function evaluation was performed by vaginal palpation and manometry before and after a single session. PFMT was composed by one series of eight sustained contractions of 6 seconds and one series of four fast contractions, in four different positions. NMES parameters were: biphasic pulsed current; frequency: 50 Hz; pulse duration: 0.7 ms; cycle on:off 4:8s; rise/decay: 2/2s, time: 20 minutes; and intensity: participant' sensibility. Data was analyzed by the ANOVA two-way for repeated measures to verify the difference between groups, within group and the interactions for PFM function. A 5% probability was considered in all tests. Results: There were no significant differences between groups. At intra-group analysis, there was a significant decrease in the maximal voluntary contraction (p = 0.01), by manometry, between pre- and post-session for both groups. Conclusion: The immediate effects of a single session of PFMT and NMES associated with voluntary PFM contraction are similar on PFM function, that is, no difference was found between groups.
Collapse
|
16
|
Assessment of the Strength Parameters of the Quadriceps Femoris Muscles in Polish University Students after a 3-Week Program of Neuromuscular Electrical Stimulation Using the RSQ1 Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111717. [PMID: 34770233 PMCID: PMC8583690 DOI: 10.3390/ijerph182111717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 11/21/2022]
Abstract
A rehabilitative program for patients who lose strength and muscle mass along with the ability to perform intensive exercises is lacking. We developed a 3-week training program based on neuromuscular electrical stimulation (NMES) using a RSQ1 device (modulated current resulting from the overlapping of two-component currents) for RSQ1 electrostimulation to improve strength parameters of the quadricep femoris muscles and compare its effectiveness to isometric training. Nineteen university students were randomly divided into the NMES group (10 sessions) and the control group who trained. We measured the circumference of the thigh, as well as peak torques of the flexor and extensor muscles before and after the start and after the end of the training program. Both tested training programs gave similar results. Differences between measured parameters were not significant except for differences in the peak torques of the knee flexors (9.9% for left limb; p = 0.2135 vs. 7.8% for rift limb; p = 0.2135) and the circumference of the left thigh—2% for both (left p = 0.5839 and right p = 0.1088). Comparable results of the tested training programs suggest that NMES is a good alternative for people who cannot perform exercises, but want to maintain or improve their physical fitness.
Collapse
|
17
|
Verch R, Stoll J, Hadzic M, Quarmby A, Völler H. Whole-Body EMS Superimposed Walking and Nordic Walking on a Treadmill-Determination of Exercise Intensity to Conventional Exercise. Front Physiol 2021; 12:715417. [PMID: 34671269 PMCID: PMC8523069 DOI: 10.3389/fphys.2021.715417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Electrical muscle stimulation (EMS) is an increasingly popular training method and has become the focus of research in recent years. New EMS devices offer a wide range of mobile applications for whole-body EMS (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. The present study aimed to determine the differences in exercise intensity between WB-EMS-superimposed and conventional walking (EMS-CW), and CON and WB-EMS-superimposed Nordic walking (WB-EMS-NW) during a treadmill test. Eleven participants (52.0 ± years; 85.9 ± 7.4 kg, 182 ± 6 cm, BMI 25.9 ± 2.2 kg/m2) performed a 10 min treadmill test at a given velocity (6.5 km/h) in four different test situations, walking (W) and Nordic walking (NW) in both conventional and WB-EMS superimposed. Oxygen uptake in absolute (VO2) and relative to body weight (rel. VO2), lactate, and the rate of perceived exertion (RPE) were measured before and after the test. WB-EMS intensity was adjusted individually according to the feedback of the participant. The descriptive statistics were given in mean ± SD. For the statistical analyses, one-factorial ANOVA for repeated measures and two-factorial ANOVA [factors include EMS, W/NW, and factor combination (EMS*W/NW)] were performed (α = 0.05). Significant effects were found for EMS and W/NW factors for the outcome variables VO2 (EMS: p = 0.006, r = 0.736; W/NW: p < 0.001, r = 0.870), relative VO2 (EMS: p < 0.001, r = 0.850; W/NW: p < 0.001, r = 0.937), and lactate (EMS: p = 0.003, r = 0.771; w/NW: p = 0.003, r = 0.764) and both the factors produced higher results. However, the difference in VO2 and relative VO2 is within the range of biological variability of ± 12%. The factor combination EMS*W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values (p = 0.035, r = 0.613), RPE differences for W/NW and EMS*W/NW were not significant. The current study results indicate that WB-EMS influences the parameters of exercise intensity. The impact on exercise intensity and the clinical relevance of WB-EMS-superimposed walking (WB-EMS-W) exercise is questionable because of the marginal differences in the outcome variables.
Collapse
Affiliation(s)
- Ronald Verch
- Clinical Exercise Science, University Outpatient Clinic Potsdam, Department Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Josephine Stoll
- University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, Department Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Miralem Hadzic
- Department of Rehabilitation Medicine, Faculty of Health Science Brandenburg, University of Potsdam, Potsdam, Germany
| | - Andrew Quarmby
- Clinical Exercise Science, University Outpatient Clinic Potsdam, Department Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Heinz Völler
- Department of Rehabilitation Medicine, Faculty of Health Science Brandenburg, University of Potsdam, Potsdam, Germany.,Department of Cardiology, Klinik am See, Rüdersdorf, Germany
| |
Collapse
|
18
|
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.
Collapse
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
| |
Collapse
|
19
|
Whole-body electrical stimulation as a strategy to improve functional capacity and preserver lean mass after bariatric surgery: a randomized triple-blind controlled trial. Int J Obes (Lond) 2021; 45:1476-1487. [PMID: 33927333 DOI: 10.1038/s41366-021-00812-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 03/10/2021] [Accepted: 04/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVES Bariatric surgery (BS) is a successful, long-lasting treatment option for obese. The early postoperative (PO) period is followed by dietary restriction and physical inactivity, leading to declines in muscle mass and functional capacity. Whole-body electromyostimulation (WB-EMS) may be a feasible and potential early rehabilitation strategy post BS. The aim was to evaluate the effects of WB-EMS with exercise training (Fe) on functional capacity, body composition, blood biomarkers, muscle strength, and endurance post BS. SUBJECTS/METHODS This is a randomized, triple-blind, sham-controlled trial. Thirty-five volunteers underwent a Roux-en-Y gastric bypass and were randomized into a WB-EMS (WB-EMSG) or control group (ShamG). Preoperative evaluations consisted of maximal and submaximal exercise testing, body composition, blood biomarkers, quadriceps strength, and endurance. After discharge, functional capacity and body composition were obtained. Exercise training protocols in both groups consisted of 14 dynamic exercises, 5 days per week, completing 30 sessions. The WB-EMSG also underwent an electrical stimulation protocol (Endurance: 85 Hz, 350 ms, 6 s of strain, 4 f of rest; Strength: 30 Hz, 350 ms, 4 s of strain, 10 seconds of rest, with bipolar electrical pulse). After intervention, subjects were reevaluated. RESULTS The protocol started on average 6.7 ± 3.7 days after discharge. Both groups presented with a decline in functional capacity after BS (p < 0.05) and a reduction in all body composition measurements (p < 0.05). The exercise training program led to significant improvements in functional capacity (ShamG - PO: 453.8 ± 66.1 m, Post: 519.2 ± 62.8 m; WB-EMSG- PO: 435.9 ± 74.5, Post: 562.5 ± 66.4 m, p < 0.05), however, only the WB-EMSG demonstrated significant changes of distance walked (interaction time vs group effect, p < 0.05). In addition, adiponectin significantly increased only in the WB-EMSG (p < 0.05). The WB-EMSG was also able to preserve muscle strength, endurance, and fatigue index, while the ShamG demonstrated significant decline (p < 0.05). CONCLUSION WB-EMS + Fe can be an attractive and feasible method following BS to enhance functional capacity and prevent deterioration of muscle function in the early PO. CLINICAL TRIAL REGISTRATION ReBEC, RBR-99qw5h, on 20 February 2015.
Collapse
|
20
|
Watanabe K, Takada T, Kawade S, Moritani T. Effect of exercise intensity on metabolic responses on combined application of electrical stimulation and voluntary exercise. Physiol Rep 2021; 9:e14758. [PMID: 33587340 PMCID: PMC7883830 DOI: 10.14814/phy2.14758] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/18/2021] [Accepted: 01/23/2021] [Indexed: 11/26/2022] Open
Abstract
The combined application of voluntary exercises and neuromuscular electrical stimulation (NMES) has been developed as a new type of exercise that can recruit motor units contributing to both aerobic and anaerobic energy metabolisms. We aimed to investigate the effect of voluntary exercise intensity on metabolic responses on the combination of voluntary exercise and NMES. In 13 volunteers, oxygen consumption and the blood lactate concentration were measured during (1) voluntary pedaling exercise at four different intensities: 50%, 75%, 100%, and 125% of the ventilatory threshold (VT) (VOL), (2) these voluntary exercises with superimposed NMES applied to the gluteus and thigh muscles (VOL+NMES), and (3) NMES only (NMES). Oxygen consumption and the blood lactate concentration in VOL+NMES were significantly greater than VOL at each exercise intensity (p < 0.05). Differences in oxygen consumption between VOL+NMES and VOL decreased with exercise intensity, and that at 125% VT was significantly lower than the net gain in oxygen consumption following NMES (p < 0.05). Differences in the blood lactate concentration between VOL+NMES and VOL increased with exercise intensity, and that at 50% VT was significantly lower than the net gain in the blood lactate concentration following NMES (p < 0.05). Our results suggest that voluntary exercise intensity has a critical impact on metabolic responses during the combined application of voluntary exercises and NMES. Superimposing NMES onto voluntary exercises at high exercise intensities may induce overlapping recruitment of motor units, leading to a markedly reduced benefit of additional metabolic responses on its superimposition.
Collapse
Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, Faculty of Liberal Arts and Sciences and School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | | | | | - Toshio Moritani
- School of Health and Sport Sciences, Chukyo University, Toyota, Japan.,Faculty of Sociology, Kyoto Sangyo University, Kyoto, Japan
| |
Collapse
|
21
|
Zéronian S, Noé F, Paillard T. Effect of the application of somatosensory and excitomotor electrical stimulation during quiet upright standing balance. Med Eng Phys 2020; 87:82-86. [PMID: 33461677 DOI: 10.1016/j.medengphy.2020.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 11/25/2020] [Accepted: 11/29/2020] [Indexed: 11/25/2022]
Abstract
Somatosensory (which activates sensory neurons only) and excitomotor (which activates both motoneurons and sensory neurons) electrical stimulations applied on the musculature of the lower-limb are likely to facilitate and disturb balance control respectively. The aim of this study was to compare the possible balance control modifications induced by somatosensory (SS) and excitomotor (EX) electrical stimulations applied on the quadriceps femoris in quiet standing condition. Kinetics and kinematics parameters were recorded with a force platform (displacements of center of foot pressure) and a 3D analysis system (hip, knee and ankle angles) respectively during a postural task. Twenty healthy young male participants carried out a monopedal postural task (i.e., unilateral stance) in three conditions: SS stimulation (1ms; 10Hz; 7±2 mA i.e., twice the intensity corresponding to the sensory threshold), EX stimulation (400 µs; 50 Hz; 20 ± 5 mA i.e., twice the intensity corresponding to the motor threshold), and a control (CONT) condition without stimulation. The results showed no significant differences between the three conditions except for the knee' angle which was higher in the EX condition (167.3±11.6 vs 164.3±5.8 and 163.9±8) (p < 0.005) than in the two other conditions (SS stimulation and CONT). This means that the EX stimulation induced a postural position change (i.e., a slight knee extension) during the monopedal postural task without altering balance control. Overall, on the basis of the stimulation parameters used in the present work, neither the SS stimulation, nor the EX stimulation facilitated or disturbed postural balance.
Collapse
Affiliation(s)
- Sacha Zéronian
- Université de Pau et des Pays de l'Adour, E2S UPPA, MEPS, Tarbes, France
| | - Frédéric Noé
- Université de Pau et des Pays de l'Adour, E2S UPPA, MEPS, Tarbes, France
| | - Thierry Paillard
- Université de Pau et des Pays de l'Adour, E2S UPPA, MEPS, Tarbes, France.
| |
Collapse
|
22
|
Sumin AN, Oleinik PA, Bezdenezhnykh AV, Ivanova AV. Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery: A randomized controlled trial. Medicine (Baltimore) 2020; 99:e22769. [PMID: 33080746 PMCID: PMC7572009 DOI: 10.1097/md.0000000000022769] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) in early rehabilitation of patients with postoperative complications after cardiovascular surgery. METHODS 37 patients (25 men and 12 women) aged 45 to 70 years with postoperative complications after cardiovascular surgery were included in the study. Eighteen patients underwent NMES daily since postoperative day 3 until discharge in addition to standard rehabilitation program (NMES group), and 19 patients underwent standard rehabilitation program only (non-NMES group). The primary outcome was the knee extensors strength at discharge in NMES group and in control. Secondary outcomes were the handgrip strength, knee flexor strength, and cross-sectional area (CSA) of the quadriceps femoris in groups at discharge. RESULTS Baseline characteristics were not different between the groups. Knee extensors strength at discharge was significantly higher in the NMES group (28.1 [23.8; 36.2] kg on the right and 27.45 [22.3; 33.1] kg on the left) than in the non-NMES group (22.3 [20.1; 27.1] and 22.5 [20.1; 25.9] kg, respectively; P < .001). Handgrip strength, knee flexor strength, quadriceps CSA, and 6 minute walk distance at discharge in the groups had no significant difference. CONCLUSIONS This pilot study shows a beneficial effect of NMES on muscle strength in patients with complications after cardiovascular surgery. The use of NMES showed no effect on strength of non-stimulated muscle, quadriceps CSA, and distance of 6-minute walk test at discharge.Further blind randomized controlled trials should be performed with emphasis on the effectiveness of NEMS in increasing muscle strength and structure in these patients.
Collapse
|
23
|
Borzuola R, Labanca L, Macaluso A, Laudani L. Modulation of spinal excitability following neuromuscular electrical stimulation superimposed to voluntary contraction. Eur J Appl Physiol 2020; 120:2105-2113. [PMID: 32676751 PMCID: PMC7419370 DOI: 10.1007/s00421-020-04430-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 07/03/2020] [Indexed: 02/03/2023]
Abstract
Purpose Neuromuscular electrical stimulation (NMES) superimposed on voluntary muscle contraction has been recently shown as an innovative training modality within sport and rehabilitation, but its effects on the neuromuscular system are still unclear. The aim of this study was to investigate acute responses in spinal excitability, as measured by the Hoffmann (H) reflex, and in maximal voluntary contraction (MVIC) following NMES superimposed to voluntary isometric contractions (NMES + ISO) compared to passive NMES only and to voluntary isometric contractions only (ISO). Method Fifteen young adults were required to maintain an ankle plantar-flexor torque of 20% MVC for 20 repetitions during each experimental condition (NMES + ISO, NMES and ISO). Surface electromyography was used to record peak-to-peak H-reflex and motor waves following percutaneous stimulation of the posterior tibial nerve in the dominant limb. An isokinetic dynamometer was used to assess maximal voluntary contraction output of the ankle plantar flexor muscles. Results H-reflex amplitude was increased by 4.5% after the NMES + ISO condition (p < 0.05), while passive NMES and ISO conditions showed a decrease by 7.8% (p < 0.05) and no change in reflex responses, respectively. There was no change in amplitude of maximal motor wave and in MVIC torque during each experimental condition. Conclusion The reported facilitation of spinal excitability following NMES + ISO could be due to a combination of greater motor neuronal and corticospinal excitability, thus suggesting that NMES superimposed onto isometric voluntary contractions may provide a more effective neuromuscular stimulus and, hence, training modality compared to NMES alone.
Collapse
Affiliation(s)
- Riccardo Borzuola
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Luciana Labanca
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luca Laudani
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK.
| |
Collapse
|
24
|
Dörmann U, Wirtz N, Micke F, Morat M, Kleinöder H, Donath L. The Effects of Superimposed Whole-Body Electromyostimulation During Short-Term Strength Training on Physical Fitness in Physically Active Females: A Randomized Controlled Trial. Front Physiol 2019; 10:728. [PMID: 31316389 PMCID: PMC6610316 DOI: 10.3389/fphys.2019.00728] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/27/2019] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to compare the effects of short-term strength training with and without superimposed whole-body electromyostimulation (WB-EMS) on straight sprinting speed (SSS), change of direction speed (CODS), vertical and horizontal jumping, as well as on strength and power in physically active females. Twenty-two active female participants (n = 22; mean ± SD: age: 20.5 ± 2.3 years; height: 171.9 ± 5.5 cm; body mass: 64.0 ± 8.2 kg; strength training experience 5.1 ± 3.6 years) were randomly assigned to two groups: strength training (S) or strength training with superimposed WB-EMS (S+E). Both groups trained twice a week over a period of 4 weeks and differed in the application of free weights or WB-EMS during four strength (e.g., split squats, glute-ham raises) and five sprinting and jumping exercises (e.g., side and box jumps, skippings). The WB-EMS impulse intensity was adjusted to 70% of individual maximal sustainable pain. SSS was tested via 30-m sprinting, CODS by a T-run, vertical and horizontal jumping using four different jump tests at pre-, post-, and retests. Maximal strength (Fmax) and power (Pmax) testing procedures were conducted on the Leg Press (LP), Leg Extension (LE), and Leg Curl (LC) machine. Significant time × group interaction effects revealed significant decreases of contact time of the Drop Jump and split time of CODS (p ≤ 0.043; ηp2 = 0.15–0.25) for S (≤ 11.6%) compared to S+E (≤ 5.7%). Significant time effects (p < 0.024; ηp2 = 0.17–0.57) were observed in both groups for SSS (S+E: ≤6.3%; S: ≤8.0%) and CODS (S+E: ≤1.8%; S: ≤2.0%) at retest, for jump test performances (S+E: ≤13.2%; S: ≤9.2%) as well as Fmax and Pmax for LE (S+E: ≤13.5%; S: ≤13.3%) and LC (S+E: ≤18.2%; S: ≤26.7%) at post- and retests. The findings of this study indicate comparable effects of short-term strength training with and without superimposed WB-EMS on physical fitness in physically active females. Therefore, WB-EMS training could serve as a reasonable but not superior alternative to classic training regimes in female exercisers.
Collapse
Affiliation(s)
- Ulrike Dörmann
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Nicolas Wirtz
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Florian Micke
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Mareike Morat
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Heinz Kleinöder
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| |
Collapse
|
25
|
Micke F, Kleinöder H, Dörmann U, Wirtz N, Donath L. Effects of an Eight-Week Superimposed Submaximal Dynamic Whole-Body Electromyostimulation Training on Strength and Power Parameters of the Leg Muscles: A Randomized Controlled Intervention Study. Front Physiol 2018; 9:1719. [PMID: 30568596 PMCID: PMC6290057 DOI: 10.3389/fphys.2018.01719] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/15/2018] [Indexed: 01/23/2023] Open
Abstract
The purpose of this study was to assess the effects of dynamic superimposed submaximal whole-body electromyostimulation (WB-EMS) training on maximal strength and power parameters of the leg muscles compared with a similar dynamic training without WB-EMS. Eighteen male sport students were randomly assigned either to a WB-EMS intervention (INT; n = 9; age: 28.8 (SD: 3.0) years; body mass: 80.2 (6.6) kg; strength training experience: 4.6 (2.8) years) or a traditional strength training group (CON; n = 9; age: 22.8 (2.5) years; body mass: 77.6 (9.0) kg; strength training experience: 4.5 (2.9) years). Both training intervention programs were performed twice a week over a period of 8 weeks with the only difference that INT performed all dynamic exercises (e.g., split squats, glute-ham raises, jumps, and tappings) with superimposed WB-EMS. WB-EMS intensity was adjusted to 70% of the individual maximal tolerable pain to ensure dynamic movement. Before (PRE), after (POST) and 2 weeks after the intervention (FU), performance indices were assessed by maximal strength (Fmax) and maximal power (Pmax) testing on the leg extension (LE), leg curl (LC), and leg press (LP) machine as primary endpoints. Additionally, vertical and horizontal jumps and 30 m sprint tests were conducted as secondary endpoints at PRE, POST and FU testing. Significant time effects were observed for strength and power parameters on LE and LC (LE Fmax +5.0%; LC Pmax +13.5%). A significant time × group interaction effect was merely observed for Fmax on the LE where follow-up post hoc testing showed significantly higher improvements in the INT group from PRE to POST and PRE to FU (INT: +7.7%, p < 0.01; CON: +2.1%). These findings indicate that the combination of dynamic exercises and superimposed submaximal WB-EMS seems to be effective in order to improve leg strength and power. However, in young healthy adults the effects of superimposed WB-EMS were similar to the effects of dynamic resistance training without EMS, with the only exception of a significantly greater increase in leg extension Fmax in the WB-EMS group.
Collapse
Affiliation(s)
| | | | | | | | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| |
Collapse
|