Whole-Body Electromyostimulation Improves Performance-Related Parameters in Runners

No beneficial effect of aerobic whole-body electromyostimulation on lower limbs strength and power - a randomized controlled trial

BACKGROUND

Applying whole-body electromyostimulation (wbEMS) to voluntary activation of the muscle is known to impact motor unit recruitment. Thus, wbEMS as an additional training stimulus enhances force-related capacities. This study aimed to evaluate the mono- and multiarticular strength adaptations to a running intervention with wbEMS compared to running without wbEMS.

METHODS

In a randomized controlled trial (RCT), 59 healthy participants (32 female/ 27 male, 41 ± 7 years) with minor running experience conducted an eight-week running intervention (2x/ week à 20 min) with a wbEMS suit (EG) or without wbEMS (control group, CG). Maximal isokinetic knee extensor and flexor strength and jump height during countermovement jumps were recorded prior and after the intervention to assess maximal strength and power.

RESULTS

Following eight weeks of running, maximal isokinetic knee extension torque decreased significantly over time for both interventions (EG Δ -4%, CG Δ -4%; F(1, 44.14) = 5.96, p = 0.02, η = 0.12). No changes were observed for flexion torque (F(1, 43.20) = 3.93, p = 0.05, η = 0.08) or jump height (F(1, 43.04) = 0.32, p = 0.57, η  = 0.01).

CONCLUSIONS

The outcomes indicate that there is no additional effect over neuromuscular function adaptations with the inclusion of wbEMS during running training. Knee extensor strength is even slightly reduced which supports the principle of training specificity in regards to strength adaptation. We conclude that strength improvements cannot be achieved by running with wbEMS.

TRIAL REGISTRATION

German Clinical Trials Register, ID DRKS00026827, date 10/26/21.

Comparison of the effects of core stability and whole-body electromyostimulation exercises on kyphosis angle and core muscle endurance of inactive people with hyper kyphosis: A quasi-experimental pre-post study

OBJECTIVE

Restoring the degree of kyphosis to be consistent with good sagittal alignment of the spine is a key concern. This study aimed to compare the effect of core stability exercises (CSE) versus whole-body electromyostimulation (WB-EMS) and a combined program (PLUS) on kyphosis angle and core muscle endurance in sedentary individuals with hyperkyphosis.

DESIGN

A quasi-experimental single group pre-post study.

SETTINGS

Laboratory of corrective exercise.

PARTICIPANTS

seventy-five untrained men (28.9 ± 5.3 years) with thoracic hyperkyphosis.

MAIN OUTCOME MEASURES

A flexible ruler was used to measure the angle of kyphosis and McGill's test was used to evaluate core stability.

RESULTS

The results of the post hoc test demonstrated that the kyphosis angle was improved in the WB-EMS and PLUS groups compared to that in the CG (P < 0.05), but no significant difference was observed among the three groups(P > 0.05). In the post-test, core stability was significantly improved in CSE, WB-EMS and PLUS groups compared to that in the CG.

CONCLUSIONS

The WB-EMS and PLUS protocols as new training methods seem to be effective in changing posture parameters and correcting postural deformities, including kyphosis. Therefore, these protocols along with other rehabilitation programs can be used to correct kyphosis and improve core muscle endurance.

The Effect of Whole-Body Electromyostimulation Program on Physical Performance and Selected Cardiometabolic Markers in Obese Young Females

Background and Objectives: Whole-body electromyostimulation is under investigation as a potential aid for obesity-related health problems, supplementing a comprehensive, evidence-based obesity management strategy that includes lifestyle, diet, and exercise. The study investigated the impact of a whole-body electromyostimulation training program on physical performance and cardiometabolic markers in young obese females. Materials and Methods: Twenty-eight obese females, aged over 18 years with BMI over 30 and body fat over 28% and no underlying health conditions or medication, were divided into a whole-body electromyostimulation group (15 participants) and a control group (13 participants). The whole-body electromyostimulation program lasted 12 weeks, with two 20 min sessions weekly, using bipolar, rectangular current. Assessments pre and post intervention included body composition, blood pressure, lipid profile, C-reactive protein levels, maximal oxygen consumption, and jumping and sprint performance. Two-way ANOVA and t-tests were used for analysis. Results: Statistical analysis revealed significant (group × time) interactions for body composition, systolic blood pressure, maximal oxygen consumption, jumping and sprint performance, and plasma levels of lipids and C-reactive protein. Post hoc analyses for the whole-body electromyostimulation group indicated improvements in body composition indices (p < 0.01), systolic blood pressure (p = 0.003), maximal oxygen consumption (p = 0.010), and both jumping and 30 m sprint performance (p < 0.001 and p = 0.001, respectively) after the intervention. Furthermore, plasma levels of lipids (p < 0.01) and C-reactive protein (p = 0.002) showed significant improvements following the training program. In contrast, no significant changes were observed for these variables in the control group. Conclusions: A 12-week whole-body electromyostimulation program significantly improved body composition (skeletal muscle mass, body mass index, body fat, and waist circumference), physical performance (maximal oxygen consumption, jumping and sprint performance), and certain cardiometabolic (plasma level of lipids) and inflammatory markers (C-reactive protein) in obese young women. Further research is needed to explore the broader effects of whole-body electromyostimulation on physical and cardiometabolic health.

Whole-Body Electromyostimulation Impacts Physiological Responses During Aerobic Running: A Randomized Trial

Objective: The aim of the current study was to evaluate the physiological and metabolic responses to running with whole-body electromyostimulation (wbEMS) compared to running without electromyostimulation (control, CG). Methods: Twenty healthy participants (9 male/11 female, age 42 ±7 years) conducted an incremental step test with respiratory gas analysis until exhaustion. Trials were conducted as wbEMS and CG in a random order. As outcome measures, (A) objective total exhaustion, (B) athletic responses (max. time and velocity) and (C) physiological and metabolic responses (V'O2/ kg, V'E, EE, RER, lactate) were compared. (D) The impact on the skeletal muscle was assessed prior, 48 h & 72 h after trial. Results: During both trials, participants (A) ran until total exhaustion. Nonetheless, (B) time and velocity till exhaustion as well as (C) RER prior to the first lactate threshold and V'E were reduced with wbEMS. All other correlates did not differ significantly between wbEMS and CG. Following 48 h and 72 h after the trial with wbEMS, (D) the impact on the skeletal muscle was 7- to 9-fold higher compared to baseline values. Values differed significantly to those after running without wbEMS. Conclusion: With the additional stimulation during voluntary activation, wbEMS induces earlier fatigue and a shift in energy metabolism toward fat utilization. Even during aerobic endurance tasks, a great impact on the skeletal muscle indicated by the rise in CK could be observed which promotes wbEMS as an alternative training stimulus that is easy-to-apply and effective during endurance training.

Running with whole-body electromyostimulation improves physiological determinants of endurance performance - a randomized control trial

BACKGROUND

This study aimed to evaluate the physiological and metabolic adaptations to an eight-week running intervention with whole-body electromyostimulation (wbEMS) compared to running without wbEMS.

METHODS

In a randomized controlled trial (RCT), 59 healthy participants (32 female/ 27 male, 41 ± 7 years, rel.V̇O2max 40.2 ± 7.4 ml/min/kg) ran twice weekly à 20 min for eight weeks either with a wbEMS suit (EG) or without wbEMS (control group, CG). Before and after the intervention, (i) rel.V̇O2max, heart rate and time to exhaustion were recorded with an incremental step test with an incremental rate of 1.20 km/h every 3 min. They were interpreted at aerobic and (indirect) anaerobic lactate thresholds as well as at maximum performance. (ii) Resting metabolic rate (RQ) as well as (iii) body composition (%fat) were assessed.

RESULTS

Following the intervention, V̇O2max was significantly enhanced for both groups (EG ∆13 ± 3%, CG ∆9 ± 3%). Velocity was elevated at lactate thresholds and maximum running speed (EG ∆3 ± 1%, CG ∆2 ± 1%); HRmax was slightly reduced by -1 beat/min. No significant changes were observed for time until exhaustion and lactate. RQ was significantly enhanced following both trainings by + 7%. %fat was reduced for both groups (EG ∆-11 ± 3%, CG ∆-16 ± 5%), without any changes in body mass. Results did not differ significantly between groups.

CONCLUSIONS

Both interventions had a positive impact on aerobic power. The rightward shift of the time-velocity graph points towards improved endurance performance. The effects of wbEMS are comparable to those after high-intensity training and might offer a time-efficient alternative to affect physiological and metabolic effects.

TRIAL REGISTRATION

German Clinical Trials Register, ID DRKS00026827, date 10/26/21.

The effects of whole-body muscle stimulation on body composition and strength parameters: A PRISMA systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis set out to determine the efficacy of whole-body muscle electrostimulation on body composition, strength, and muscle power in active and non-active adults (aged ≥18 years).

METHOD

This review was reported in accordance with the Protocol Statement of Preferred Reporting Element Guidelines for Systematic Reviews and Meta-Analysis included controlled trials; whole-body electromyostimulation trials with at least 1 exercise and control group; participants >18 years old. Outcome measures were defined as standardized mean differences for muscle mass, body fat mass, strength, and power. Studies were searched in the following electronic databases: PubMed, Web of Science, Scopus, SPORTDiscus, and EMBASE for all articles published up to July 30, 2021. The risk of bias was assessed by 2 independent researchers using the Physiotherapy Evidence Database scale and Grading of Recommendations, Assessment, Development and Evaluations approach. Analyses were performed using the metafor package of the statistical software R (version 4.0.3; R Core Team, 2020). Random effects models, forest, and funnel plots to quantify the asymmetry associated with publication bias were fitted using the metafor library in R. Statistical heterogeneity was assessed using I2 statistics.

RESULTS

In total, 26 studies representing 1183 participants were included (WB-electromyostimulation: n = 586 and control group: n = 597). The mean age of the participants ranged from a minimum of 20.4 to a maximum of 77.4 years old. Interventions lasted a minimum of 4 and a maximum of 54 weeks. Standardized mean difference was 0.36 (95% confidence interval [CI]: 0.16-0.57) for muscle mass, -0.38 (95% CI: -0.62-0.15) for body fat, 0.54 (95% CI: 0.35-0.72) for strength, and 0.36 (95% CI: 0.02-0.71) for power with significant differences between groups (all P < .04). I2 revealed low heterogeneity of muscle mass (15%) and power (0%) between trials and medium heterogeneity of body fat (45%) and strength (55%).

CONCLUSION

We concluded that WB-electromyostimulation has significant positive effects on muscle mass, body fat, strength, and power.

Bibliometric Analysis of Studies on Whole Body Electromyostimulation

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.

Effects of electromyostimulation on performance parameters in sportive and trained athletes: A systematic review and network meta-analysis

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.

Whole-Body EMS Superimposed Walking and Nordic Walking on a Treadmill-Determination of Exercise Intensity to Conventional Exercise

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.

Whole-body electrical stimulation as a strategy to improve functional capacity and preserver lean mass after bariatric surgery: a randomized triple-blind controlled trial

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.

The effects of whole-body muscle stimulation on body composition and strength parameters: A protocol for systematic review and meta-analysis

BACKGROUND

This study will analyze the effect of Whole Body Electromyostimulation (WB-EMS) in strength and body composition outcomes in adult population.

METHODS

This study will search the following electronic databases up to July 21, 2020: PubMed, WOS, Scopus, SPORTDiscus y EMBASE. There will be no language limitation. Two authors will independently identify titles/abstracts and full text all potential studies, and will collect data from eligible studies. Additionally, study quality will be assessed by PEDro Scale risk of bias. We will conduct meta-analysis if enough trials are included.

RESULTS

This study will explore the effects of WB-EMS in strength and body composition outcomes.

CONCLUSION

The findings of this study may summarize the effectiveness of WB-EMS in increasing strength and improving body composition in adult population.

INPLASY REGISTRATION NUMBER

INPLASY202120050.

Effects of Whole-Body Electromyostimulation Associated with Dynamic Exercise on Functional Capacity and Heart Rate Variability After Bariatric Surgery: a Randomized, Double-Blind, and Sham-Controlled Trial

PURPOSE

Bariatric surgery is the most effective treatment for morbid obesity. In association with dietary restrictions, the ability to exercise in the immediate post-surgical phase is limited. In this context, whole-body electromyostimulation (WB-EMS), strategy that stimulates various muscle groups, in conjunction with physical exercise, holds promise for improving functional capacity, and cardiac autonomic control, following surgery. The purpose of this study was to analyze whether a rehabilitation program consisting of WB-EMS with 30 exercise training sessions following bariatric surgery significantly improves functional capacity, body mass and heart rate variability (HRV).

METHODS

Randomized, double-blind, and sham-controlled trial. Twenty obesity patients were randomized into the WB-EMS (n = 10) and sham (n = 10) groups. On average, 7 days after surgery, individuals underwent a six-minute walk test (6MWT), HRV, and body composition analysis at rest. The next day, patients initiated an exercise training protocol, five times per week, over 6 weeks. Walking distance changes (post-pre = ΔWD) obtained by 6MWT and HRV indices were determined following the intervention.

RESULTS

Only WB-EMSG significantly increased WD and body mass index (BMI) after the intervention (p = 0.002) and ΔWD was significantly higher in this group when compared with sham (p = 0.04). Moreover, both groups demonstrated an improvement in key measures of HRV after the intervention.

CONCLUSION

An exercise training intervention initiated shortly after bariatric surgery improved functional capacity and cardiac autonomic tone. Improvements in functional capacity and BMI following exercise training were greater with the addition of WB-EMS but did not promote additional improvements in HRV beyond that realized with exercise training alone.

Efficacy of Whole-Body Electromyostimulation (WB-EMS) on Body Composition and Muscle Strength in Non-athletic Adults. A Systematic Review and Meta-Analysis

This systematic review and meta-analysis set out to determine the efficacy on whole-body electromyostimulation (WB-EMS) on body composition and strength parameters in non-athletic cohorts. A systematic review of the literature according to the PRISMA statement included (a) controlled trials, (b) WB-EMS trials with at least one exercise and one control group, (c) WB-EMS as primary physical intervention, (d) WB-EMS with at least six electrodes covering most muscle groups, (e) non-athletic cohorts. We searched eight electronic databases up to June 30, 2020, without language restrictions. Standardized mean differences (SMD) for muscle mass parameters, total body fat mass, maximum leg extension, and trunk extension strength were defined as outcome measures. In summary, 16 studies with 19 individual WB-EMS groups representing 897 participants were included. Studies vary considerably with respect to age, BMI, and physical conditions. Impulse protocols of the studies were roughly comparable, but training frequency (1-5 sessions/week) and intervention length (6-54 weeks) differed between the studies. SMD average was 1.23 (95%-CI: 0.71-1.76) for muscle mass, 0.98 (0.74-1.22) for maximum leg, and 1.08 (0.78-1.39) for maximum trunk extension strength changes (all p < 0.001). SMD for body fat changes (-0.40, [-0.98 to 0.17]), however, did not reach significance. I ² and Q-statistics revealed substantial heterogeneity of muscle and fat mass changes between the trials. However, rank and regression tests did not indicate positive evidence for small-study bias and funnel plot asymmetries. This work provided further evidence for significant, large-sized effects of WB-EMS on muscle mass and strength parameters, but not on body fat mass. Clinical Trial Registration: ClinicalTrials.gov, PROSPERO; ID: CRD42020183059.

Effects of Whole Body Electromyostimulation on Physical Fitness and Health in Postmenopausal Women: A Study Protocol for a Randomized Controlled Trial

Background: Age-related problems such as chronic diseases, functional limitation and dependence, reduce the quality of life in the elderly, and increase public spending in health. It has been established that physical activity plays a fundamental role in the health of the elderly. The whole body electromyostimulation (WB-EMS) could be a successful methodology as high-intensity training to improve the physical fitness of older people. Methods: A minimum of 13 women between 55 and 70 years old will be randomized in two groups. The exercise with WB-EMS group (EX + WB-EMS) will conduct a resistance strength training program with superimposed WB-EMS while the exercise group (EX) will perform only resistance strength and aerobic training. Balance, strength, flexibility, agility, speed, and aerobic performance (EXERNET battery and progressive resistance test), as well as body composition, blood parameters and physical activity reporting (IPAQ-E) will be assessed to analyze the effects of whole body electromyostimulation in the physical fitness and the health in postmenopausal women. Discussion: Innovative and scientifically well-designed protocols are needed to enhance the knowledge of the body's responses within this training methodology which is being used by a big quantity of population. This trial will provide evidence on the effectiveness of whole-body electromyostimulation in physical fitness and health in elderly women. Trial Registration: ISRCTN15558857 registration data: 27/11/2019 (retrospectively registered).

Whole-body electromyostimulation in physical therapy: do gender, skinfold thickness or body composition influence maximum intensity tolerance?

[Purpose] Whole-body electromyostimulation (WB-EMS) is an extension of the EMS application known in physical therapy. In WB-EMS, body composition and skinfold thickness seem to play a decisive role in influencing the Ohmic resistance and therefore the maximum intensity tolerance. That is why the therapeutic success of (WB-)EMS may depend on individual anatomical parameters. The aim of the study was to find out whether gender, skinfold thickness and parameters of body composition have an influence on the maximum intensity tolerance in WB-EMS. [Participants and Methods] Fifty-two participants were included in the study. Body composition (body impedance, body fat, fat mass, fat-free mass) and skinfold thicknesses were measured and set into relation to the maximum intensity tolerance. [Results] No relationship between the different anthropometric parameters and the maximum intensity tolerance was detected for both genders. Considering the individual muscle groups, no similarities were found in the results. [Conclusion] Body composition or skinfold thickness do not seem to have any influence on the maximum intensity tolerance in WB-EMS training. For the application in physiotherapy this means that a dosage of the electrical voltage within the scope of a (WB-) EMS application is only possible via the subjective feedback (BORG Scale).

Effects of an Impulse Frequency Dependent 10-Week Whole-body Electromyostimulation Training Program on Specific Sport Performance Parameters

The difference in the efficacy of altered stimulation parameters in whole-body-electromyostimulation (WB-EMS) training remains largely unexplored. However, higher impulse frequencies (>50 Hz) might be most adequate for strength gain. The aim of this study was to analyze potential differences in sports-related performance parameters after a 10-week WB-EMS training with different frequencies. A total of 51 untrained participants (24.9 ± 3.9 years, 174 ± 9 cm, 72.4 ± 16.4 kg, BMI 23.8 ± 4.1, body fat 24.7 ± 8.1 %) was randomly divided into three groups: one inactive control group (CON) and two training groups. They completed a 10-week WB-EMS program of 1.5 sessions/week, equal content but different stimulation frequencies (training with 20 Hz (T20) vs. training with 85 Hz (T85)). Before and after intervention, all participants completed jumping (Counter Movement Jump (CMJ), Squat Jump (SJ), Drop Jump (DJ)), sprinting (5m, 10m, 30m), and strength tests (isometric trunk flexion/extension). One-way ANOVA was applied to calculate parameter changes. Post-hoc least significant difference tests were performed to identify group differences. Significant differences were identified for CMJ (p = 0.007), SJ (p = 0.022), trunk flexion (p = 0.020) and extension (p=.013) with significant group differences between both training groups and CON (not between the two training groups T20 and T85). A 10-week WB-EMS training leads to significant improvements of jump and strength parameters in untrained participants. No differences could be detected between the frequencies. Therefore, both stimulation frequencies can be regarded as adequate for increasing specific sport performance parameters. Further aspects as regeneration or long term effects by the use of different frequencies still need to be clarified.

Effects of Whole-Body Electromyostimulation on Physical Fitness in Postmenopausal Women: A Randomized Controlled Trial

Whole-body electromyostiulation (WB-EMS) has experienced a boom in recent years, even though its effectiveness is controversial. A sedentary lifestyle is deeply rooted in the European population, mainly in the elderly. This experimental study analyzed the impact of WB-EMS on the physical fitness of postmenopausal women. Thirty-four healthy sedentary women between 55 and 69 years followed an experimental design pre–post-test. Both groups conducted a ten-week aerobic and strength training program. The experimental group overlaid the WB-EMS during exercise. At the end of the intervention, both groups improved upper and lower body strength, lower extremity flexibility, agility, and speed levels (p_Bonferroni < 0.05). Significant interactions were observed at upper and lower body strength, agility, speed, and cardiovascular endurance (p < 0.05). The WB-EMS group scored better agility than the control group at the end of the intervention (p_Bonferroni < 0.05) and was the only group that improved cardiovascular endurance. WB-EMS shows a favorable isolate effect on the development of dynamic leg strength, agility, and cardiovascular endurance but did not in dynamic arm strength, gait speed, balance, or flexibility of postmenopausal women.

Seven Weeks of Jump Training with Superimposed Whole-Body Electromyostimulation Does Not Affect the Physiological and Cellular Parameters of Endurance Performance in Amateur Soccer Players

Intramuscular density of monocarboxylate-transporter (MCT) could affect the ability to perform high amounts of fast and explosive actions during a soccer game. MCTs have been proven to be essential for lactate shuttling and pH regulation during exercise and can undergo notable adaptational changes depending on training. The aim of this study was to evaluate the occurrence and direction of potential effects of a 7-weeks training period of jumps with superimposed whole-body electromyostimulation on soccer relevant performance surrogates and MCT density in soccer players. For this purpose, 30 amateur soccer players were randomly assigned to three groups. One group performed dynamic whole-body strength training including 3 x 10 squat jumps with WB-EMS (EG, n = 10) twice a week in addition to their daily soccer training routine. A jump training group (TG, n = 10) performed the same training routine without EMS, whereas a control group (CG, n = 8) merely performed their daily soccer routine. 2 (Time: pre vs. post) x 3 (group: EG, TG, CG) repeated measures analyses of variance (rANOVA) revealed neither a significant time, group nor interaction effect for VO₂peak, Total Time to Exhaustion and La_max as well as MCT-1 density. Due to a lack of task-specificity of the underlying training stimuli, we conclude that seven weeks of WB-EMS superimposed to jump exercise twice a week does not relevantly influence aerobic performance or MCT density.

Metabolic rate in sedentary adults, following different exercise training interventions: The FIT-AGEING randomized controlled trial

BACKGROUND & AIMS

This study compares the influence of different exercise training programs on basal metabolic rate (BMR) and fat oxidation, in basal conditions (BFox) and during exercise (MFO), in sedentary, middle-aged adults.

METHODS

The study subjects of this 12 week-long, randomised controlled trial, were 71 middle-aged adults (age 53.5 ± 4.9 years; 52% women). Subjects were randomly assigned to one of the following groups: (1) no exercise, (2) concurrent training based on international physical activity recommendations (PAR group), (3) high intensity interval training (HIIT group), and (4) high intensity interval training plus whole-body electromyostimulation (HIIT + EMS group). Subject BMR, BFox and MFO were determined by indirect calorimetry before and after the intervention.

RESULTS

The HIIT + EMS subjects showed significant increases in BFox following the intervention compared with the control group (all P = 0.043); no such differences were seen in the PAR and HIIT compared with the control group (all P ≥ 0.1). A significant increase in post-intervention MFO was noted for the HIIT and HIIT + EMS group compared to the non-exercise control group (P < 0.05); no such difference was seen in the PAR group compared to the control group (all P ≥ 0.05).

CONCLUSIONS

Twelve weeks of high intensity interval training plus whole-body electromyostimulation may increase the BFox and MFO of middle-aged sedentary adults. These findings have important clinical implications; a well-designed high-intensity interval training program plus whole-body electromyostimulation might be followed to help combat the appearance of chronic metabolic diseases characterized by metabolic inflexibility in middle-aged sedentary adults, though it will be necessary to determine how long the effects last.

Effects of Whole-Body Electromyostimulation on Strength-, Sprint-, and Jump Performance in Moderately Trained Young Adults: A Mini-Meta-Analysis of Five Homogenous RCTs of Our Work Group

Background: Whole-body electromyostimulation (WB-EMS) gained increasing interest in sports within recent years. However, few intervention studies have examined the effects of WB-EMS on trained subjects in comparison to conventional strength training. Objective: The aim of the present mini-meta-analysis of 5 recently conducted and published randomized controlled WB-EMS trails of our work group was to evaluate potentially favorable effects of WB-EMS in comparison to conventional strength training. Methods: We included parameter of selected leg muscle's strength and power as well as sprint and jump performance. All subjects were moderately trained athletes [>2 training sessions/week, >2 years of experience in strength training; experimental group (n = 58): 21.5 ± 3.3 y; 178 ± 8 cm; 74.0 ± 11 kg; control group (n = 54): 21.0 ± 2.3 y; 179.0 ± 9 cm; 72.6 ± 10 kg]. The following WB-EMS protocols were applied to the experimental group (EG): 2 WB-EMS sessions/week, bipolar current superimposed to dynamic exercises, 85 Hz, 350 μs, 70% of the individual pain threshold amperage. The control groups (CG) underwent the same training protocols without WB-EMS, but with external resistance. Results: Five extremely homogenous studies (all studies revealed an I ² = 0%) with 112 subjects in total were analyzed with respect to lower limb strength and power in leg curl, leg extension and leg press machines, sprint-and jump performance. Negligible effects in favor of WB-EMS were found for F_max of leg muscle groups [SMD: 0.11 (90% CI: -0.08, 0.33), p = 0.73, I ² = 0%] and for CMJ [SMD: 0.01 (90% CI: -0.34, 0.33), p = 0.81, I ² = 0%]. Small effects, were found for linear sprint [SMD: 0.22 (90% CI: -0.15, 0.60), p = 0.77, I ² = 0%] in favor of the EMS-group compared to CON. Conclusion: We conclude that WB-EMS is a feasible complementary training stimulus for performance enhancement. However, additional effects on strength and power indices seem to be limited and sprint and jump-performance appear to be benefiting only slightly. Longer training periods and more frequent application times and a slightly larger stimulus could be investigated in larger samples to further elucidate beneficial effects of WB-EMS on performance parameters in athletes.

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.

Adjustment Effects of Maximum Intensity Tolerance During Whole-Body Electromyostimulation Training

Intensity regulation during whole-body electromyostimulation (WB-EMS) training is mostly controlled by subjective scales such as CR-10 Borg scale. To determine objective training intensities derived from a maximum as it is used in conventional strength training using the one-repetition-maximum (1-RM), a comparable maximum in WB-EMS is necessary. Therefore, the aim of this study was to examine, if there is an individual maximum intensity tolerance plateau after multiple consecutive EMS application sessions. A total of 52 subjects (24.1 ± 3.2 years; 76.8 ± 11.1 kg; 1.77 ± 0.09 m) participated in the longitudinal, observational study (38 males, 14 females). Each participant carried out four consecutive maximal EMS applications (T1-T4) separated by 1 week. All muscle groups were stimulated successively until their individual maximum and combined to a whole-body stimulation index to carry out a possible statement for the development of the maximum intensity tolerance of the whole body. There was a significant main effect between the measurement times for all participants (p < 0.001; 𝜂² = 0.39) as well as gender specific for males (p = 0.001; 𝜂² = 0.18) and females (p < 0.001; 𝜂² = 0.57). There were no interaction effects of gender × measurement time (p = 0.394). The maximum intensity tolerance increased significantly from T1 to T2 (p = 0.001) and T2 to T3 (p < 0.001). There was no significant difference between T3 and T4 (p = 1.0). These results indicate that there is an adjustment of the individual maximum intensity tolerance to a WB-EMS training after three consecutive tests. Therefore, there is a need of several habituation units comparable to the identification of the individual 1-RM in conventional strength training. Further research should focus on an objective intensity-specific regulation of the WB-EMS based on the individual maximum intensity tolerance to characterize different training areas and therefore generate specific adaptations to a WB-EMS training compared to conventional strength training methods.

Changes in Physical Fitness After 12 Weeks of Structured Concurrent Exercise Training, High Intensity Interval Training, or Whole-Body Electromyostimulation Training in Sedentary Middle-Aged Adults: A Randomized Controlled Trial

This study aimed to investigate the influence of different exercise training modalities [(i) a concurrent training based on physical activity recommendation from the World Health Organization group (PAR group), (ii) a high intensity interval training group (HIIT group), and (iii) a high intensity interval training adding whole-body electromyostimulation group (WB-EMS group)] on physical fitness in sedentary middle-aged adults. A total of 89 (52.7% women) middle-aged sedentary adults (53.7 ± 5.1 years old) were enrolled in the FIT-AGING study. Cardiorespiratory fitness was determined by a maximum treadmill test using indirect calorimetry. Lower, upper, and core body muscular strength were assessed by an isokinetic strength test, by the handgrip strength test, and by several core strength endurance tests, respectively. All the exercise types induced similar increases on cardiorespiratory fitness (Δ VO₂max ≥ 11%, Δ maximal heart rate ≥ 8%, and Δ total test duration ≥ 14%; all P ≤ 0.034), as well as on muscular strength (Δ extension and flexion peak torque ≥ 10%, Δ total hand grip ≥ 3%, Δ core strength endurance tests ≥ 20%; all P ≤ 0.050) compared with a control group. In conclusion, our results suggest that a 12-week structured exercise intervention improves physical fitness regardless of the training program in sedentary middle-aged adults. Despite slightly greater improvements in some physical fitness variables, the changes observed in the WB-EMS group were not superior to the other exercise programs.