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Tamiya H, Kawashiri H, Miyamoto T, Tsubaki A. Acute Effects of Skeletal Muscle Electrical Stimulation on Central and Lower Extremity Hemodynamics. Cureus 2024; 16:e62988. [PMID: 38915840 PMCID: PMC11194163 DOI: 10.7759/cureus.62988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION Belt electrode-skeletal muscle electrical stimulation (B-SES) is a treatment prescribed for individuals with difficulty performing exercise therapy that improves muscle strength, exercise tolerance, and glucose metabolism. However, the effects of B-SES on the hemodynamics of the central and lower extremity conduit arteries have not been studied. Therefore, this study compared the acute effects of B-SES on the central and lower extremity conduit arteries in healthy young males. METHODS This randomized crossover study included nine healthy young males (mean age: 21.0±1.1 years). Participants were assigned to the following experimental conditions, with a washout period of one week: condition 1 included 20 min of electrical stimulation of the lower extremity at the participant's sensation threshold intensity (Sham, n=9) and condition 2 included 20 min of electrical stimulation of the lower extremity at the maximum intensity the participant can tolerate (B-SES, n=9). The heart rate (HR), stroke volume (SV), cardiac output (CO), mean arterial pressure (MAP), and total peripheral vascular resistance (TPR) were measured as central hemodynamics. The hemodynamics of the lower extremity conduit arteries were measured and calculated for the shallow femoral artery (SFA), including vessel diameter, mean blood flow velocity (MBFV), shear rate (SR), and mean blood flow (MBF) rate. These indices were measured before stimulation (Pre), 10 min after the start of stimulation (Stimulating), and immediately after the end of stimulation (Post). These indices were compared using a repeated two-way analysis of variance. RESULTS In B-SES, HR (Pre: 63.2±8.6; Stimulating: 73.7±6.9; Post: 70.0±4.2 bpm, p<0.01), CO (Pre: 5.1±1.0; Stimulating: 6.5±1.5, p<0.01; Post: 6.3±1.2 L/min, p=0.02), and MAP (Pre: 104.0±11.5; Stimulating: 116.4±10.8, p<0.01; Post: 109.6±9.7 mmHg, p=0.02) increased significantly. In addition, B-SES significantly increased MBFV (Pre: 19.2±4.0; Stimulating: 50.5±14.9; Post: 30.1±4.0 cm/s, p<0.01), SR (Pre: 118.9±28.8; Stimulating: 302.7±91. 2, p<0.01; Post: 182.1±70.1/s, p=0.02), and MBF (Pre: 382.0±61.5; Stimulating: 1009.6±321.4; Post: 626.8±176.6 mL/min, p<0.01). However, there were no significant changes in SV and TPR. CONCLUSIONS The findings of this study indicate that B-SES in healthy young males increases CO without increasing SV or TPR and improves the MBFV and SR in the SFA.
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Affiliation(s)
- Hajime Tamiya
- Department of Exercise Physiology, Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, JPN
| | - Hina Kawashiri
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, JPN
| | - Toshiaki Miyamoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kansai Medical University, Osaka, JPN
| | - Atsuhiro Tsubaki
- Department of Exercise Physiology, Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, JPN
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von Stengel S, Fröhlich M, Ludwig O, Eifler C, Berger J, Kleinöder H, Micke F, Wegener B, Zinner C, Mooren FC, Teschler M, Filipovic A, Müller S, England K, Vatter J, Authenrieth S, Kohl M, Kemmler W. Revised contraindications for the use of non-medical WB-electromyostimulation. Evidence-based German consensus recommendations. Front Sports Act Living 2024; 6:1371723. [PMID: 38689869 PMCID: PMC11058671 DOI: 10.3389/fspor.2024.1371723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: "Arteriosclerosis, arterial circulation disorders", "Diabetes mellitus" (DM), "Tumor and cancer" (TC), "Neurologic diseases, neuronal disorders, epilepsy". Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list.
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Affiliation(s)
- S. von Stengel
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - M. Fröhlich
- Department of Sports Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany
| | - O. Ludwig
- Department of Sports Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany
| | - C. Eifler
- German University for Prevention and Health Management, Saarbrücken, Germany
| | - J. Berger
- German University for Prevention and Health Management, Saarbrücken, Germany
| | - H. Kleinöder
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - F. Micke
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - B. Wegener
- Musculoskeletal University Center, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - C. Zinner
- Hessian College of Police and Administration, Wiesbaden, Germany
| | - F. C. Mooren
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - M. Teschler
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | | | | | - K. England
- Glucker Kolleg, Frankfurt, Germany
- Bundeswehr Medical Academy Munich, Munich, Germany
| | - J. Vatter
- Soccer Club Paderborn 07, Paderborn, Germany
- PT Lounge Cologne, Cologne, Germany
| | - S. Authenrieth
- Glucker Kolleg, Frankfurt, Germany
- EMS-Performance, Kornwestheim, Germany
| | - M. Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - W. Kemmler
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
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Beier M, Schoene D, Kohl M, von Stengel S, Uder M, Kemmler W. Non-Athletic Cohorts Enrolled in Longitudinal Whole-Body Electromyostimulation Trials-An Evidence Map. SENSORS (BASEL, SWITZERLAND) 2024; 24:972. [PMID: 38339689 PMCID: PMC10857049 DOI: 10.3390/s24030972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Whole-body electromyostimulation (WB-EMS) can be considered as a time-efficient, joint-friendly, and highly customizable training technology that attracts a wide range of users. The present evidence map aims to provide an overview of different non-athletic cohorts addressed in WB-EMS research. Based on a comprehensive systematic search according to PRISMA, eighty-six eligible longitudinal trials were identified that correspond with our eligibility criteria. In summary, WB-EMS research sufficiently covers all adult age categories in males and females. Most cohorts addressed (58%) were predominately or exclusively overweight/obese, and in about 60% of them, diseases or conditions were inclusion criteria for the trials. Cohorts specifically enrolled in WB-EMS trials suffer from cancer/neoplasm (n = 7), obesity (n = 6), diabetes mellitus (n = 5), metabolic syndrome (n = 2), nervous system diseases (n = 2), chronic heart failure (n = 4), stroke (n = 1), peripheral arterial diseases (n = 2), knee arthrosis (n = 1), sarcopenia (n = 3), chronic unspecific low back pain (n = 4), and osteopenia (n = 3). Chronic kidney disease was an eligibility criterion in five WB-EMS trials. Finally, three studies included only critically ill patients, and two further studies considered frailty as an inclusion criterion. Of importance, no adverse effects of the WB-EMS intervention were reported. In summary, the evidence gaps in WB-EMS research were particular evident for cohorts with diseases of the nervous and cerebrovascular system.
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Affiliation(s)
- Miriam Beier
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Daniel Schoene
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, 78056 Villingen-Schwenningen, Germany;
| | - Simon von Stengel
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
| | - Wolfgang Kemmler
- Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany; (M.B.); (D.S.); (S.v.S.); (M.U.)
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, 91052 Erlangen, Germany
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