Does whole-body electrical muscle stimulation combined with strength training promote morphofunctional alterations?

Non-Athletic Cohorts Enrolled in Longitudinal Whole-Body Electromyostimulation Trials-An Evidence Map

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.

Immediate Effects of Whole-Body versus Local Dynamic Electrostimulation of the Abdominal Muscles in Healthy People Assessed by Ultrasound: A Randomized Controlled Trial

Dynamic electrostimulation consists of the application of local or global electrostimulation together with physical exercise. This study aimed to investigate the immediate effects of a dynamic electrostimulation session on the thickness of the abdominal musculature, inter-rectus distance, heart rate, blood pressure, and body temperature, and to identify possible differences in its form of application. A total of 120 healthy participants were divided into three groups: the whole-body electrostimulation group, the local electrostimulation group, and the control group without electrical stimulation. All groups performed a single session with the same dynamic exercise protocol. Muscle thickness and inter-rectus distance were evaluated ultrasonographically using the Rehabilitative Ultrasound Imaging technique both at rest and in muscle contraction (the active straight leg raise test) to find the post-intervention differences. The results showed significant differences in immediate post-intervention heart rate, with a smaller increase in the local electrostimulation group compared to the control and whole-body electrostimulation groups. No significant differences were identified between the groups after the interventions in the rest of the variables analyzed. Therefore, a local application, with the same effects as a global application on the abdominal musculature, has fewer contraindications, which makes its use more advisable, especially in populations with cardiorespiratory disorders, for which more research is needed.

Additional Active Movements Are Not Required for Strength Gains in the Untrained during Short-Term Whole-Body Electromyostimulation Training

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.

Belt Electrode-Skeletal Muscle Electrical Stimulation During Early Hematopoietic Post-Transplantation To Prevent Skeletal Muscle Atrophy and Weakness

A decline in physical functions at the early stage of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a serious issue. Belt electrode-skeletal muscle electrical stimulation (B-SES) can induce significant muscle contractions with electrical stimulation and reduce muscle weakness. However, this approach has not been used in allo-HSCT patients. This study aimed to examine the effect of B-SES on physical function, and safety in patients during the early post-transplantation period. Forty-three adult patients who underwent B-SES after allo-HSCT were stratified into 2 groups based on the intensity of electrical stimulation (high versus low). B-SES was performed in combination with exercise therapy for 4 post-transplantation weeks. Knee extensor strength (KES) in the low B-SES group decreased significantly, whereas no change was observed in the high-intervention group. A significant positive correlation was observed between total intensity and ΔKES. A reduction in the 6-minute walking distance in the high B-SES group patients was lower than that of historical data. Two patients had B-SES-related complications including muscle pain. This study is the first to propose a new rehabilitation intervention strategy for allo-HSCT. Combined use of B-SES may be a new approach to reducing the decline of physical function in the early post-transplantation period.

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.

Acute Effect of Electromyostimulation Superimposed on Running on Maximal Velocity, Metabolism, and Perceived Exertion

Electromyostimulation has been shown to intensify exercise when superimposed on cycling. However, little is known about the application during running, which might help to prevent injuries linked to high running volumes, as intensification of running allows for a reduction in training volume. Therefore, the purpose of the study was to examine the effects of electromyostimulation superimposed on running. Men who were no younger than 18 and no older than 35 were eligible for inclusion in the study. Exclusion criteria were previous experience with electromyostimulation training, the presence of a contraindication according to the manufacturer, or a contraindication to physical activity. A sample of 22 healthy males with an ordinary performance capability accomplished three similar cardiopulmonary treadmill tests until exhaustion in a crossover study design that included lactate measurements and interrogations of perceived exertion. The first test was conducted without electromyostimulation and was followed in a randomized order by the second and the third test condition with 30 or 85 Hz stimulation, respectively, of the lower body. Superimposed electromyostimulation significantly reduced the maximal achieved velocity (control 15.6 ± 1.1 vs. 30 Hz 15.1 ± 1.2, p = 0.002; vs. 85 Hz 14.9 ± 1.1 km/h, p < 0.001), increased the perceived exertion at 10, 12 and 14 km/h (85 Hz + 0.7, p = 0.036; +0.9, p = 0.007; +1.3, p < 0.001; 30 Hz + 0.7, p = 0.025; +1.0, p = 0.002; +1.2, p < 0.001), and induced a significantly higher oxygen uptake at 8 km/h (85 Hz + 1.1, p = 0.006; 30 Hz + 0.9 mL·min−1·kg−1, p = 0.042), 10 km/h (30 Hz + 0.9 mL·min−1·kg−1, p = 0.032), and 14 km/h (85 Hz + 1.0 mL·min−1·kg−1, p = 0.011). Both electromyostimulation conditions significantly limited the maximal lactate level (30 Hz p = 0.046; 85 Hz p < 0.001) and 85 Hz also the recovery lactate level (p < 0.001). Superimposed electromyostimulation is feasible and intensifies running. Coaches and athletes could benefit from the increased training stimulus by reducing running velocity or volume, by combining endurance and strength training, and also by inducing better adaptations while maintaining the same velocity or volume. Therefore, electromyostimulation superimposed on running could be an interesting training tool for runners.

Profile of Whole Body Electromyostimulation Training Users-A Pilot Study

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

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

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

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

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

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

Resistance Exercise, Electrical Muscle Stimulation, and Whole-Body Vibration in Older Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials

It has been shown that resistance exercise (RT) is one of the most effective approaches to counteract the physical and functional changes associated with aging. This systematic review with meta-analysis compared the effects of RT, whole-body vibration (WBV), and electrical muscle stimulation (EMS) on muscle strength, body composition, and functional performance in older adults. A thorough literature review was conducted, and the analyses were limited to randomized controlled trials. In total, 63 studies were included in the meta-analysis (48 RT, 11 WBV, and 4 EMS). The results showed that RT and WBV are comparably effective for improving muscle strength, while the effects of EMS remains debated. RT interventions also improved some outcome measures related to functional performance, as well as the cross-sectional area of the quadriceps. Muscle mass was not significantly affected by RT. A limitation of the review is the smaller number of WBV and particularly EMS studies. For this reason, the effects of WBV and EMS could not be comprehensively compared to the effect of RT for all outcome measures. For the moment, RT or combinations of RT and WBV or EMS, is probably the most reliable way to improve muscle strength and functional performance, while the best approach to increase muscle mass in older adults remains open to further studies.