Effects of whole-body electromyostimulation combined with individualized nutritional support on body composition in patients with advanced cancer: a controlled pilot trial

Abstract

BackgroundPhysical exercise and nutritional treatment are promising measures to prevent muscle wasting that is frequently observed in advanced-stage cancer patients. However, conventional exercise is not always suitable for these patients due to physical weakness and therapeutic side effects. In this pilot study, we examined the effect of a combined approach of the novel training method whole-body electromyostimulation (WB-EMS) and individualized nutritional support on body composition with primary focus on skeletal muscle mass in advanced cancer patients under oncological treatment.MethodsIn a non-randomized controlled trial design patients (56.5% male; 59.9 ± 12.7 years) with advanced solid tumors (UICC III/IV, N = 131) undergoing anti-cancer therapy were allocated to a usual care control group (n = 35) receiving individualized nutritional support or to an intervention group (n = 96) that additionally performed a supervised physical exercise program in form of 20 min WB-EMS sessions (bipolar, 85 Hz) 2×/week for 12 weeks. The primary outcome of skeletal muscle mass and secondary outcomes of body composition, body weight and hand grip strength were measured at baseline, in weeks 4, 8 and 12 by bioelectrical impedance analysis and hand dynamometer. Effects of WB-EMS were estimated by linear mixed models. Secondary outcomes of physical function, hematological and blood chemistry parameters, quality of life and fatigue were assessed at baseline and week 12. Changes were analyzed by t-tests, Wilcoxon signed-rank or Mann-Whitney-U-tests.ResultsTwenty-four patients of the control and 58 of the WB-EMS group completed the 12-week trial. Patients of the WB-EMS group had a significantly higher skeletal muscle mass (0.53 kg [0.08, 0.98]; p = 0.022) and body weight (1.02 kg [0.05, 1.98]; p = 0.039) compared to controls at the end of intervention. WB-EMS also significantly improved physical function and performance status (p < 0.05). No significant differences of changes in quality of life, fatigue and blood parameters were detected between the study groups after 12 weeks.ConclusionsSupervised WB-EMS training is a safe strength training method and combined with nutritional support it shows promising effects against muscle wasting and on physical function in advanced-stage cancer patients undergoing treatment.Trial registrationClinicalTrials.gov NCT02293239 (Date: November 18, 2014).

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

“…Given that the aging and growth of the population resulted in an increase in global cardiovascular deaths in Europe [62], we can consider this as an interesting advance in the field of health and physical activity. This result is in accordance with what was obtained in the same test by Schink et al [28], which reinforces the conclusions drawn here.…”

“…The suitability of using WB-EMS as an intensity method to improve the physical condition of older women has been raised since it guarantees sufficient effort in those people unable or unwilling to do so on their own initiative [24]. Previous studies analyzed the effects of WB-EMS on the health of elders finding improvements in cardiometabolic risk and sarcopenia [23][24][25][26][27][28][29]. Besides, in young people, the WB-EMS has established itself as an effective method of physical conditioning, achieving improvements in VO2max, aerobic threshold, anaerobic threshold, and running economy [30] and in the maximum isometric strength of leg extenders, vertical jump, and strength hand grip [21,24,25,[29][30][31].…”

Side effects of and contraindications for whole-body electro-myo-stimulation: a viewpoint

“…The technique of WB-EMS, indications and how it may induce muscular damage has been summarised 15. Muscular damage, assessed by elevation of serum creatine-kinase (CK) activity, has been reported after WB-EMS, as listed in table 1 1 2 8 16. CK activity rose continuously until the last measurement.…”

“…Whole-body electro-myo-stimulation (WB-EMS) is used as a complement to voluntary exercise in athletes, for improving fitness and health in healthy subjects and in patients who cannot perform conventional voluntary exercise because of illness 1–8…”

Assessment of gait parameters and physical function in patients with advanced cancer participating in a 12‐week exercise and nutrition programme: A controlled clinical trial

“…The high dropout rate in the WB‐EMS group also contributed to this. Reasons for the higher attrition levels in the exercise intervention group were discussed in our prior publication (Schink, Herrmann, et al, ). Patients treated for advanced malignant diseases are faced with a highly intensive and exhausting oncological treatment that can cause severe physiological and psychological effects.…”