Efficacy and Safety of Low Frequency Whole-Body Electromyostimulation (WB-EMS) to Improve Health-Related Outcomes in Non-athletic Adults. A Systematic Review

Abstract

Exercise positively affects most risk factors, diseases and disabling conditions of middle to advanced age, however the majority of middle-aged to older people fall short of the exercise doses recommended for positively affecting cardio-metabolic, musculoskeletal and neurophysiological fitness or disabling conditions. Whole-Body Electromyostimulation (WB-EMS) may be a promising exercise technology for people unable or unmotivated to exercise conventionally. However, until recently there has been a dearth of evidence with respect to WB-EMS-induced effects on health-related outcomes. The aim of this systematic review is to summarize the effects, limitations and risks of WB-EMS as a preventive or therapeutic tool for non-athletic adults. Electronic searches in PubMed, Scopus, Web of Science, PsycINFO, Cochrane and Eric were run to identify randomized controlled trials, non-randomized controlled trials, meta-analyses of individual patient data and peer reviewed scientific theses that examined (1) WB-EMS-induced changes of musculoskeletal risk factors and diseases (2) WB-EMS-induced changes of functional capacity and physical fitness (3) WB-EMS-induced changes of cardio-metabolic risk factors and diseases (4) Risk factors of WB-EMS application and adverse effects during WB-EMS interventions. Two researchers independently reviewed articles for eligibility and methodological quality. Twenty-three eligible research articles generated by fourteen research projects were finally included. In summary, thirteen projects were WB-EMS trials and one study was a meta-analysis of individual patient data. WB-EMS significantly improves muscle mass and function while reducing fat mass and low back pain. Although there is some evidence of a positive effect of WB-EMS on cardio-metabolic risk factors, this aspect requires further detailed study. Properly applied and supervised, WB-EMS appears to be a safe training technology. In summary, WB-EMS represents a safe and reasonable option for cohorts unable or unwilling to join conventional exercise programs. However, much like all other types of exercise, WB-EMS does not affect every aspect of physical performance and health.

Exercise training improves sleep quality: A randomized controlled trial

“…The HIIT-EMS group showed an improvement of 14.9% in total sleep time, 6.4% in sleep efficiency, and −24.4% in wake after sleep onset, enhancing therefore the objective sleep quality. These improvements could be related to several physiological mechanisms: (a) the electrical muscle stimulation (EMS) produces a greater growth hormone response than voluntary exercise in addition to voluntary muscular contractions, 25 which may stimulate rapid eye movement sleep 26 ; (b) the EMS improves body composition parameters (fat mass, muscle mass and bone mineral density), 27 which may enhance sleep quality 28 ; and (c) the EMS ameliorates physical fitness, 27 which could improve sleep quality. 28 However, this study did not support such mechanisms.…”

Rhabdomyolysis in an elite dancer after training with electromyostimulation: A case report

“…Each set involved 25 repetitions. The subject set the intensity of the EMS to a level where full contraction was visible and palpable (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)35 Hz). Workload was 6 seconds of activation and 7 seconds resting time (COMPEX SP 8.0 wireless).…”

“…9 This effect can be precipitated from a low intensity, low frequency, non-damaging EMS protocol. 9,10,25 Ultimately, this allows the athlete to adapt to the initial stimulus and then later on be able to tolerate a higher intensity, frequency, and volume of exercise. 9 Thus, if practitioners assess the EMS rehabilitation tool/exercise protocol there might be a theoretical rationale for making the initial bout at low intensity and low frequency to ensure the RBE is in place.…”

Effects of different exercise training programs on body composition: A randomized control trial

“…Despite high‐intensity interval training is currently the trendiest time‐efficient exercise method, alternative exercise training programs are arising. Whole‐body electromyostimulation training is able to stimulate all the main muscle groups with dedicated intensity simultaneously and has become increasingly popular during the last decade. A total of 21 studies have investigated its influence on physical fitness and health in trained and untrained individuals, and in patients who cannot perform conventional modalities of exercise because of physical or mental illness .…”