Abstract
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. I2 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.
Highlights
Whole-body electromyostimulation (WB-EMS) is an ever more popular training technology that can stimulate multiple muscle groups simultaneously with regionally dedicated intensity
One strategy predominately used in athletic performance (e.g., Filipovic et al, 2015, 2016, 2019; Wirtz et al, 2016, 2019; Amaro-Gahete et al, 2018a,b; Micke et al, 2018; Ludwig et al, 2020), but rarely applied in the health and fitness domain (Amaro-Gahete et al, 2019a; Pano-Rodriguez et al, 2020a,b), combined different stimulation parameters and prescribes high voluntary loads superimposed by WBEMS with an impulse intensity that just allows the proper application of the target exercise
Sixteen studies were included in this systematic review and meta-analysis, comprising 19 individual training groups based on our eligibility criteria (Kemmler et al, 2010a,b, 2014, 2016c,d, 2018a,b; Vatter, 2010; Kemmler and von Stengel, 2013; Schink et al, 2018; Weissenfels et al, 2018; Jee, 2019; Bellia et al, 2020; Kim and Jee, 2020; Ludwig et al, 2020; Ricci et al, 2020)
Summary
Whole-body electromyostimulation (WB-EMS) is an ever more popular training technology that can stimulate multiple muscle groups simultaneously with regionally dedicated intensity. The more popular WB-EMS strategy, almost exclusively applied by commercial WB-EMS suppliers, focuses on negligible to low effort voluntary workload by gentle movements and (adjuvant) moderate-high impulse intensities, i.e., “electric current” not voluntary workload providing the dominant effect Independently of this aspect, WBEMS can be classified predominately as a resistance type exercise. Several studies focus on athletic performance in younger adults (e.g., Filipovic et al, 2016, 2019; Amaro-Gahete et al, 2018b; D’Ottavio et al, 2019; Wirtz et al, 2019; Ludwig et al, 2020), the vast majority of WB-EMS trials address the health and fitness domain in predominately untrained, middleaged to older adults (Kemmler et al, 2020b) This core client group of commercial WB-EMS providers (EMS-Training.de, 2017) might be predominately attracted by the perceived time efficiency, low mechanical demands, joint “friendliness,” and individual scalability (Kemmler et al, 2020b) of this training technology. The aim of the present study was to provide further evidence for the effectiveness of WB-EMS to impact body composition, muscle strength, and function
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