Article

Whole-Body Electromyostimulation Improves Performance-Related Parameters in Runners

Abstract and Figures

The aim of this study was to study the effects of a 6-session (one per week) WB-EMS training intervention on maximum oxygen uptake, aerobic and gas exchange thresholds, running economy, and muscular power in male recreational runners. Twelve men were randomized into WB-EMS intervention (n = 6; 27.0 ± 7.5 years; 70.1 ± 11.1 kg; 1.75 ± 0.5 m) or control (n = 6; 27.0 ± 6.1 years; 73.6 ± 3.4 kg; 1.77 ± 0.3 m). The WB-EMS group reduced the running training frequency to one per week and followed one WB-EMS training session per week during 6 weeks. Participants in the control group maintained their usual running endurance training. Each participant completed four assessments: physiological parameters [(i) VO 2 max, aerobic and gas exchange threshold values, and (ii) running economy at two intensities], muscular power (vertical jump), and anthropometric parameters both at baseline and after the intervention. Participants in the WB-EMS group improved VO 2 max, aerobic and gas exchange threshold values, running economy, and vertical jump (p < 0.05) compared to the control group. There, WB-EMS seems to be an effective training methodology leading to improvements in performance during endurance training volume reduction in male recreational runners.
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ORIGINAL RESEARCH
published: 13 November 2018
doi: 10.3389/fphys.2018.01576
Edited by:
Wolfgang Kemmler,
Friedrich-Alexander-Universität
Erlangen-Nürnberg, Germany
Reviewed by:
Pedro Jiménez Reyes,
Universidad Rey Juan Carlos, Spain
Nicolas Wirtz,
German Sport University Cologne,
Germany
*Correspondence:
Francisco J. Amaro-Gahete
amarof@ugr.es
Angel Gutierrez
gutierre@ugr.es
Specialty section:
This article was submitted to
Exercise Physiology,
a section of the journal
Frontiers in Physiology
Received: 31 July 2018
Accepted: 22 October 2018
Published: 13 November 2018
Citation:
Amaro-Gahete FJ, De-la-O A,
Sanchez-Delgado G,
Robles-Gonzalez L, Jurado-Fasoli L,
Ruiz JR and Gutierrez A (2018)
Whole-Body Electromyostimulation
Improves Performance-Related
Parameters in Runners.
Front. Physiol. 9:1576.
doi: 10.3389/fphys.2018.01576
Whole-Body Electromyostimulation
Improves Performance-Related
Parameters in Runners
Francisco J. Amaro-Gahete1,2*, Alejandro De-la-O1, Guillermo Sanchez-Delgado2,
Lidia Robles-Gonzalez1, Lucas Jurado-Fasoli1, Jonatan R. Ruiz2and Angel Gutierrez1*
1Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain, 2PROmoting FITness
and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty
of Sport Sciences, University of Granada, Granada, Spain
The aim of this study was to study the effects of a 6-session (one per week) WB-EMS
training intervention on maximum oxygen uptake, aerobic and gas exchange thresholds,
running economy, and muscular power in male recreational runners. Twelve men were
randomized into WB-EMS intervention (n= 6; 27.0 ±7.5 years; 70.1 ±11.1 kg;
1.75 ±0.5 m) or control (n= 6; 27.0 ±6.1 years; 73.6 ±3.4 kg; 1.77 ±0.3 m). The
WB-EMS group reduced the running training frequency to one per week and followed
one WB-EMS training session per week during 6 weeks. Participants in the control
group maintained their usual running endurance training. Each participant completed
four assessments: physiological parameters [(i) VO2max, aerobic and gas exchange
threshold values, and (ii) running economy at two intensities], muscular power (vertical
jump), and anthropometric parameters both at baseline and after the intervention.
Participants in the WB-EMS group improved VO2max, aerobic and gas exchange
threshold values, running economy, and vertical jump (p<0.05) compared to the
control group. There, WB-EMS seems to be an effective training methodology leading
to improvements in performance during endurance training volume reduction in male
recreational runners.
Keywords: WB-EMS, VO2max, running economy, detraining, recreational runners, endurance
INTRODUCTION
Long-distance running performance depends on the interaction of physiological, biomechanical,
and psychological factors (Bassett and Howley, 2000). Physiological attributes include (i) high
cardiac output and high rate of oxygen availability and delivery to working muscles reflected
on maximum oxygen consumption (VO2max) and dependent of muscle capillary density, stroke
volume, maximal heart rate, and hemoglobin content; (ii) capacity to sustain a high VO2fraction
for long periods of time [i.e., ventilatory threshold 1 (VT1) and ventilatory threshold 2 (VT2), which
depend on aerobic enzyme activity, and distribution of power output]; (iii) capacity to produce
movement with the minimum energy cost [i.e., running economy (RE), which depends on the
percentage of slow twitch muscle fibers, anthropometry, and elasticity] (Bassett and Howley, 2000;
Foster and Lucia, 2007;Joyner and Coyle, 2008); and (iv) capacity to develop muscular power (Nuhr
et al., 2003).
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Detraining has been characterized as a partial loss of
training-induced physiological and performance adaptations, as a
consequence of various weeks of training cessation (Maldonado-
Martín et al., 2016). However, detraining periods are frequent
and, in many cases, uncontrollable in most sport disciplines
(injuries, transition periods, discharge micro-cycle, etc.). It has
been shown that detraining periods produce several decrements
in VO2max after 3 and 8 weeks (7% and 16%, respectively)
(Costill et al., 1985;Mujika and Padilla, 2001). Therefore, it is
necessary to seek for other alternatives to prevent or reduce
the large decreases in physiological and performance-related
parameters induced by training cessation (Mujika and Padilla,
2001;Berryman et al., 2018).
Strength training has emerged as an effective strategy to
improve aerobic running performance (Mujika, 2017;Berryman
et al., 2018). Although local electromyostimulation training
seems an alternative to traditional strength training (Filipovic
et al., 2012), there are no studies that evaluate its effects on
physiological parameters related physical fitness in recreational
runners.
Whole-body electromyostimulation (WB-EMS) is becoming
increasingly popular as a novel training technology. While local
electromyostimulation produces an external stimulation of single
specific muscle groups, WB-EMS is able to simultaneously
stimulate up to 14–18 regions or 8–12 different muscle groups
with up to 2.800 cm2electrode area (Filipovic et al., 2015).
Positive effects of WB-EMS on health biomarker parameters
have been shown. WB-EMS improves body composition in
elderly women (60 years) with sarcopenic obesity or at risk
of sarcopenia (Kemmler et al., 2014, 2016c), in postmenopausal
(Kemmler et al., 2010) and in healthy untrained middle-aged men
(Kemmler et al., 2016b). Secondly, WB-EMS increases resting
metabolic rate in postmenopausal women (Kemmler et al., 2010),
and increases energy expenditure during exercise in moderately
trained men (Kemmler et al., 2012). WB-EMS also improves
strength levels in elite football players (Filipovic et al., 2016), in
postmenopausal women (Kemmler et al., 2010), and in healthy
untrained middle-aged men (Kemmler et al., 2016b), as well as
bone mineral density in osteopenic women (>70 years) (Von
Stengel et al., 2015). Finally, WB-EMS training seems to improve
human red blood cell deformability in elite football players
(Filipovic et al., 2015). Whether WB-EMS is able to improve
running performance parameters is unknown, and whether it is
able to prevent or reduce performance-related detraining after a
period of training volume reduction remains to be investigated.
However, considering that previous studies have demonstrated
that WB-EMS can enhance muscular strength (Kemmler et al.,
2010, 2014;Filipovic et al., 2016) and body composition
(Kemmler et al., 2010, 2014, 2016b,c) by an increment of total
muscle contraction during a training session, and that the
development of muscular strength and body composition are
related to endurance performance (Mujika, 2017;Berryman et al.,
2018), it seems plausible that a well-designed WB-EMS training
program can induce an improvement of endurance performance-
related parameters. A possible physiological explanation that
support this idea could be that the extra activation produced by
WB-EMS may induce better neural function, peripheral changes
such as a shift in muscle-fiber distribution (from fast twitch type
IIb toward fatigue-resistant type IIa) and increases in muscle–
tendon stiffness improving endurance performance.
To note, most of the intervention programs applied in
scientific studies using WB-EMS consisted of a set of non-
functional exercise tasks (i.e., not considering the motor
requirements of specific sport or functional movements).
Moreover, these programs did not modify electrical or training
parameters across sessions. This lack of stimuli variation could
lead to a decrease in training efficiency (Harries et al., 2015),
and poor sport performance (Kiely, 2012). Thus, there is a need
to study whether a WB-EMS intervention based on functional
exercises (considering the motor requirements of specific sport)
and with electrical parameters following a periodization improves
running performance.
The aim of this study was to determine the effects of a 6 weeks
(once session per week) WB-EMS training program on VO2max,
VT1, VT2, RE, and vertical jump in recreational runners, while
participants reduced the running frequency training to once per
week. Our hypothesis, is that WB-EMS training program could
keep and even improve running performance despite a relative
running frequency training reduction.
MATERIALS AND METHODS
Experimental Approach
The present study is part of a parallel randomized controlled
trial that followed the CONSORT statements (ClinicalTrials.gov
ID: NCT03425981). The first part of this project that studied
the effects of a periodized and functional WB-EMS training on
VO2max, VT1, VT2, RE, and vertical jump in runners compared
with a traditional WB-EMS was published recently (Amaro-
Gahete et al., 2018). The present study investigated the effects
of the periodized and functional WB-EMS training modality on
running performance with a control group. Participants in the
WB-EMS group were instructed to reduce their running training
program volume, whereas the CG continued with their running
training in term of volume and intensity: two or three times
per week (45–60 min per day) at an intensity of 60–70% heart
rate reserve, which was controlled by heart rate monitor (Polar
RS300X, POLAR, Kempele, Finland), and with 24–48 h of rest
between sessions. Nevertheless, there is some overlap between
the two publications with respect to participants and general
methodology.
Participants
Fourteen healthy male recreational runners (26.6 years;
BMI = 23.5 kg/m2) participated in the study. Participants were
frequent runners (running frequency of two to three times per
week, at least 90–180 min/week) and none had received WB-
EMS training. Two out of fourteen participants did not complete
the study and were excluded from the analysis. Participants
signed an informed consent to participate in the study and no
ethical issues were raised in relation to the type of measurements
to be performed in the study. The study was approved by the
Human Research Ethics Committee of the University of Granada
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(200/CEIH/2016) and complied with the ethical guidelines of the
Declaration of Helsinki, last modified in 2013. Participants were
instructed not to modify their nutrition habits.
WB-EMS Training Program
The WB-EMS device used (Miha Bodytec, Augsburg, Germany)
allows to modify several electrical parameters: (i) frequency,
defined as the number of electrical pulses per time unit. Several
studies shown that slow and fast fibers are not selectively activated
with local electromyostimulation at low or high frequencies, but
it is well known that it preferentially recruits fast versus slow
motor units independently of the frequency applied (Gregory
and Bickel, 2005), (ii) impulse width, which could influence
the intensity of muscle contraction when combined with other
stimulation parameters in the recommended range (Filipovic
et al., 2012;Amaro-Gahete et al., 2017); (iii) impulse intensity,
which was adjusted (at the subject’s maximum tolerance levels)
because of the increasing tolerability of the current intensity,
following the guided and supervised low-intensity resistance
protocols recently described (Kemmler et al., 2016a) every 3–
5 min in close cooperation with the participants (Kemmler
et al., 2010, 2012, 2014, 2016b,c;Kemmler and von Stengel,
2013;Von Stengel et al., 2015); and (iv) duty cycle, which is
defined as the ratio between time receiving electrical stimuli
and the total cycle time (in relation to the frequency selected,
as high duty cycle need to be used with low frequencies
to be feasible) (Filipovic et al., 2012;Amaro-Gahete et al.,
2017).
The WB-EMS equipment enables the simultaneous activation
of sixteen different muscle groups (e.g., upper legs, upper arms,
gluteals, abdomen, chest, lower back, upper back, shoulder;
total size of electrodes: at least 2,800 cm2). The WB-EMS
training program consisted of six WB-EMS training sessions
(one per week) and six running training sessions (also one per
week). All WB-EMS training sessions were short (<20 min)
and a high intensity training approach was applied. Participants
went through a familiarization session (prior to the exercise
program) aiming to learn movement patterns (i.e., proper
techniques of the exercises) and adapt to the electric stimuli.
Electrical parameters (frequency, impulse intensity, and duty
cycle), volume (training session time and work-recovery time),
and perceived intensity (RPE) were gradually increased along the
6 weeks of intervention. Despite several reviews have provided
information about efficacy ranges of most common electrical
parameters in local electromyostimulation (Gregory and Bickel,
2005;Maffiuletti, 2010;Filipovic et al., 2011), the rationale of our
periodization was based on the principle of progression, because
it is not well known which are the best specific values of each
electrical parameter in WB-EMS training for improving running
performance. Participants were asked to report the intensity of
the electric impulse training and the perceived intensity by using
the RPE scale (Borg, 1982).
Running training sessions consisted in 20 min running at
two different intensities; 10 min at VT1 speed and 10 min
at 90% of VT2 speed, and these running sessions were also
performed by the control group as a part of its running training
volume per week. All WB-EMS sessions were supervised by
TABLE 1 | Electric parameters description in WB-EMS sessions (periodization).
WB-
EMS/SESSION
1 2 3 4 5 6
W S HP HT W S HP HT W S HP HT W S HP HT W S HP HT W S HP HT
Total duration
(min)
2 6 2 2 4 6 3 3 4 8 3 3 4 8 4 4 4 8 4 4 4 8 4 4
Frequency (Hz) 12 55 60 20 12 65 70 25 12 75 80 35 12 85 90 40 12 85 90 40 12 85 90 40
Impulse width
(µs)
350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350 350
RPE impulse
intensity (6–20)
10 12 13 13 10 12 13 13 10 14 15 15 10 16 17 17 10 16 17 17 10 16 17 17
Duty
cycle (%)
50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50 50
4:4 4:4 10:10 30:30 4:4 4:4 10:10 30:30 4:4 4:4 10:10 30:30 4:4 4:4 10:10 30:30 4:4 4:4 10:10 30:30 4:4 4:4 10:10 10:10
WB-EMS, whole-body electromyostimulation training; W, warm-up phase; S, strength phase; HP, high intensity interval power training phase; HT, high intensity interval training phase; RPE, rated perceived exertion;
Min, minutes; Hz, hertz; µs, microseconds; mA, milliamps.
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an experienced National Strength and Conditioning Association
Certified Personal Trainer (NSCA-CPT).
This intervention program followed a within-day undulating
periodization model. The training sessions were divided into
four parts: warm up (phase A), strength training part (phase B),
high intensity interval power training part (phase C), and high
intensity interval training part (phase D). In all cases, participants
only did movements when receiving electrical impulse. Electrical
parameters were modified throughout different parts of the
training program and throughout the session (see Table 1).
A circuit training methodology was applied (with no rest between
exercises) in all phases and no external load was used. In phase
A, participants performed 7–10 repetitions (one set) of three
exercises (e.g., 1/2squat and arm curl); both concentric and
eccentric phases lasted 2 s each in every repetition. In phase B,
participants performed one to two sets of 5–10 repetitions of six
exercises (e.g., Bulgarian squat and military press); concentric
phase lasted one second and eccentric phase duration was three
seconds. In phase C, participants performed one set of eight
exercises (e.g., climber); they were instructed to do as many
repetitions as possible in 10 s with a 10-s rest between exercises.
In phase D, participants did one to two interval sets running
on a treadmill with two different intensities: moderate intensity
(65% VO2max speed, 30..) and high intensity (>85% VO2max
speed, 30..). Specific exercises of each training session have been
largely described in a previous study (Amaro-Gahete et al.,
2018).
Assessments of Dependent Variables
Before and after the intervention, participants were examined
during 2 days. On day 1, an anthropometric assessment and
a maximal treadmill exercise test were performed; on day 2, a
vertical jump test and a running economy test were conducted
(Figure 1). Assessments were performed at the same time of
day (midmorning) to avoid diurnal variation in performance and
changes in laboratory conditions (19–22C temperature; 45–55%
relative humidity). Subjects were asked to consume their habitual
diet and to avoid alcohol, caffeine, and vigorous-intensity exercise
in the 48 h prior to assessments days. Day 1 and day 2 were
separated by 48 h.
Anthropometry
Body mass was determined with an accuracy of 100 g on a SECA
scale (SECA, Hamburg, Germany) and height was determined
with an accuracy of 0.100 cm with a SECA stadiometer (SECA,
Hamburg, Germany); and body mass index was calculated
(kg/m2).
Maximal Oxygen Consumption
Maximal oxygen consumption was assessed using a maximum
treadmill (H/P/Cosmos Pulsar treadmill, H/P/Cosmos Sport
and Medical GMBH, Germany) exercise test with a progressive
incremental protocol that has been extensively used and validated
(Machado et al., 2013). In brief, after a warm-up consisting in
walking at 5 km/h for 3 min, protocol started with an initial
speed of 8 km/h, which was increased 1 km/h every minute
until participants reached their volitional exhaustion. Thereafter,
participants underwent a cooling-down period (4 km/h during
5 min). O2uptake and CO2production were measured with
a gas analyzer (Oxycon Pro; Jaeger, Höchberg, Germany). The
gas analyzer was calibrated with a known gas mixture (0%
O2and 5.5% CO2) and environmental air (20.9% O2and
0.03% CO2) immediately before each test. Participants were
strongly encouraged to invest maximum effort consistently across
assessments. Participants were previously familiarized with the 6–
20 Borg scale (Borg, 1982), which was used to measure the RPE
during the last 15 s of each stage and at exhaustion. Heart rate
(HR) was recorded every 5 s (Polar RS300, Kempele, Finland)
and maximum heart rate (HRmax) was defined as the highest
recorded HR value (Tanaka et al., 2001). We also registered
respiratory, RPE, and heart rate parameters during cooling-
down period. Serum lactate was measured by a Lactate Pro
analyzer (Fact Canada, Quesnel, BC, Canada) 3 min after the
volitional exhaustion was reached. The electrocardiogram was
continuously monitored. Gas exchange data was averaged each
10 s and was downloaded for later analysis. Poole and Jones
FIGURE 1 | Experimental timeline: Testing period in week 0 and week 7, training and running economy from week 1 to week 6. WB-EMS, whole-body
electromyostimulation; VO2max, maximal treadmill exercise test; VJ, vertical jump test; RET, running economy test; FS, familiarization session; WB-E, whole-body
electromyostimulation training session; RT, running training session.
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(2017) recommended to check VO2max plateau with a constant
work rate test performed at 110% of the work rate achieved after
ramp protocol test. However, we decided not to include it because
our participant were recreational runners and this validation is
important specially in sedentary people or patients (Poole and
Jones, 2017).
Ventilatory Thresholds
VT1 and VT2 were estimated from gas exchange data
through different respiratory variables: minute ventilation (VE)
and equivalents for oxygen (VE/VO2) and carbon dioxide
(VE/VCO2) by two independent researchers (FAG and AGS).
A third researcher opinion was sought when they disagreed
(AOP). VT1 was determined at the first point where an increase
in VE/VO2with no increase in VE/VCO2and the departure from
linearity of VE occurred (Lucía et al., 2000). VT2 was determined
at the first point where an increase in both the VE/VO2and
VE/VCO2occurred (Lucía et al., 2000). Speed at VT1 and VT2
was determined and VO2max percentage in VT1 and VT2 were
also calculated.
Running Economy
Running economy was determined during a treadmill test
following a specific protocol used in previous studies (Foster and
Lucia, 2007;Shaw et al., 2014). The treadmill test consisted of two
10-min stages at two different intensities. The two stages were
performed at the speed where VT1 and the 90% of VT2 were
reached in the pre-intervention maximum treadmill exercise test.
The first 2 min of each stage were discarded. RE (oxygen cost of
running a kilometer at a specific velocity) was calculated using the
following equation: VO2(ml/kg/min)/[speed (km/h)/60] (Foster
and Lucia, 2007;Shaw et al., 2014).
Muscular Power
Vertical jump performance was assessed using the
countermovement jump (CMJ) and Abalakov jump (ABJ)
tests. Jumping height was calculated from flight time using
kinematic equations (Lehance et al., 2005) estimated by Ergo
Jump Bosco SystemR
(Globus, Treviso, Italy). Before carrying
out the tests, a standardized warm-up was performed which
included 5 min run at 50% of heart rate reserve, mobility and
muscle activation exercises.
To perform the CMJ, participants were instructed to start
in a standing position without arm swing; they performed
a 2-leg CMJ consisting in a fast-downward movement to a
freely chosen angle, immediately followed by a fast-maximal
vertical thrust. Any jump that was perceived to deviate from
the required instructions was repeated. Two trials separated by
1 min of passive recovery were performed. The highest jump was
considered for further analysis. For the ABJ, participants did the
same actions than CMJ, but including arm swing.
Statistical Analyses
All outcome variables were checked for normality with a
graphical test (QQ-Plots) and results expressed as mean
and SD. Baseline and post intervention data were compared
using Student’s paired t-test. One-way analysis of covariance
(ANCOVA) was used to examine the effect of treatment
group (fixed factor) on performance-related parameters. Multiple
comparisons were adjusted according to Bonferroni. We
conducted all statistical analyses using SPSS Statistics (version 20,
IBM, Ehningen, Germany) software, setting level of significance
at p<0.05.
RESULTS
Participants completed 95.83% training sessions in WB-EMS.
No WB-EMS related adverse effects were reported by any
participant. Baseline characteristics, post-intervention values,
and mean change of study performance-related variables and
body composition parameters in WB-EMS and control groups
are listed in Table 2. There was no difference between
groups before the intervention program. The impulse intensity
reported by the participants for each session (measured by
RPE) was similar to the impulse intensity pre-established
(mean difference ±SD, 0.84 ±0.24). This fact confirmed that
participants of WB-EMS group adhered to the protocol designed
in term of impulse intensity. Detailed information of the training
performed by control group during the intervention study is
listed in Table 3.
Figure 2 shows changes (post–pre) on maximal performance-
related parameters by group. Student’s paired t-test showed
no statistical changes in absolute values of VO2max in
WB-EMS and CG, but clinically relevant in WB-EMS
(104.01 ±41.22 ml/kg/min, P= 0.082) (Figure 2A). However,
relative values of VO2max significantly increased in WB-EMS
(2.79 ±0.89 ml/kg/min, P= 0.001), while no significant
changes were registered in CG (0.36 ±1.08 ml/kg/min,
P= 0.821) (Figure 2C). We observed significant changes when
comparing WB-EMS with CG (P<0.001) only in relative terms
(Figures 2B,D).
ANCOVA revealed significant differences in maximal aerobic
speed and VT2 speed when comparing changes of WB-EMS with
CG (P<0.05 for maximal aerobic speed and P<0.001 for VT2
speed) (Figures 2E,F,3E,F) but no differences were found in VT1
speed (P= 0.243).
Student’s paired t-test also showed significant increases in
VO2at VT2 in WB-EMS (p= 0.01) (Figure 3A). When
compared mean change in WB-EMS with CG, we also observed
significant differences (P<0.001) (Figure 3B). Changes of the
VO2max percentage reached in VT2 were also higher in WB-
EMS when compared with CG (P<0.001) (Figures 3C,D) and
no changes were observed in VO2max percentage reached in VT1
(P= 0.517).
Running economy at VT1 speed significantly increased
in WB-EMS (9.99 ±3.80 ml/kg/min) compared with CG
(P<0.001; Figures 4A,B). Running economy at 90% of
VT2 speed (Figures 4C,D) was also increased in WB-EMS
(15.38 ±4.72 ml/kg/min, P= 0.01).
Muscular power, assessed by vertical jump (CMJ and ABJ),
improved in WB-EMS (0.02 ±0.02 m in CMJ and 0.03 ±0.01
m in ABJ, respectively), while no changes were observed in CG
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TABLE 2 | Descriptive parameters and changes in primary and secondary outcomes following a 6-week training program.
WB-EMS (n= 6) CONTROL GROUP (n= 6)
PRE POST P-value PRE POST P-value
Body mass (kg) 70.1 ±11.1 68.6 ±11.0 0.02373.6 ±2.1 74.1 ±1.9 0.083
BMI (kg/m2) 22.6 ±2.8 22.2 ±2.6 0.03123.4 ±0.8 23.5 ±0.7 0.060
VO2max (ml/min) 3790.8 ±812.4 3894.8 ±802.4 0.082 3905.8 ±480.2 3905.0 ±412.6 0.983
VO2max (ml/kg/min) 53.9 ±5.3 56.7 ±5.2 0.001∗∗ 53.1 ±6.4 52.7 ±5.6 0.442
VO2VT1 28.2 ±3.4 29.6 ±3.4 0.010∗∗ 27.0 ±3.6 26.8 ±3.4 0.399
VO2VT2 40.8 ±4.6 43.7 ±5.1 0.004∗∗ 40.6 ±3.3 40.1 ±3.7 0.325
%max VO2VT1 56.3 ±8.5 58.8 ±12.1 0.336 54.2 ±5.4 54.9 ±2.8 0.797
%max VO2VT2 84.2 ±5.4 87.2 ±7.1 <0.001 ∗∗ 85.2 ±4.5 83.9 ±3.5 0.101
SPEEDpeak (km/h) 16.7 ±1.6 17.5 ±1.8 0.04115.5 ±1.6 15.5 ±0.8 1.000
VT1s (km/h) 9.3 ±1.2 10.3 ±1.4 0.0428.3 ±0.5 8.5 ±0.5 0.611
VT2s (km/h) 14.0 ±1.1 15.2 ±0.8 0.001∗∗ 13.2 ±1.2 13.2 ±1.2 0.511
RE VT1 (ml/kg/km) 210.1 ±12.0 202.4 ±12.5 0.001 220.5 ±20.5 219.8 ±19.6 0.465
RE VT2 (ml/kg/km) 248.5 ±26.3 233.1 ±22.6 0.001 258.7 ±21.2 260.1 ±23.7 0.340
CMJ (m) 0.32 ±0.06 0.33 ±0.06 0.0270.32 ±0.04 0.32 ±0.03 0.967
ABJ (m) 0.36 ±0.06 0.38 ±0.06 0.001 0.37 ±0.01 0.37 ±0.01 0.789
P<0.05, ∗∗ P<0.01, ∗∗ P<0.001, Student’s paired t-test. BMI, body mass index; VO2max, maximum oxygen uptake; %max VO2VT1, oxygen uptake percentage
in ventilatory threshold 1 relative of maximum oxygen uptake; %max VO2VT2, oxygen uptake percentage in ventilatory threshold 2 relative of maximum oxygen uptake;
VT1s, ventilatory threshold 1 speed; VT2s, ventilatory threshold 2 speed; CMJ, countermovement jump; ABJ, Abalakov jump; RE VT1, running economy ventilatory
threshold 1; RE VT2, running economy at 90% of ventilatory threshold 2; WB-EMS, whole-body electromyostimulation group.
TABLE 3 | Detailed information of the training performed by control group during
the intervention study.
Training session
(session/weeks)
Session duration
(min)
Session intensity
(%HRres)
Week 1 2.7 ±0.3 51.7 ±6.2 64.8 ±3.1
Week 2 2.6 ±0.4 48.3 ±8.0 61.4 ±7.8
Week 3 2.7 ±0.5 53.1 ±4.6 62.8 ±4.7
Week 4 2.5 ±0.4 49.5 ±5.2 66.7 ±5.7
Week 5 2.8 ±0.3 50.3 ±7.3 67.1 ±3.8
Week 6 2.4 ±0.5 54.4 ±5.7 65.7 ±4.3
Results are expressed as mean ±SD. HRres, heart rate reserve.
(Figures 5A,C). Significant differences were found in CMJ and in
ABJ changes between WB-EMS and CG (P<0.05 and P<0.01,
respectively) (Figures 5B,D).
DISCUSSION
The major findings of this study were that 6 weeks of WB-
EMS training (coupled to a reduction in running endurance
training) improved: (i) VO2max (5.2%); (ii) speed and VO2max
percentage at which VT2 is reached (1= 8.6% and 1= 4.6%,
respectively); (iii) running economy at speeds where VT1 and
90% of VT2 were reached (3.3% and 6.2%, respectively);
and (iv) muscular power in CMJ and ABJ (1= 4.4% and
1= 8.4%, respectively). These results suggest that, in recreational
runners, WB-EMS training increased performance in spite of
the significant reductions in endurance training, provided that
WB-EMS training program follows a specific periodization of
electrical parameters and is based on functional exercises.
Maximal Oxygen Consumption
VO2max is not only an excellent marker of running performance
(Bassett and Howley, 2000) but also a marker of health and
quality of life (Kodama et al., 2009;McKinney et al., 2016).
Available evidence suggests that aerobic endurance training, at
an intensity of at least 65% of VO2max is an adequate stimulus to
improve VO2max in individuals with baseline aerobic capacities
below 40 ml/kg/min (Swain and Franklin, 2002). This finding was
confirmed by a meta-analysis which revealed that the training
effect of this modality was greater for less fit runners and
with longer duration interventions (Milanovi´
c et al., 2015). On
the other hand, it has been shown that other fitness training
programs, such as HIIT, improved cardiovascular fitness and
other fitness parameters (strength, body composition, or physical
appearance) applying lower volume but higher intensity training.
For this reason, HIIT is suggested to be a viable alternative
to the traditional approach of continuous endurance training
(Milanovi´
c et al., 2015). There are no plausible studies examining
the effect of WB-EMS on cardiorespiratory fitness. However,
Nuhr et al. (2003) found that the chronic application of local
electromyostimulation (10 weeks, 4 h per day, 7 days per week)
at low frequency (15 Hz) of the knee extensor and hamstring
muscles of both legs in healthy volunteers improve maximal
aerobic-oxidative capacity and VO2at the anaerobic threshold
26% and 20%, respectively. In our study, we expected a decrease
in VO2max as a result of the reduction applied in running
training session; paradoxically an increase of 5.2% in relative
values of VO2max was observed after 6 weeks of WB-EMS. This
effect was similar to an intervention program consisting of 24
sessions of HIIT in people with cardiometabolic disorders (2–
5 min at 80% VO2max with active recovery at 60% VO2max)
and a bit smaller than the effects determined by 4 weeks of HIIT
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FIGURE 2 | Pre and post 6-week intervention values and mean change (95% CI) in maximal oxygen uptake (absolute and relative values), and maximal aerobic
speed after the intervention program. (A,B) Maximal oxygen uptake [VO2max (mlmin1)]; (C,D) maximal oxygen uptake [VO2max (mlkg1min1)]; (E,F) maximal
aerobic speed [MAS (kmh1)]. §P<0.05, §§ P<0.01, §§§ P<0.001 (analysis pre–post; Student’s paired t-test). P<0.05, P<0.01, ∗∗ P<0.001 (analysis
between groups; ANCOVA).
(4 ×4-min interval training at 90–95% HRmax with 3 min of
active resting periods at 70% HRmax between each interval) in
adults that elevated VO2max by 7.5% (Adamson et al., 2014).
Ventilatory Thresholds
VT1 and VT2 speed performance is associated with muscle
respiratory capacity, and the ability to produce less lactate at
a given running speed is a determinant of prolonged running
performance. It has been suggested that the submaximal blood
lactate response to exercise is associated with peripheral factors
including muscle fiber type, capillary density, and mitochondrial
volume density (Esfarjani and Laursen, 2007). In the present
study, speed at which VT1 and VT2 are reached were increased
in WB-EMS (8.9% and 8.3%, respectively) compared with
baseline values. These results are slightly smaller than those
obtained in a specific HIIT intervention [high-intensity running
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FIGURE 3 | Pre and post 6-week intervention values and mean change (95% CI) in oxygen uptake at ventilatory threshold 2, maximal oxygen uptake percentage in
ventilatory threshold 2, and ventilatory threshold 2 speed. (A,B) Oxygen uptake at ventilatory threshold 2 [VO2VT2s (mlkg1min1)]; (C,D) maximal oxygen
uptake percentage in ventilatory threshold 2 [%VO2max VT2]; (E,F) ventilatory threshold 2 speed [VT2 speed (kmh1)]. §P<0.05, §§ P<0.01, §§§ P<0.001
(analysis pre–post; Student’s paired t-test). P<0.05, P<0.01, P<0.001 (analysis between groups; ANCOVA).
bouts at 15.7 (0.7) km/h for 3.5 (0.7) min followed by low
intensity recovery runs at 7.8 (0.3) km/h for 3.5 (0.7) min]
in moderately trained young males (improvement of 11.7% in
VT2 compared to baseline) (Esfarjani and Laursen, 2007). The
increased mitochondrial enzyme content, which is associated
with an increase in the rate of lipid utilization and consequently
a decrease in rate of glycogen depletion and increased capillary
density after endurance training, could also increase the exchange
area and decrease the distance between the site of lactate
production and the capillary wall, which could improve the
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FIGURE 4 | Pre and post 6-week intervention values and mean change (95% CI) in running economy at ventilatory threshold 1 and 90% of ventilatory threshold 2
speed after the intervention program. (A,B) Running economy at ventilatory threshold 1 speed [VO2VT1s (ml/kg/km)]; (C,D) running economy at 90% of ventilatory
threshold 2 speed [VO2VT2s (ml/kg/km)]. §P<0.05, §§ P<0.01, §§§ P<0.001 (analysis pre–post; Student’s paired t-test). P<0.05, P<0.01, ∗∗ P<0.001
(analysis between groups; ANCOVA).
lactate exchange ability (Esfarjani and Laursen, 2007). These are
possible explanations for the increase of speed at which VT1 and
VT2 is reached, after the application of WB-EMS training. Other
possible reasons that could explain the increase of VT2 speed are
the improvement of (i) running economy, (ii) VO2max, and (iii)
maximal oxygen uptake percentage in VT2. Our results suggest
that if we examined WB-EMS parameters, we could remark that
improvements in VT2 speed could be the consequence of the sum
of the three previous factors.
Running Economy
Running economy refers to the oxygen uptake required at a given
absolute exercise intensity (Barnes and Kilding, 2015). We have
not found previous studies analysing the effects of WB-EMS in
RE. However, it is well known that other training methodologies
produce improvements in running economy. A traditional 14-
week strength training protocol (six exercises, three to five sets,
three to five reps, % 1RM) added to typical endurance training
(concurrent training) produced a significant improvement in RE
(5.6%) in middle-level young athletes (Guglielmo et al., 2009).
In addition, explosive strength based on sprints (20–100 m) and
plyometric training during 9 weeks also induced a significant
improvement in RE (8.0%) comparing with a control group (no
exercise) (Guglielmo et al., 2009). On the other hand, a HIIT
protocol (3 min at 60–65% of maximal heart rate followed by
four bouts alternating 4 min at 90–95% maximal heart rate
and 3 min at 60–65% maximal heart rate, during 3 weeks)
produced improvements in running economy at VT2 speed
(8.8%) in healthy, physically active adults (Holmes et al., 2015).
In our study, RE improved after the implementation of an
intervention program with WB-EMS in two levels: VT1 speed
and 90% of VT2 speed. The differences in both cases were
a decrease of 3.3% VO2in the VT1 speed and 6.2% in the
90% of VT2 speed intensity. Possible reasons for these results
could be: (i) improvement of lower limb coordination and co-
activation of muscles, increased leg stiffness and decreased stance
phase contact times, allowing a faster transition from the braking
to the propulsive phase through elastic recoil; (ii) changes in
the nervous system increasing the activation capacity of the
working muscles, thus producing a greater net force with each
stride; (iii) increasing motor unit recruitment and motor unit
synchronization that could improve mechanical efficiency and
motor recruitment patterns; (iv) that greater muscular strength
following strength and electromyostimulation training could
produce a delay in muscular fatigue, resulting in a smaller
increase in oxygen uptake (increased RE) at any given speed
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FIGURE 5 | Pre and post 6-week intervention values and mean change (95% CI) countermovement jump and Abalakov jump after the intervention program.
(A,B) Countermovement jump [CMJ (m)], (C,D) Abalakov jump [ABJ (m)]. §P<0.05, §§ P<0.01, §§§ P<0.001 (analysis pre–post; Student’s paired t-test).
P<0.05, ∗∗ P<0.01, ∗∗ P<0.001 (analysis between groups; ANCOVA).
during sustained running (Foster and Lucia, 2007;Barnes and
Kilding, 2015).
Muscular Power
Muscular power is considered a critical element for carrying
out daily activities and occupational tasks, as well as successful
athletic performance and usually it is measured by vertical
jump (Markovic, 2007). In our study, we analyzed the effects
on two types of jump that allow differentiation between
the elastic muscle component (CMJ) and coordinative jump
component (ABJ). Both CMJ and ABJ improved after WB-
EMS (4.4% and 8.4%, respectively). These results were similar
to those showed in a meta-analysis, which concluded that
plyometric training improved vertical jump performance, with
CMJ improvements between 7 and 10.4% and ABJ improvements
between 6.2 and 10.8% (Markovic, 2007). On the other hand,
a 4-week local electromyostimulation in quadriceps combined
with plyometric training program [16 sessions, four times per
week: eight electromyostimulation training sessions (two each
week) and eight plyometric training sessions (two each week)]
increased CMJ (8.7%) (Herrero et al., 2006). The results of
our study could be explained by neuromuscular adaptations,
such as increased neural drive to the agonist muscles, improved
intermuscular coordination, changes in the muscle–tendon
mechanical-stiffness characteristics, changes in muscle size or
architecture, and changes in single-fiber mechanics produced for
the training protocol (de Villarreal et al., 2009). Of note, WB-EMS
included a strength phase (thought to improve muscular power),
HIIT which include plyometric exercises (thought to improve
biomechanical parameters such us elastic muscular component),
HIIT (thought to improve ventilatory and metabolic parameters),
being all of them accompanied by WB-EMS (thought to improve
neural activation of the trained muscles).
LIMITATIONS
Our study has some limitations: (i) lack of food intake control; (ii)
we cannot extrapolate the study results to well-trained athletes
or sedentary population because our sample only includes male
recreational runners; (iii) the absence of an additional group
which includes WB-EMS while maintaining previous endurance
training prevents us from knowing if these effects are equal
or better when the WB-EMS is added to the habitual running
training; (iv) we cannot measure health biomarkers which
confirm the absence of high values of creatine kinase levels and/or
rhabdomyolysis, yet participants did not report muscle pain or
fatigue; (v) participants had no previous experience with WB-
EMS training and we do not know whether these results extent to
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Amaro-Gahete et al. WB-EMS Improves Performance Runners
athletes with previous WB-EMS experience; (vi) the small sample
size and therefore the low statistical power; (vii) the assignment
of a WB-EMS effects in our study is difficult since we combined a
variation of multiple stimuli (strength, power and HIIT training
modalities); (viii) we did not use belts and cable to ensure speed
actions like power-training. However, we strongly encouraged
participants to perform each power action as fast as possible.
CONCLUSION
In conclusion, our results suggest that a 6-week WB-EMS training
program (six training sessions) combined with a significant
reduction in endurance training, improved VO2max, VT1, VT2,
RE, and vertical jump, which are related to running performance
in recreational runners. Therefore, WB-EMS could be an effective
training methodology to produce improvements in performance
of recreational runners despite reductions in endurance training
and to avoid detraining when aerobic training is reduced for
certain reasons.
WB-EMS once per week combined with a relatively low
volume of endurance training can be used to improve
physiological performance attributes and muscular power
capacities within a relatively short time period in male
recreational runners. This study shows that a functional running
structure of WB-EMS programming is able to improve VO2max,
VT1, VT2, RE, and vertical jump over a 6-week period.
For optimal adaptation and development of endurance and
muscular power qualities, WB-EMS sessions should be carefully
programmed considering the load, volume, and intensity of
other training sessions without WB-EMS. In addition, it could
be interesting to evaluate whether a combined WB-EMS and
other training program produce extra improvements when
controlling for confounders variables (physical activity, nutrition,
rest, etc.). Inasmuch, when training cessation are superimposed
(muscle discomfort, injuries, environmental conditions, etc.),
WB-EMS could be a feasible and effective training alternative
to prevents not only detraining consequences, but even to
increase performance. We do not know whether these results
can be extended to elite athletes, since the scope of performance
in these individuals are lower. However, the fact that the
application of WB-EMS is a novel stimulus could derive in an
increment of running performance of the same magnitude as
in recreationally runners. Moreover, further studies are needed
to examine the physiological mechanisms that produce these
improvements, and to well-understand if the improvement
of endurance performance-related parameters observed in our
study, are dependent of the exercises selected, the electrical
parameters, or their combination.
DATA AVAILABILITY STATEMENT
The raw data supporting the conclusions of this manuscript will
be made available by the authors, without undue reservation, to
any qualified researcher.
AUTHOR CONTRIBUTIONS
FA-G, AD-l-O, LR-G, JR, and AG conceived and designed the
study. FA-G, AD-l-O, LR-G, and AG designed the tests and
did the intervention training. FA-G, GS-D, and JR elaborated
the statistical section. FA-G drafted the manuscript. AG and JR
revised the manuscript. All authors read and approved the final
manuscript.
FUNDING
The study was supported by the Spanish Ministry of Education
(FPU 13/04365, FPU14/04172, and FPU15/03960). The study was
partially supported by the University of Granada, Plan Propio de
Investigación 2016, Excellence actions: Units of Excellence; Unit
of Excellence on Exercise and Health (UCEES). This study was
also partially supported by Wiemspro, Spain.
ACKNOWLEDGMENTS
We would like to thank all the runners who participated in this
study for their time and effort. We are grateful to Ms. Carmen
Sainz Quinn for assistance with the English language, and
to Manuel Castillo, and Alejandro Romero for constructive
scientific discussions. This study is part of a Ph.D. Thesis
conducted in the Biomedicine Doctoral Studies of the University
of Granada, Spain.
REFERENCES
Adamson, S. B., Lorimer, R., Cobley, J. N., and Babraj,J. A. (2014). E xtremely short-
duration high-intensity training substantially improves the physical function
and self-reported health status of elderly adults. J. Am. Geriatr. Soc. 62, 1380–
1381. doi: 10.1111/jgs.12916
Amaro-Gahete, F. J., de la, O. A., Jurado-Fasoli, L., Ruiz, J. R., and Gutiérrez, Á
(2017). Could superimposed electromyostimulation be an effective training to
improve aerobic and anaerobic capacity? Methodological considerations for its
development. Eur. J. Appl. Physiol. 117, 1513–1515. doi: 10.1007/s00421-017-
3625-x
Amaro-Gahete, F. J., De-la, O. A., Sanchez-Delgado, G., Robles-González, L.,
Jurado-Fasoli, L., Ruiz, J., et al. (2018). Functional exercise training
and undulating periodization enhances the effect of whole-body
electromyostimulation training on running performance. Front. Physiol.
9:720. doi: 10.3389/fphys.2018.00720
Barnes, K. R., and Kilding, A. E. (2015). Strategies to improve running economy.
Sport Med. 45, 37–56. doi: 10.1007/s40279-014- 0246-y
Bassett, D. R., and Howley, E. T. (2000). Limiting factors for maximum
oxygen uptake and determinants of endurance performance. Med.
Sci. Sports Exerc. 32, 70–84. doi: 10.1097/00005768-200001000-
00012
Berryman, N., Mujika, I., Arvisais, D., Roubeix, M., Binet, C., and Bosquet, L.
(2018). Strength training for middle- and long-distance performance: a meta-
analysis. Int. J. Sports Physiol. Perform. 13, 57–63. doi: 10.1123/ijspp.2017-
2032
Borg, G. A. (1982). Psychophysical bases of perceived exertion. Med. Sci. Sports
Exerc. 14, 377–381. doi: 10.1249/00005768-198205000- 00012
Frontiers in Physiology | www.frontiersin.org 11 November 2018 | Volume 9 | Article 1576
fphys-09-01576 November 10, 2018 Time: 17:22 # 12
Amaro-Gahete et al. WB-EMS Improves Performance Runners
Costill, D. L., Fink, W. J., Hargreaves, M., King, D. S., Thomas, R., and Fielding, R.
(1985). Metabolic characteristics of skeletal muscle during detraining from
competitive swimming. Med. Sci. Sports Exerc. 17, 339–343. doi: 10.1249/
00005768-198506000-00007
de Villarreal, E., Kellis, E., Kraemer, W. J., and Izquierdo, M. (2009).
Determining variables of plyometric training for improving vertical jump
height performance: a meta-analysis. J. Strength Cond. Res. 23, 495–506. doi:
10.1519/JSC.0b013e318196b7c6
Esfarjani, F., and Laursen, P. B. (2007). Manipulating high-intensity interval
training: effects on VO2max, the lactate threshold and 3000 m running
performance in moderately trained males. J. Sci. Med. Sport 10, 27–35. doi:
10.1016/j.jsams.2006.05.014
Filipovic, A., Grau, M., Kleinöder, H., Zimmer, P., Hollmann, W., and Bloch, W.
(2016). Effects of a whole-body electrostimulation program on strength,
sprinting, jumping, and kicking capacity in elite soccer players. J. Sports Sci.
Med. 15, 639–648.
Filipovic, A., Kleinöder, H., Dörmann, U., and Mester, J. (2011).
Electromyostimulation-A systematic review of the influence of training
regimens and stimulation parameters on effectiveness in electromyostimulation
training of selected strength parameters. J. Strength Cond. Res. 25, 3218–3230.
doi: 10.1519/JSC.0b013e318212e3ce
Filipovic, A., Kleinöder, H., Dörmann, U., and Mester, J. (2012).
Electromyostimulation-a systematic review of the effects of different
electromyostimulation methods on selected strength parameters in
trained and elite athletes. J. Strength Cond. Res. 26, 2600–2614.
doi: 10.1519/JSC.0b013e31823f2cd1
Filipovic, A., Kleinöder, H., Plück, D., Hollmann, W., Bloch, W., and Grau, M.
(2015). Influence of whole-body electrostimulation on human red blood
cell deformability. J. Strength Cond. Res. 29, 2570–2578. doi: 10.1519/JSC.
0000000000000916
Foster, C., and Lucia, A. (2007). Running economy: the forgotten factor in elite
performance. Sports Med. 37, 316–319. doi: 10.2165/00007256-200737040-
00011
Gregory, C. M., and Bickel, C. S. (2005). Recruitment patterns in
human skeletal muscle during electrical stimulation. Phys. Ther. 85,
358–364.
Guglielmo, L. G. A., Greco, C. C., and Denadai, B. S. (2009). Effects of strength
training on running economy. Int. J. Sports Med. 30, 27–32. doi: 10.1055/s-
2008-1038792
Harries, S. K., Lubans, D. R., and Callister, R. (2015). Systematic review and meta-
analysis of linear and undulating periodized resistance training programs on
muscular strength. J. Strength Cond. Res. 29, 1113–1125. doi: 10.1519/JSC.
0000000000000712
Herrero, J. A., Izquierdo, M., Maffiuletti, N. A., and García-López, J. (2006).
Electromyostimulation and plyometric training effects on jumping and
sprint time. Int. J. Sports Med. 27, 533–539. doi: 10.1055/s-2005-86
5845
Holmes, K., Cannon, A., Wingerd, E., Stepler, K., Fish, A., Peterson, M., et al.
(2015). Effects of 3-weeks of high-intensity interval training on running
economy and endurance. Int. J. Exerc. Sci. 41, 1–10.
Joyner, M. J., and Coyle, E. F. (2008). Endurance exercise performance: the
physiology of champions. J. Physiol. 586, 35–44. doi: 10.1113/jphysiol.2007.
143834
Kemmler, W., Bebenek, M., Engelke, K., and von Stengel, S. (2014). Impact of
whole-body electromyostimulation on body composition in elderly women at
risk for sarcopenia: the training and electrostimulation Trial (TEST-III). Age36,
395–406. doi: 10.1007/s11357-013- 9575-9572
Kemmler, W., Froehlich, M., von Stengel, S., and Kleinöder, H. (2016a). Whole-
body electromyostimulation – the need for common sense! rationale and
guideline for a safe and effective training. Dtsch. Z. Sportmed. 2016, 218–221.
doi: 10.5960/dzsm.2016.246
Kemmler, W., Teschler, M., Weißenfels, A., Bebenek, M., Fröhlich, M., Kohl, M.,
et al. (2016b). Effects of whole-body electromyostimulation versus high-
intensity resistance exercise on body composition and strength: a randomized
controlled study. Evid. Based Complement. Altern. Med. 3, 44–55. doi: 10.1155/
2016/9236809
Kemmler, W., Teschler, M., Weissenfels, A., Bebenek, M., von Stengel, S., Kohl, M.,
et al. (2016c). Whole-body electromyostimulation to fight sarcopenic obesity in
community-dwelling older women at risk. Results of the randomized controlled
FORMOsA-sarcopenic obesity study. Osteoporos. Int. 27, 3261–3270. doi: 10.
1007/s00198-016-3662-z
Kemmler, W., Schliffka, R., Mayhew, J. L., and von Stengel, S. (2010).
Effects of whole-body electromyostimulation on resting metabolic rate, body
composition, and maximum strength in postmenopausal women: the training
and electrostimulation trial. J. Strength Cond. Res. 24, 1880–1887. doi: 10.1519/
JSC.0b013e3181ddaeee
Kemmler, W., and von Stengel, S. (2013). Whole-body electromyostimulation as a
means to impact muscle mass and abdominal body fat in lean, sedentary, older
female adults: subanalysis of the TEST-III trial. Clin. Interv. Aging 8, 1353–1364.
doi: 10.2147/CIA.S52337
Kemmler, W., Von Stengel, S., Schwarz, J., and Mayhew, J. L. (2012).
Effect of whole-body electromyostimulation on energy expenditure during
exercise. J. Strength Cond. Res. 26, 240–245. doi: 10.1519/JSC.0b013e31821
a3a11
Kiely, J. (2012). Periodization paradigms in the 21st century: evidence-led or
tradition-driven? Int. J. Sports Physiol. Perform. 7, 242–250. doi: 10.1123/ijspp.
7.3.242
Kodama, S., Saito, K., Tanaka, S., Maki, M., Yachi, Y., Asumi, M., et al. (2009).
Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and
cardiovascular events in healthy men and women: a meta-analysis. JAMA 301,
2024–2035. doi: 10.1001/jama.2009.681
Lehance, C., Croisier, J., and Bury, T. (2005). Optojump system efficiency in the
assessment of lower limbs explosive strength. Sci. Sport 20, 131–135. doi: 10.
1016/j.scispo.2005.01.001
Lucía, A., Hoyos, J., and Chicharro, J. L. (2000). The slow component of VO2
in professional cyclists. Br. J. Sports Med. 34, 367–374. doi: 10.1136/bjsm.34.
5.367
Machado, F. A., Kravchychyn, A. C. P., Peserico, C. S., da Silva, D. F., and
Mezzaroba, P. V. (2013). Incremental test design, peak “aerobic” running speed
and endurance performance in runners. J. Sci. Med. Sport 16, 577–582. doi:
10.1016/j.jsams.2012.12.009
Maffiuletti, N. A. (2010). Physiological and methodological considerations for the
use of neuromuscular electrical stimulation. Eur. J. Appl. Physiol. 110, 223–234.
doi: 10.1007/s00421-010- 1502-y
Maldonado-Martín, S., Cámara, J., James, D. V. B. B., Fernández-López, J. R.,
and Artetxe-Gezuraga, X. (2016). Effects of long-term training cessation in
young top-level road cyclists. J. Sports Sci. 35, 1–6. doi: 10.1080/02640414.2016.
1215502
Markovic, G. (2007). Does plyometric training improve vertical jump height? A
meta-analytical review. Br. J. Sports Med. 41, 349–355. doi: 10.1136/bjsm.2007.
035113
McKinney, J., Lithwick, D., Bohk, H. I. S., McKinney, J., Lithwick, D., Isserow, S.,
et al. (2016). The health benefits of physical activity and cardiorespiratory
fitness. Med. J. 58, 131–133.
Milanovi´
c, Z., Sporiš, G., and Weston, M. (2015). Effectiveness of High-
Intensity Interval Training (HIT) and continuous endurance training
for VO2max improvements: a systematic review and meta-analysis of
controlled trials. Sports Med. 45, 1469–1481. doi: 10.1007/s40279-015-
0365-0
Mujika, I. (2017). Quantification of training and competition loads in endurance
sports: methods and applications. Int. J. Sports Physiol. Perform. 12, S29–S217.
doi: 10.1123/ijspp.2016-2403
Mujika, I., and Padilla, S. (2001). Muscular characteristics of detraining in humans.
Med. Sci. Sports Exerc. 33, 1297–1303. doi: 10.1097/00005768-200108000-
00009
Nuhr, M., Crevenna, R., Gohlsch, B., Bittner, C., Pleiner, J., Wiesinger, G., et al.
(2003). Functional and biochemical properties of chronically stimulated human
skeletal muscle. Eur. J. Appl. Physiol. 89, 202–208. doi: 10.1007/s00421-003-
0792-798
Poole, D. C., and Jones, A. M. (2017). Measurement of the maximum
oxygen uptake ˙
VO2max: ˙
VO2peak is no longer acceptable.
J. Appl. Physiol. 122, 997–1002. doi: 10.1152/japplphysiol.01063.
2016
Shaw, A. J., Ingham, S. A., and Folland, J. P. (2014). The valid measurement
of running economy in runners. Med. Sci. Sports Exerc. 46, 1968–1973. doi:
10.1249/MSS.0000000000000311
Frontiers in Physiology | www.frontiersin.org 12 November 2018 | Volume 9 | Article 1576
fphys-09-01576 November 10, 2018 Time: 17:22 # 13
Amaro-Gahete et al. WB-EMS Improves Performance Runners
Swain, D. P., and Franklin, B. A. (2002). VO(2) reserve and the minimal intensity
for improving cardiorespiratory fitness. Med. Sci. Sports Exerc. 34, 152–157.
doi: 10.1097/00005768-200201000- 00023
Tanaka, H., Monahan, K., and Seals, D. (2001). Age-predicted maximal heart
rate revisited. J. Am. Coll. Cardiol. 37, 153–156. doi: 10.1016/S0735-1097(00)
01054-8
Von Stengel, S., Bebenek, M., Engelke, K., and Kemmler, W. (2015).
Whole-body electromyostimulation to fight osteopenia in elderly
females: the randomized controlled training and electrostimulation
trial (TEST-III). J. Osteoporos. 11, 1–7. doi: 10.1155/2015/64
3520
Conflict of Interest Statement: The authors declare that the research was
conducted in the absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.
Copyright © 2018 Amaro-Gahete, De-la-O, Sanchez-Delgado, Robles-Gonzalez,
Jurado-Fasoli, Ruiz and Gutierrez. This is an open-access article distributed under
the terms of the Creative Commons Attribution License (CC BY). The use,
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... Loss of fat mass and changes in body composition are also other effects demonstrated in some studies [18][19][20]. On the other hand, there are also studies that report improvement in chronic low back pain [21][22][23] and improving sports performance by increasing jumping, sprinting and muscle power [24][25][26]. ...
... When it comes to cardiovascular endurance in the few studies where these types of exercises have been done, they are either done in metabolic circuits (e.g., high-intensity interval training) or are combined with strength exercises in a two-part hybrid training session [25,40,41]. ...
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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.
... 23 trials used a two-armed design (Amaro-Gahete et al., 2018;Avila et al., 2008;Babault et al., 2007;Billot et al., 2010;Brocherie et al., 2005;da Cunha et al., 2020;Dörmann et al., 2019;Filipovic et al., 2015Filipovic et al., , 2016Kale & Gurol, 2019;Ludwig et al., 2020;Maffiuletti et al., 2000Maffiuletti et al., , 2002Martin et al., 1994;Mathes et al., 2017;Micke et al., 2018;Miller & Thépaut-Mathieu, 1993;Oliveira et al., 2018;Pantović et al., 2015;Pichon et al., 1995;Schuhbeck et al., 2019;Wirtz et al., 2016;Zory et al., 2010), 9 studies a three-armed design (Benito-Martínez et al., 2013;Dervisevic et al., 2002;Filipovic et al., 2019;Girold et al., 2012;Gulick et al., 2011;A. J. Herrero et al., 2010aA. ...
... Due to the limited number of studies on the topic of aerobic capacity, the results of this network should be treated with caution. Large effects could be observed for the intervention WB-EMS/BW + HIT (Amaro-Gahete et al., 2018). This intervention was conducted with runners for over 6 weeks. ...
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This systematic review and network meta-analysis aimed to evaluate the effectiveness of different electromyostimulation (EMS) training interventions on performance parameters in trained athletes. The research was conducted until may 2021 using the online databases PubMed, Web of Science, Cochrane and SPORTDiscus for studies with the following inclusion criteria: (a) controlled trials, (b) EMS trials with at least one exercise and/or control group, (c) strength and/or jump and/or sprint and/or aerobic capacity parameter as outcome (d) sportive/trained subjects. Standardized mean differences (SMD) with 95% confidence interval (CI) and random effects models were calculated. Thirty-six studies with 1.092 participants were selected and 4 different networks (strength, jump, sprint, aerobic capacity) were built. A ranking of different exercise methods was achieved. The highest effects for pairwise comparisons against the reference control "active control" were found for a combination of resistance training with superimposed EMS and additional jump training (outcome strength: 4.43 SMD [2.15; 6.70 CI]; outcome jump: 3.14 SMD [1.80;4.49]), jump training with superimposed whole-body electromyostimulation (WB-EMS) (outcome sprint: 1.65 SMD [0.67; 2.63 CI] and high intensity bodyweight resistance training with superimposed WB-EMS (outcome aerobic capacity: 0.83 SMD [-0.49; 2.16 CI]. These findings indicate that the choice of EMS-specific factors such as the EMS application mode, the combination with voluntary activation, and the selection of stimulation protocols has an impact on the magnitude of the effects and should therefore be carefully considered, especially in athletes. Superimposed EMS with relatively low volume, high intensity and outcome-specific movement pattern appeared to positively influence adaptations in athletes.
... These programs are often based on aerobic exercise, with protocols differing in initiation of the intervention (1-3 months post BS) as well as duration and frequency [13,36]. Regarding WB-EMS, studies demonstrate this technique holds promise as an additional therapeutic mode when other approaches of exercise are not indicated [28], leading to improvements in exercise performance and aerobic capacity (V̇O 2 max) in runners and healthy volunteers [37,38] as well as patients with chronic diseases, such as type II diabetes mellitus, sarcopenic obesity [29,[39][40][41] and chronic heart failure [42]. Previous research has demonstrated positive results with WB-EMS following a 6week intervention [37,38] corroborating the findings of present study and emphasizing the importance of including early rehabilitation programs following BS, which can be enhanced by WB-EMS technology. ...
... Regarding WB-EMS, studies demonstrate this technique holds promise as an additional therapeutic mode when other approaches of exercise are not indicated [28], leading to improvements in exercise performance and aerobic capacity (V̇O 2 max) in runners and healthy volunteers [37,38] as well as patients with chronic diseases, such as type II diabetes mellitus, sarcopenic obesity [29,[39][40][41] and chronic heart failure [42]. Previous research has demonstrated positive results with WB-EMS following a 6week intervention [37,38] corroborating the findings of present study and emphasizing the importance of including early rehabilitation programs following BS, which can be enhanced by WB-EMS technology. ...
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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. 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. 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). 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. ReBEC, RBR-99qw5h, on 20 February 2015.
... Whole-Body Electromyostimulation (WB-EMS) has gained increasing interest in professional and recreational sports within recent years [1,2]. It has been recommended as substitute of exercise and classical methods of training in different health groups including non-trained sedentary [3] and obese people [4,5], patients with haematological malignancies [6], cardiomyopathy [7] or cancer [8] and also in trained athletes [9,10]. ...
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Objectives The use of whole body-electrostimulation (WB-EMS) in combination with strength exercises has been proposed in order to improve muscle strength and rehabilitation. However, the combination of stimulation of muscle with exercise can induce muscle fibers break. This manuscript study Pilates Mat without or in combination with WB-EMS in trained individuals in order to determine the level of muscle damage. Methods We determined the effect of WB-EMS in combination of Pilates Mat in eighteen healthy and trained Intermediate Pilates Mat volunteers to determine the release of muscle damage biomarkers in plasma. Plasma levels of muscle damage markers (CK and transaminases) were determined by enzymatic assays. Results We found that WB-EMS produced a high rise of the release of creatine kinase and transaminases in individuals whereas Pilates Mat did not produce such as effect. The levels of CK in plasma were very high indicating dangerous levels near rhabdomyolysis. This effect was not accompanied by a rise in oxidative stress damage. Conclusions Our results indicate that WB-EMS must be used with precaution in trained and more importantly in non-trained individuals in order to avoid severe muscle damage.
... However, other studies have reported no effects of PTP induced by local electrostimulation on bench press performance [9], nor on jumping, sprinting, and running performance [10]. Nevertheless, it is possible that a higher potentiation effect could be achieved by whole-body electrostimulation (WB-EMS) devices that allow simultaneous exogenous activation of several muscle groups [12,13]. However, to our knowledge, no study has examined the influence of PTP induced by WB-EMS on subsequent muscle performance. ...
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It is currently unknown the most effective potentiation protocol to increase maximum strength. Hence, we investigated the separated and combined effects of post-tetanic potentiation (PTP) induced by whole- body electrostimulation (WB-EMS) and post-activation potentiation (PAP) induced by voluntary maximum isometric contractions on maximum isometric strength. Ten trained males were randomly evaluated on four occasions. In session A, maximum isometric strength (split squat) was measured in minutes 1, 4, and 8. In session B, the measurements were taken in minutes 2, 6, and 10. In session C, a WB-EMS protocol was applied to elicit PTP and the measurements were performed in minutes 1, 4, and 8. In session D, the same WB-EMS protocol was applied and the measurements were taken in minutes 2, 6, and 10. No signi cant differences in maximum isometric strength were observed between: (i) the control and WB-EMS in minutes 1 vs. 1 and 2 vs. 2; (ii) the control and PAP in minutes 1 vs. 4, 1 vs. 8, 2 vs. 6, and 2 vs. 10; and (iii) the PAP and WB-EMS plus PAP in minutes 4 vs. 4, 8 vs. 8, 6 vs. 6, and 10 vs. 10. In contrast, the WB-EMS plus PAP revealed a signi cant increase of 54% (~450 N) compared to the WB-EMS in minutes 4 and 8 compared to the minute 1 (p < 0.001), but not between minutes 2 vs. 6 and 2 vs. 10. The present results showed that PTP induced by WB-EMS in isolation or combined with PAP induced by voluntary maximum isometric contractions did not produce a signi cant increase in maximum isometric strength compared to the control and PAP alone, respectively.
... [8] The training programs are variable according to the objectives and characteristics of their practitioners, increasing their physical condition and improving body composition with the most outstanding benefits, according to experts and manufacturers. [9][10][11] Previous studies [12][13][14][15] verified the effectiveness of WB-EMS and its use as an alternative sports activity, both for those who flee from conventional methodologies and for athletes who want to improve their performance in sports through WB-EMS sessions. This training method has also shown improvements in body composition and strength in the elderly [16][17][18][19][20] and in the active and healthy population. ...
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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.
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Electrical muscle stimulation (EMS) is an increasingly popular training method and has become the focus of research in recent years. New EMS devices offer a wide range of mobile applications for whole-body EMS (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. The present study aimed to determine the differences in exercise intensity between WB-EMS-superimposed and conventional walking (EMS-CW), and CON and WB-EMS-superimposed Nordic walking (WB-EMS-NW) during a treadmill test. Eleven participants (52.0 ± years; 85.9 ± 7.4 kg, 182 ± 6 cm, BMI 25.9 ± 2.2 kg/m2) performed a 10 min treadmill test at a given velocity (6.5 km/h) in four different test situations, walking (W) and Nordic walking (NW) in both conventional and WB-EMS superimposed. Oxygen uptake in absolute (VO2) and relative to body weight (rel. VO2), lactate, and the rate of perceived exertion (RPE) were measured before and after the test. WB-EMS intensity was adjusted individually according to the feedback of the participant. The descriptive statistics were given in mean ± SD. For the statistical analyses, one-factorial ANOVA for repeated measures and two-factorial ANOVA [factors include EMS, W/NW, and factor combination (EMS*W/NW)] were performed (α = 0.05). Significant effects were found for EMS and W/NW factors for the outcome variables VO2 (EMS: p = 0.006, r = 0.736; W/NW: p < 0.001, r = 0.870), relative VO2 (EMS: p < 0.001, r = 0.850; W/NW: p < 0.001, r = 0.937), and lactate (EMS: p = 0.003, r = 0.771; w/NW: p = 0.003, r = 0.764) and both the factors produced higher results. However, the difference in VO2 and relative VO2 is within the range of biological variability of ± 12%. The factor combination EMS*W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values (p = 0.035, r = 0.613), RPE differences for W/NW and EMS*W/NW were not significant. The current study results indicate that WB-EMS influences the parameters of exercise intensity. The impact on exercise intensity and the clinical relevance of WB-EMS-superimposed walking (WB-EMS-W) exercise is questionable because of the marginal differences in the outcome variables.
Conference Paper
Full-text available
Electromyostimulation (EMS) represents an artificial muscle stimulation with a well-defined protocol that is precisely designed to reduce discomfort during unnatural muscle activation. The main goal was to find new information on the basis of systematic review of many studies which examined the impact of EMS on athletes vertical jumping performance, as well as to expand the already known conclusions. Electronic databases (Google Scholar, Pub Med, Web of Science and ResearchGate) were searched for the original scientific research projects on the topic of the impact of EMS on athletes' vertical jumping performance. The last search was conducted in June 2020 with a limitation to study published in English. As many as 415 scientific studies were indentified and only 15 of them were selected and then systematically reviewed and analyzed. The results of the research projects with the total sample size of 445 athletes showed that the treatment of global and local EMS, in combination with another types of training, is an effective method for the development of explosive strength, such as vertical jumping. It has been proven that the EMS represents an effective strategy for improving vertical jumping performance, as well as for improving physical performance of athletes in general.
Article
Full-text available
Electrical muscle stimulation (EMS) is an increasingly popular training method and has become the focus of research in recent years. New EMS devices offer a wide range of mobile applications for whole-body EMS (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. The present study aimed to determine the differences in exercise intensity between WB-EMS-superimposed and conventional walking (EMS-CW), and CON and WB-EMS-superimposed Nordic walking (WB-EMS-NW) during a treadmill test. Eleven participants (52.0 ± years; 85.9 ± 7.4 kg, 182 ± 6 cm, BMI 25.9 ± 2.2 kg/m 2) performed a 10 min treadmill test at a given velocity (6.5 km/h) in four different test situations, walking (W) and Nordic walking (NW) in both conventional and WB-EMS superimposed. Oxygen uptake in absolute (VO 2) and relative to body weight (rel. VO 2), lactate, and the rate of perceived exertion (RPE) were measured before and after the test. WB-EMS intensity was adjusted individually according to the feedback of the participant. The descriptive statistics were given in mean ± SD. For the statistical analyses, one-factorial ANOVA for repeated measures and two-factorial ANOVA [factors include EMS, W/NW, and factor combination (EMS * W/NW)] were performed (α = 0.05). Significant effects were found for EMS and W/NW factors for the outcome variables VO 2 (EMS: p = 0.006, r = 0.736; W/NW: p < 0.001, r = 0.870), relative VO 2 (EMS: p < 0.001, r = 0.850; W/NW: p < 0.001, r = 0.937), and lactate (EMS: p = 0.003, r = 0.771; w/NW: p = 0.003, r = 0.764) and both the factors produced higher results. However, the difference in VO 2 and relative VO 2 is within the range of biological variability of ± 12%. The factor combination EMS * W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values (p = 0.035, r = 0.613), RPE differences for W/NW and EMS * W/NW were not significant. The current study results indicate that WB-EMS influences the parameters of exercise intensity. The impact on exercise intensity and the clinical relevance of WB-EMS-superimposed walking (WB-EMS-W) exercise is questionable because of the marginal differences in the outcome variables.
Thesis
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Die vorliegende Dissertation hat sich in ihren Inhalten maßgeblich mit drei Aspekten der Ganzkörper-Elektromyostimulation (GK-EMS) beschäftigt: der Zielgruppe, den Stimulationsparametern sowie der Effektivität des Trainings. Auf Basis der durchgeführten Studien konnte die zu trainierende Zielgruppe um ein jugendliches Probandengut mit unterschiedlichem sportlichem Hintergrund (Radsport, Fußball) erweitert werden, was die Anwendung einer GK-EMS Applikation nun auch bei minderjährigen Athleten unter Einhaltung diverser Sicherheitsaspekte möglich macht. Bei den untersuchten Stimulationsparametern wurden die Erkenntnisse in Bezug zur maximalen Intensitätstoleranz erweitert, hier kommt es nach drei aufeinanderfolgenden Untersuchungen zu einer Anpassung dieser, was ein Ansatz zur Erstellung eines Maximums und einer nachfolgenden Ableitung von objektiven Trainingsintensitäten sein kann. Die verwendete Stimulationsfrequenz (20 Hz oder 85 Hz) hat des Weiteren keinen Einfluss auf die Leistungssteigerungen unterschiedlicher Parameter (Counter Movement Jump, Squat Jump, Rumpfflexion und Rumpfextension) nach einer 10-wöchigen GK-EMS Applikation mit einem untrainierten Probandengut. Die Effektivität des GK-EMS konnte durch einen 8 bis 10-wöchigen Trainingszeitraum mit unterschiedlichen Zielgruppen anhand unterschiedlicher Zielparameter belegt werden, vor allem bei den Maximalkraftparametern der Rumpfflexion (+33.7%), Rumpfextension (+20.9%), der Knieflexion (+20.7%) sowie Knieextension (+31.4%) wurden hierbei signifikante Leistungssteigerungen festgestellt. Aufbauend auf den generierten Ergebnissen wurde ein 4-Faktoren-Modell des GK-EMS aufgestellt, welches in der praktischen Anwendung als ein dynamisches Leitbild zur sicheren und effektiven GK-EMS Anwendung zu betrachten ist und der Maximierung des Trainingserfolgs bei gleichzeitiger Kontrolle der Inhalte und Minimierung von gesundheitlichen Risiken für den Trainierenden dient. Die Inhalte des GK-EMS, vor allem in Bezug auf die verwendeten Stimulationsparameter, sollten in zukünftigen Untersuchungen weiter spezifiziert werden, um eine verbesserte Systematisierung und somit eine sichere Anwendung des GK-EMS zu gewährleisten.
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The popularity of whole-body electromyostimulation is growing during the last years, but there is a shortage of studies that evaluate its effects on physical fitness and sport performance. In this study, we compared the effects of a periodized and functional whole-body-electromyostimulation training on maximum oxygen uptake (VO 2 max), ventilatory thresholds (VT1 and VT2), running economy (RE), and lower-body muscle strength in runners, vs. a traditional whole-body-electromyostimulation training. A total of 12 male recreational runners, who had been running 2-3 times per week (90-180 min/week) for at least the previous year and had no previous experience on WB-EMS training, were enrolled in the current study. They were randomly assigned to a periodized and functional whole-body-electromyostimulation training group (PFG) (n = 6; 27.0 ± 7.5 years; 70.1 ± 11.1 kg; 1.75 ± 0.05 m) whose training program involved several specific exercises for runners, or a traditional whole-body-electromyostimulation training group (TG) (n = 6; 25.8 ± 7.4 years; 73.8 ± 9.8 kg; 1.73 ± 0.07 m), whose sessions were characterized by circuit training with 10 dynamic and general exercises without external load. The training programs consisted of one whole-body electromyostimulation session and one 20-min running session per week, during 6 weeks. The PFG followed an undulating periodization model and a selection of functional exercises, whereas the TG followed a traditional session structure used in previous studies. Both groups were instructed to stop their habitual running training program. VO 2 max, VT1, VT2, RE, and lower body muscle strength (vertical jump) were measured before and after the intervention. The PFG obtained significantly higher improvements when compared with the TG in terms of VO 2 max (2.75 ± 0.89 vs. 1.03 ± 1.01 ml/kg/min, P = 0.011), VT2 (2.95 ± 1.45 vs. 0.35 ± 0.85 ml/kg/min, P = 0.005), VO 2 max percentage at VT2 (5.13 ± 2.41 vs. 0.63 ± 1.61%), RE at VT1 (−7.70 ± 2.86 vs. −3.50 ± 2.16 ml/kg/km, P = 0.048), RE at 90% of VT2 (−15.38 ± 4.73 vs. −3.38 ± 4.11 ml/kg/km, P = 0.005), and vertical jump in Amaro-Gahete et al. Functional Periodization WB-EMS Running Performance Abalakov modality (2.95 ± 0.94 vs. 0.52 ± 1.49 cm, P = 0.008). Therefore, we conclude that running performance improvements were better after a 6-week program following an undulating periodization and consisting on functional exercises when compared with a 6-week traditional WB-EMS program.
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Purpose: The objective of this study was to assess the net effects of strength training on middle- and long-distance performance through a meta-analysis of the available literature. Methods: Three databases were searched from which 28 out of 554 potential studies met all inclusion criteria. Standardized mean differences (SMDs) were calculated and weighted by the inverse of variance to calculate an overall effect and its 95% confidence interval (CI). Subgroup analyses were conducted to determine whether the strength-training intensity, duration and frequency, and population performance level, age, sex and sport were outcomes that may influence the magnitude of the effect. Results: The implementation of a strength-training mesocycle in running, cycling, cross-country skiing and swimming was associated with moderate improvements in middle- and long-distance performance [net SMD (95%CI) = 0.52 (0.33 to 0.70)]. These results were associated with improvements in the energy cost of locomotion [net SMD (95%CI) = 0.65 (0.32 to 0.98)], maximal force [net SMD (95%CI) = 0.99 (0.80 to 1.18)] and maximal power [net SMD (95%CI) = 0.50 (0.34 to 0.67)]. Maximal force training led to greater improvements than other intensities. Subgroup analyses also revealed that beneficial effects on performance were consistent irrespective of the athletes' level. Conclusion: Taken together, these results provide a framework that supports the implementation of strength training in addition to traditional sport-specific training to improve middle- and long-distance performance, mainly through improvements in the energy cost of locomotion, maximal power and maximal strength.
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The maximum rate of VO2 uptake (i.e., VO2max), as measured during large muscle mass exercise such as cycling or running, is widely considered to be the gold standard measurement of integrated cardiopulmonary-muscle oxidative function. The development of rapid-response gas analyzers, enabling measurement of breath-by-breath pulmonary gas exchange, has led to replacement of the discontinuous progressive maximal exercise test (that produced an unambiguous VO2-work rate plateau definitive for VO2max) with the rapidly-incremented or ramp testing protocol. Whilst this expedient is more suitable for clinical and experimental investigations and enables measurement of the gas exchange threshold, exercise efficiency, and VO2 kinetics, a VO2-work rate plateau is not an obligatory outcome. This shortcoming has led to investigators resorting to so-called secondary criteria such as respiratory exchange ratio, maximal heart rate and/or maximal blood lactate concentration, the acceptable values of which may be selected arbitrarily and result in grossly inaccurate VO2max determination. Whereas this may not be an overriding concern in young, healthy subjects with experience of performing exercise to volitional exhaustion, exercise test naïve subjects, patient populations and less motivated subjects may stop exercising before their VO2max is reached. When VO2max is a or the criterion outcome of the investigation this represents a major experimental design issue. This CORP presents the rationale for incorporation of a second, constant-work rate test performed at 105-110% of the work rate achieved on the initial ramp test to resolve the classic VO2-work rate plateau that is the unambiguous validation of VO2max. The broad utility of this procedure has been established for children, adults of varying fitness, obese individuals and patient populations.
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The aim of the present study was to investigate the effect of a 14-week dynamic Whole-Body Electrostimulation (WB-EMS) training program on muscular strength, soccer relevant sprint, jump and kicking velocity performance in elite soccer players during competitive season. Twenty-two field-players were assigned to 2 groups: WB-EMS group (EG, n = 12), jump-training group (TG, n = 10). The training programs were conducted twice a week concurrent to 6-7 soccer training sessions during the 2nd half of the season. Participants were tested before (baseline), during (wk-7) and after (wk-14). Blood serum samples for analyzing IGF-1 and CK were taken before each testing, 15-30min post and 24h post the training program. Our findings of the present study were that a 14-week in-season WB-EMS program significant increased one-leg maximal strength (1RM) at the leg press machine (1.99 vs. 1.66 kg/kg, p = 0.001), and improved linear sprinting (5m: 1.01 vs. 1.04s, p=0.039), sprinting with direction changes (3.07 vs. 3.25s, p = 0.024), and vertical jumping performance (SJ: 38.8 vs. 35.9cm p = 0.021) as well as kicking velocity (1step: 93.8 vs. 83.9 km∙h⁻¹, p < 0.001). The TG showed no changes in strength and performance. The EG revealed significantly increased CK levels 24h post training and yielded significantly higher CK levels compared to the TG. IGF-1 serum levels neither changed in the EG nor in the TG. The results give first hints that two sessions of a dynamic WB-EMS training in addition to 6-7 soccer sessions per week can be effective for significantly enhancing soccer relevant performance capacities in professional players during competitive season.
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