Effect of neuromuscular electrical stimulation frequency on postprandial glycemia, current-related discomfort, and muscle soreness. A crossover study

Abstract

Consensus is lacking regarding optimal neuromuscular electrical stimulation (NMES) parameters for postprandial glycemic control. Therefore, the aim of this study was to determine the NMES frequency inducing the greatest hypoglycemic effect in healthy individuals. The secondary aim was to compare current-related discomfort and muscle soreness between different frequencies. We conducted an experimental clinical study with a randomized crossover design. Sixteen healthy and sedentary participants received NMES for 20 min at 5, 10, or 50 Hz (pulse duration: 400 μs, on-off ratio: 4:12 s) following a standardized meal. Glycemia, discomfort, and muscle soreness during and after NMES were compared between conditions. Five-hertz NMES generated a significant hypoglycemic effect, contrary to 10 Hz and 50 Hz. Ten-hertz and 50-Hz NMES resulted respectively in lower current-related discomfort and greater muscle soreness compared with the other frequencies. Women reported higher discomfort than men. These findings contribute towards the possibility of more efficient long-term NMES treatments in terms of glycemic response and patient tolerance.

Walking Attenuates Postprandial Glycemic Response: What Else Can We Do without Leaving Home or the Office?

“…Similarly, performing 30 min of passive stimulation did not affect the glucose response over the three hours after the meal. These results are in contrast with previous findings that have found a reduced glucose response in diabetic and healthy sedentary individuals after 30 min of intermittent NMES [25,26]. For instance, Myiamoto et al ( 2012) have shown that in old patients with type 2 diabetes, treated with oral hypoglycemic agents, 30 min of continuous passive NMES applied with a frequency of 4 Hz on the lower limb muscles reduced the glycemic response to a meal [25].…”

“…For instance, Myiamoto et al ( 2012) have shown that in old patients with type 2 diabetes, treated with oral hypoglycemic agents, 30 min of continuous passive NMES applied with a frequency of 4 Hz on the lower limb muscles reduced the glycemic response to a meal [25]. Similar results have been found in normoglycemic young sedentary individuals, in which 20 min of discontinuous (4 s ON and 12 s OFF) passive NMES at 5 Hz elicited a substantial reduction of post-meal blood glucose concentration [26]. Conversely, in our population (i.e., healthy young active individuals), passive NMES did not have any effect on the postmeal glycemic response.…”

“…The feasibility of the different options for exercising in less conventional settings should then be evaluated in relation to the need to exercise in close proximity to the meal, as well as in relation to its effectiveness in attenuating postprandial blood glucose. Some attempts have been made to test the effectiveness of NMES on the glycemic response to a meal based on the premise that at least part of the effect of exercise depends on muscle contraction, but the findings obtained so far are controversial and limited [24][25][26]. More studies are required in order to clarify whether NMES is an effective strategy for improving the post-meal glucose response in different populations.…”

Four weeks of electrical stimulation improves glucose tolerance in a sedentary overweight or obese Hispanic population

“…It has been well established that muscle contraction effectively increases glucose uptake via an insulin-independent signaling pathway ( 14 , 15 ). Human studies on the effects of NMES-induced muscle contraction on insulin sensitivity are limited to the population with T2DM ( 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ) and spinal cord injury (SCI) ( 24 , 25 , 26 , 27 ). Two studies conducted in healthy individuals reported an increased acute glucose disposal rate measured by a hyperinsulinemic–euglycemic clamp ( 28 , 29 ).…”

Effects of neuromuscular electrical stimulation on glycemic control: a systematic review and meta-analysis

“…There were 22 longitudinal studies that investigated the chronic effects of NMES on glycemic control were included in this systematic review. Except for four studies that investigated young adult population ( 30 , 59 , 69 , 74 ), all studies were conducted in middle-aged and elderly men and women. Majority of the studies (n=16) reported improvement in glycemic control measured by various methods including fasting blood glucose ( 56 – 58 , 60 , 62 , 63 ), OGTT ( 23 , 29 , 31 , 72 , 79 ), MGTT ( 73 ), HbA1c ( 64 , 70 ), and hyperinsulinemic euglycemic clamp ( 75 , 76 ), while two studies reported no changes in glycemic control as measured by fasted blood glucose ( 65 ), and hyperinsulinemic euglycemic clamp ( 71 ).…”