Effects of electromyostimulation on performance parameters in sportive and trained athletes: A systematic review and network meta‐analysis

Abstract

This systematic review and network meta-analysis aimed to evaluate the effectiveness of different electromyostimulation (EMS) interventions on performance parameters in 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 CI]), 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 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 patterns appeared to positively influence adaptations in athletes. HIGHLIGHTS. Key performance parameters such as maximal strength, jump height and sprint time can be increased by adequate EMS intervention programs in already well-trained athletes. . The effectiveness of EMS training in athletes is highly dependent on the selected EMS method.Volume, intensity, exercise and movement specificity play a crucial role for the efficiency of the training. . The most effective option for athletes appears to be a combination of superimposed EMS with relatively low EMS volume, high intensity, and movement-specific exercise pattern.

Position statement and updated international guideline for safe and effective whole-body electromyostimulation training-the need for common sense in WB-EMS application

“…Thus, the physical presence of the trainer during all training sessions is indispensable. Apart from the “safety” aspect, it is noticeable that all reliable published clinical studies which reported positive effects of WB-EMS training on both sports performance and human health applied a low supervision ratio ( Kemmler et al, 2021 ; Micke et al, 2022 ). This feature indicates the crucial role of consistent and close supervision for the management of adequate impulse intensity specification as a key factor of successful WB-EMS application.…”

“…Finally and with respect to training frequency in athletic cohorts, the WB-EMS application strategy considerably varies from conventional non-medical application. “Superimposed WB-EMS” (e.g., exercises including jumps or short sprints) with high voluntary effort supported by moderate impulse-intensity EMS is the method of choice in athletic populations ( Micke et al, 2022 ). Considering 1) The lower impulse intensity used, 2) the more sophisticated regeneration methods and 3) the medical supervision and support may justify a slightly higher training frequency in athletes than the recommended by the present guideline.…”

Assessing the Impact of Neuromuscular Electrical Stimulation-Based Fingerboard Training versus Conventional Fingerboard Training on Finger Flexor Endurance in Intermediate to Advanced Sports Climbers: A Randomized Controlled Study

“…After a 12-week EMS application of the knee extensors, plantar flexors, and gluteus muscles, rugby players benefited from increased isokinetic maximum strength in eccentric (18.0 ± 26.3%) and concentric (19.4 ± 28.9%) conditions, increased 1RM squat strength (15.0 ± 8.0%), and the jump height of the squat jump (10.0 ± 9.5%) and drop jump from a 40 cm height (6.6 ± 6.1%) also increased significantly [29]. In past studies, athletes from other sports, such as ice hockey, cycling, and basketball, have also benefited from both WB-NMES and the local application [24,30]. Physiologically, this could be due to the fact that GK-EMS training appears to result in a reversal of the recruitment pattern so that faster type II fibers are stimulated at an early stage.…”