Whole body-electromyostimulation effects on serum biomarkers, physical performances and fatigue in Parkinson’s patients: A randomized controlled trial

Abstract

BackgroundWhole-body electromyostimulation (WB-EMS) was never previously applied to Parkinson’s disease (PD) patients. This randomized controlled study aimed to find the most effective and safe WB-EMS training protocol for this population.MethodsTwenty-four subjects (age: 72.13 ± 6.20 years), were randomly assigned to three groups: a high-frequency WB-EMS strength training group (HFG) (rectangular stimulation at 85 Hz, 350 μs, 4 s stimulation/4 s rest), a low-frequency WB-EMS aerobic training group (LFG) (rectangular stimulation 7 Hz, 350 μs, with a continuous pulse duration), and an inactive control group (CG). Participants of the two experimental groups underwent 24 controlled WB-EMS training sessions, with a duration of 20 min each, during 12-week intervention. Serum growth factors (BDNF, FGF-21, NGF and proNGF), α-synuclein, physical performance and Parkinson’s Disease Fatigue Scale (PFS-16) responses were analyzed to evaluate the pre-post variation and differences among groups.ResultsSignificant interactions of Time*Groups were detected for BDNF (Time*Groups p = 0.024; Time*CG, b = −628, IC95% = −1,082/−174, p = 0.008), FGF-21 (Time*Groups p = 0.009; Time*LFG b = 1,346, IC95% = 423/2268, p = 0.005), and α-synuclein (Time*Groups p = 0.019; Time*LFG b = −1,572, IC95% = −2,952/−192, p = 0.026). Post hoc analyses and comparisons of ΔS (post–pre), performed independently for each group, showed that LFG increased serum BDNF levels (+ 203 pg/ml) and decreased α-synuclein levels (−1,703 pg/ml), while HFG showed the opposite effects (BDNF: −500 pg/ml; α-synuclein: + 1,413 pg/ml). CG showed a significant BDNF reduction over time. Both LFG and HFG showed significant improvements in several physical performance outcomes and the LFG showed better results than HFG. Concerning PFS-16, significant differences over time (b = −0.4, IC95% = −0.8/−0.0, p = 0.046) and among groups (among all groups p < 0.001) were found, and the LFG exhibited better results than the HFG (b = −1.0, IC95% = −1.3/−0.7, p < 0.001), and CG (b = −1.7, IC95% = −2.0/−1.4, p < 0.001) with this last one that worsened over time.ConclusionLFG training was the best choice for improving or maintaining physical performance, fatigue perception and variation in serum biomarkers.Clinical trial registrationhttps://www.clinicaltrials.gov/ct2/show/NCT04878679, identifier NCT04878679.

Revised contraindications for the use of non-medical WB-electromyostimulation. Evidence-based German consensus recommendations

“…The NRCT of Mori et al ( 24 ) addressed Huntington patients during dialysis with WB-EMS-application for 6 weeks 7 . While di Cagno et al ( 13 ) observed no adverse effects; unfortunately Mori et al ( 24 ) did not report unintended effects of WB-EMS application.…”

“…Unfortunately, only a few studies focused on cohorts with diseases of the nervous system ( 13 , 24 ). The high-quality RCT of di Cagno et al ( 13 ) focused on stage 1 (mild) to 3 (moderate) Parkinson's disease in 50–80 years old patients for 12-week. The NRCT of Mori et al ( 24 ) addressed Huntington patients during dialysis with WB-EMS-application for 6 weeks 7 .…”

Effects and Mechanisms of Exercise on Brain-Derived Neurotrophic Factor (BDNF) Levels and Clinical Outcomes in People with Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…The quality of all trials was assessed. Three studies [ 51 , 52 , 53 ] were categorized as “good”, one trial [ 54 ] was categorized as “fair”, and one trial was categorized as “poor” [ 55 ]. Table 2 shows individual results for each of the 14 NIH quality criteria questions used to assess the methodological quality and make an informed decision about the possible risk for bias of each of the included trials, and it provides numerical results to assess the total methodological quality score and rating.…”

“…The trials were published between 2013 and 2023, and a total of 216 participants with PD contributed to the articles included in this systematic review. Three trials [ 52 , 54 , 55 ] conducted a moderate-intensity exercise program, and two trials [ 51 , 53 ] conducted a vigorous-intensity exercise program according to standards for exercise intensity articulated by Liguori and the American College of Sports Medicine (ACSM) [ 56 ]. Additionally, exercise frequencies ranged from two to five sessions per week, and intervention duration ranged from 20 to 180 min per session over a period of four to twelve weeks.…”

Long-Term Physical Activity Effectively Reduces the Consumption of Antihypertensive Drugs: A Randomized Controlled Trial

“…In conclusion, there are three essential conditions that must be considered when designing a physical protocol with the goal of reducing blood pressure and, consequently, medication intake: a long-term commitment to regular PA; good adherence to the exercise protocol; and appropriate volume, intensity, and modality of exercise [28]. Enhancing enjoyment and motivation through various strategies, such as group exercise or the utilization of technological equipment, could facilitate long-term adherence to physical activity programs for the elderly [45,46].…”