Whole-body electromyostimulation training: fitness or prevention?

Whole-body electromyostimulation (WB-EMS) promises time-efficient muscle strength training that has positive effects after just a few sessions per week. Its objective is a fast increase in muscle mass and reduction of body fat. Can WB-EMS training replace conventional strength and endurance training? And can it help to prevent diseases or pain?

In this interview with MEDICA.tradefair.com, Professor Wolfgang Kemmler, who has conducted several studies on the effects of WB-EMS training, describes the target audience for an EMS training program, clarifies whether it is more situated in the field of fitness or prevention and explains whether it is able to replace conventional training.

Professor Kemmler, what is the principle behind whole-body electromyostimulation?

Prof. Wolfgang Kemmler: In the case of WB-EMS, stimulation current is applied to the muscles akin to the well-known local EMS technology. The new aspect with WB-EMS is that it not only activates one individual body area but is able to simultaneously stimulate all major muscle groups, but with varying regional intensity. All in all, this pertains to up to twelve body regions with a surface area measuring approximately 2,800 square centimeters.

What can EMS contribute to preventing diseases or pain from your point of view? Would you rather situate it in the area of fitness or prevention?

Kemmler: EMS has a wide variety of applications. The classic therapeutic realm typically uses local electrical stimulation, for example, when the goal is a regeneration of hamstring tendons after anterior cruciate ligament injuries. Meanwhile, WB-EMS is primarily used in preventive medicine, particularly in the case of systemic diseases. In older people, for example, this pertains to so-called sarcopenia, the loss of muscle tissue as part of the aging process. Having said that, EMS or WB-EMS can also be used in the fitness or competitive sports realm. In competitive sports, it is less used to facilitate improvements in specific disciplines but rather to help strengthen and maintain the back muscles. This applies to runners or cyclists, who don’t want to invest time in preventive back muscle exercises for example. On the whole, there are many different areas of application. WB-EMS should primarily be recognized as a strength oriented training technology, that is to say, as long as the training goals are not too specific, WB-EMS can be seen as a time-efficient option to a strength training program. Existing research shows that the effect of WB-EMS on muscle mass and hypertrophy is comparable. However, it produces a somewhat lesser effect on functional abilities like muscle strength or performance. 

You have conducted a study on EMS training for sarcopenia. What were you planning to discover?

Kemmler: Sarcopenia is a disease associated with the aging process characterized by a considerable loss of muscle mass and a dramatic functional decline. Many people are no longer able to live independently. Oftentimes, sarcopenia is accompanied by obesity. This combination is called sarcopenic obesity. Physical activity would be a treatment option in this case but many aging adults who have not done any sports up to this point don't want or are unable to get on board with it. This is a case where WB-EMS provides a relatively low-threshold, joint-friendly and individualized training option. The emphasis here is on maintaining or increasing muscle mass. The function of muscles, strength, walking speed and a lower body fat percentage are also key training objectives.

How exactly was this study conducted?

Kemmler: This was a randomized controlled trial with three arms. One group was administered Vitamin D and protein, the second group was supplied with protein, Vitamin D, and WB-EMS, while the third group was only administered Vitamin D as a control group. We conducted a final measurement after 16 weeks where we measured the same parameters we assessed at the beginning of the study.

What were the findings?

Kemmler: One classic parameter of sarcopenia is a loss of muscle mass in the arms and legs. There was a significant muscle mass increase in both the EMS&Protein and the Protein group. Both groups also showed a reduction in the total and abdominal body fat percentage. Abdominal body fat, in particular, is an elevated cardiometabolic risk factor. Strength and walking speed only increased in the combined WB-EMS&Protein group. The 'normal' walking speed is an important fitness parameter because it is closely connected to autonomy and mortality. Incidentally, the control group did not exhibit any changes in body composition or functional ability despite the administration of Vitamin D.

Is EMS training mainly suited for the age cohort of the test subjects, or would you also recommend it for younger people? For whom is this training especially interesting?

Kemmler: I believe that people who are able to and like to do "sports" should continue to do so. Having said that, WB-EMS can be an alternative to time-consuming strength training for endurance athletes suffering from erector spinae muscle pain for example. In fact, WB-EMS is a very time-efficient technology. Especially for people who lack the motivation or the time to do sports, EMS is a great option to implement strength oriented training goals such as increasing muscle mass, strength, stabilization but also fat reduction. As is the case with traditional strength training, the effects on endurance performance tend to be slight. Another important aspect is the fact that WB-EMS should be implemented as part of a personal training regimen, meaning the close interaction between trainer and client, to ensure safety and effectiveness. In doing so, the client has the trainer's constant attention and care plus gets feedback and motivation. This is definitely a key factor for successful training.

Does your Institute continue its research of EMS training and its effects on the body? Do you have plans for further studies?

Kemmler: We have just completed a study on chronic, non-specific back pain. We compared a group that was treated with WB-EMS with conventional back training, whole body vibration therapy, and a non-training control group. The study showed that all three training methods were able to significantly reduce the intensity of pain. Many WB-EMS facilities had already advertised these corresponding effects but this had not been proven yet. Our study was able to fill this academic void.