Skip to main content
Log in

Side effects of whole-body electro-myo-stimulation

Nebenwirkungen der Ganzkörperelektromyostimulation

  • review
  • Published:
Wiener Medizinische Wochenschrift Aims and scope Submit manuscript

Summary

Whole-body-electro-myo-stimulation (WB-EMS) has been introduced as an alternative to physical training. The aim of the review is to summarize the data about indications and side effects of WB-EMS.

A literature search in PubMed disclosed 11 randomized trials, 3 cohort studies, and 7 case reports. From healthy volunteers, enormous creatine kinase (CK) elevations were reported. There is a lack of data about biological consequences of WB-EMS on other organs. In randomized trials, CK levels were not investigated, but several patients discontinued WB-EMS because of “muscular discomfort.” Contraindications for WB-EMS are not clearly defined. Nine cases of rhabdomyolysis after WB-EMS were found, preferentially after the first application.

Regulatory authorities should increase the safety of WB-EMS. Patients with a history of rhabdomyolysis should not undergo WB-EMS and those experiencing rhabdomyolysis should be neurologically investigated. Since the value of WB-EMS as an alternative to physical exercise is uncertain, we need to proof or disproof its benefit.

Zusammenfassung

Die Ganzkörperelektromyostimulation (GK-EMS) wurde als Alternative zu körperlichem Training eingeführt. Ziel der Übersichtsarbeit ist eine Zusammenfassung der Daten zu Indikationen und Nebenwirkungen von GK-EMS.

Eine Recherche in PubMed erbrachte 11 randomisierte Studien, 3 Kohortenstudien und 7 Fallberichte. Bei gesunden Probanden wurden enorme Kreatinkinase(CK)-Anstiege nach GK-EMS beobachtet. Es gibt keine Daten zu den biologischen Konsequenzen von GK-EMS für andere Organsysteme. In den randomisierten Studien wurde die CK nicht untersucht, mehrere Patienten brachen die GK-EMS aber wegen „muskulärer Missempfindungen“ ab. Kontraindikationen für GK-EMS sind uneinheitlich und nicht eindeutig formuliert. Neun Fälle mit Rhabdomyolyse nach GK-EMS wurden gefunden, hauptsächlich nach der ersten Anwendung.

Die Gesundheitsbehörden sollten Anstrengungen unternehmen, um die Sicherheit der GK-EMS zu erhöhen. Patienten mit Rhabdomyolyse in der Anamnese sollten keine GK-EMS absolvieren. Nach GK-EMS-induzierter Rhabdomyolyse sollten die Patienten neurologisch untersucht werden. Die Rolle der GK-EMS als Alternative zu körperlichem Training ist umstritten und sollte besser erforscht werden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Herzig D, Maffiuletti NA, Eser P. The application of neuromuscular electrical stimulation training in various non-neurologic patient populations: a narrative review. Pm R. 2015;7:1167–78.

    Article  PubMed  Google Scholar 

  2. Filipovic A, Grau M, Kleinöder H, et al. Effects of a whole-body electrostimulation program on strength, sprinting, jumping, and kicking capacity in elite soccer players. J Sports Sci Med. 2016;15:639–48.

    PubMed  PubMed Central  Google Scholar 

  3. Fritzsche D, Fruend A, Schenk S, et al. Electromyostimulation (EMS) in cardiac patients. Will EMS training be helpful in secondary prevention? Herz. 2010;35:34–40.

    Article  PubMed  Google Scholar 

  4. van Buuren F, Mellwig KP, Prinz C, et al. Electrical myostimulation improves left ventricular function and peak oxygen consumption in patients with chronic heart failure: results from the exEMS study comparing different stimulation strategies. Clin Res Cardiol. 2013;102:523–34.

    Article  CAS  PubMed  Google Scholar 

  5. Kemmler W, Grimm A, Bebenek M, et al. Effects of combined whole-body electromyostimulation and protein supplementation on local and overall muscle/fat distribution in older men with sarcopenic obesity: the randomized controlled Franconia Sarcopenic obesity (FranSO) study. Calcif Tissue Int. 2018; https://doi.org/10.1007/s00223-018-0424-2.

    Article  PubMed  Google Scholar 

  6. Kemmler W, Kohl M, Freiberger E, et al. Effect of whole-body electromyostimulation and/or protein supplementation on obesity and cardiometabolic risk in older men with sarcopenic obesity: the randomized controlled FranSO trial. Bmc Geriatr. 2018;18:70. https://doi.org/10.1186/s12877-018-0759-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Kemmler W, Weissenfels A, Teschler M, et al. Whole-body electromyostimulation and protein supplementation favorably affect sarcopenic obesity in community-dwelling older men at risk: the randomized controlled FranSO study. Clin Interv Aging. 2017;12:1503–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Wittmann K, Sieber C, von Stengel S, et al. Impact of whole body electromyostimulation on cardiometabolic risk factors in older women with sarcopenic obesity: the randomized controlled FORMOsA-sarcopenic obesity study. Clin Interv Aging. 2016;11:1697–706.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kemmler W, Teschler M, Weissenfels A, et al. 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. 2016;27:3261–70.

    Article  CAS  PubMed  Google Scholar 

  10. Kemmler W, Teschler M, Weißenfels A, et al. Effects of whole-body electromyostimulation versus high-intensity resistance exercise on body composition and strength: a randomized controlled study. Evid Based Complement Alternat Med. 2016;2016:9236809.

    Article  PubMed  PubMed Central  Google Scholar 

  11. von Stengel S, Bebenek M, Engelke K, et al. Whole-body electromyostimulation to fight osteopenia in elderly females: the randomized controlled training and electrostimulation trial (TEST-III). J Osteoporos. 2015;2015:643520.

    Google Scholar 

  12. Kemmler W, Bebenek M, Engelke K, et al. Impact of whole-body electromyostimulation on body composition in elderly women at risk for sarcopenia: the Training and ElectroStimulation Trial (TEST-III). Age (dordr). 2014;36:395–406.

    Article  Google Scholar 

  13. Kemmler W, von Stengel S. 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. 2013;8:1353–64. https://doi.org/10.2147/CIA.S52337.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jee YS. The efficacy and safety of whole-body electromyostimulation in applying to human body: based from graded exercise test. J Exerc Rehabil. 2018;14:49–57. https://doi.org/10.12965/jer.1836022.011.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kemmler W, Fröhlich M, von Stengel S, et al. Whole-Body electromyostimulation—the need for common sense! Rationale guideline for a safe and effective training. Dtsch Z Sportmed. 2016;67:218–20.

    Article  Google Scholar 

  16. Kemmler W, Weissenfels A, Willert S, et al. Efficacy and safety of low frequency whole-body electromyostimulation (WB-EMS) to improve health-related outcomes in non-athletic adults. A systematic review. Front Physiol. 2018;9:573. https://doi.org/10.3389/fphys.2018.00573.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gondin J, Brocca L, Bellinzona E, et al. Neuromuscular electrical stimulation training induces atypical adaptations of the human skeletal muscle phenotype: a functional and proteomic analysis. J Appl Physiol. 2011;110:433–50.

    Article  CAS  PubMed  Google Scholar 

  18. Nosaka K, Aldayel A, Jubeau M, et al. Muscle damage induced by electrical stimulation. Eur J Appl Physiol. 2011;111:2427–37.

    Article  PubMed  Google Scholar 

  19. Jubeau M, Muthalib M, Millet GY, et al. Comparison in muscle damage between maximal voluntary and electrically evoked isometric contractions of the elbow flexors. Eur J Appl Physiol. 2012;112:429–38.

    Article  PubMed  Google Scholar 

  20. Crameri RM, Aagaard P, Qvortrup K, et al. Myofibre damage in human skeletal muscle: effects of electrical stimulation versus voluntary contraction. J Physiol. 2007;583:365–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Foure A, Duhamel G, Wegrzyk J, et al. Heterogeneity of muscle damage induced by electrostimulation: a multimodal MRI study. Med Sci Sports Exerc. 2015;47:166–75.

    Article  PubMed  Google Scholar 

  22. Foure A, Wegrzyk J, Le Fur Y, et al. Impaired mitochondrial function and reduced energy cost as a result of muscle damage. Med Sci Sports Exerc. 2015;47:1135–44.

    Article  PubMed  Google Scholar 

  23. Malnick SD, Band Y, Alin P, et al. It’s time to regulate the use of whole body electrical stimulation. BMJ. 2016;352:i1693. https://doi.org/10.1136/bmj.i1693.

    Article  PubMed  Google Scholar 

  24. Ministry of Health has taken actions to regulate the use of EMS devices. 2017. https://www.health.gov.il/English/News_and_Events/Spokespersons_Messages/Pages/11022016_1.aspx. Accessed 09.12.

    Google Scholar 

  25. Kemmler W, Teschler M, Bebenek M, et al. (Very) high Creatinkinase concentration after exertional whole-body electromyostimulation application: health risks and longitudinal adaptations. Wien Med Wochenschr. 2015;165:427–35.

    Article  PubMed  Google Scholar 

  26. Herzog A, Büchele F, Keller DI. Muskelschmerzen nach Elektromyostimulationstraining. Praxis. 2017;106:1121–4.

    Article  PubMed  Google Scholar 

  27. Kästner A, Braun M, Meyer T. Two cases of rhabdomyolysis after training with electromyostimulation by 2 young male professional soccer players. Clin J Sport Med. 2015;25:e71–e3.

    PubMed  Google Scholar 

  28. Guillén Astete CA, Zegarra Mondragón S, Medina Quiñones C. Rhabdomiolysis secondary to physical activity and simultaneous electrostimulation. A case report. Reumatol Clin. 2015;11:262–3.

    Article  PubMed  Google Scholar 

  29. Finsterer J, Stöllberger C. Severe rhabdomyolysis after MIHA-bodytec® electrostimulation with previous mild hyper-CK-emia and noncompaction. Int J Cardiol. 2015;180:100–2. https://doi.org/10.1016/j.ijcard.2014.11.148.

    Article  PubMed  Google Scholar 

  30. Hong JY, Hyeok Oh J, Shin JH. Rhabdomyolysis caused by knee push-ups with whole body electromyostimulation. Br J Hosp Med (lond). 2016;77:542–3.

    Article  Google Scholar 

  31. Guarascio P, Lusi EA, Soccorsi F. Electronic muscular stimulators: a novel unsuspected cause of rhabdomyolysis. Br J Sports Med. 2004;38:505.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Boa BCS, Yudkin JS, van Hinsbergh VWM, et al. Exercise effects on perivascular adipose tissue: endocrine and paracrine determinants of vascular function. Br J Pharmacol. 2017;174:3466–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Batouli SAH, Saba V. At least eighty percent of brain grey matter is modifiable by physical activity: a review study. Behav Brain Res. 2017;332:204–17. https://doi.org/10.1016/j.bbr.2017.06.002.

    Article  PubMed  Google Scholar 

  34. Ponikowski P, Voors AA, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur Heart J. 2016;37:2129–200. Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

    Article  PubMed  Google Scholar 

  35. Cervellin G, Comelli I, Benatti M, et al. Non-traumatic rhabdomyolysis: background, laboratory features, and acute clinical management. Clin Biochem. 2017;50:656–62.

    Article  PubMed  Google Scholar 

  36. Fong Yan A, Cobley S, Chan C, et al. The effectiveness of dance interventions on physical health outcomes compared to other forms of physical activity: A systematic review and meta-analysis. Sports Med. 2017; https://doi.org/10.1007/s40279-017-0853-5.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Claudia Stöllberger.

Ethics declarations

Conflict of interest

C. Stöllberger and J. Finsterer declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stöllberger, C., Finsterer, J. Side effects of whole-body electro-myo-stimulation. Wien Med Wochenschr 169, 173–180 (2019). https://doi.org/10.1007/s10354-018-0655-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10354-018-0655-x

Keywords

Schlüsselwörter

Navigation