Handcycling with concurrent lower body low-frequency electromyostimulation significantly increases acute oxygen uptake: implications for rehabilitation and prevention

PeerJ. 2022 May 18:10:e13333. doi: 10.7717/peerj.13333. eCollection 2022.

Abstract

Background: Acute increases in exercise-induced oxygen uptake (V̇O2) is crucial for aerobic training adaptations and depends on how much muscle mass is involved during exercising. Thus, handcycling is per se limited for higher maximal oxygen uptakes (V̇O2max) due to restricted muscle involvement. Handcycling with additional and simultaneous application of low-frequency electromyostimulation (EMS) to the lower extremities might be a promising stimulus to improve aerobic capacity in disabled and rehabilitative populations.

Method: Twenty-six healthy young adults (13 female, age: 23.4 ± 4.5 years, height: 1.77 ± 0.09 m, mass: 71.7 ± 16.7 kg) completed 4 ×10 minutes of sitting (SIT), sitting with concurrent EMS (EMS_SIT), handcycling (60 rpm, 1/2 bodyweight as resistance in watts) (HANDCYCLE) and handcycling with concurrent EMS of the lower extremities (EMS_HANDCYCLE). During EMS_SIT and EMS_HANDCYCLE, low frequency EMS (impulse frequency: 4Hz, impulse width: 350 µs, continuous stimulation) was applied to gluteal, quadriceps and calf muscles. The stimulation intensity was selected so that the perceived pain could be sustained for a duration of 10 minutes (gluteus: 80.0 ± 22.7 mA, quadriceps: 94.5 ± 20.5 mA, calves: 77.5 ± 19.1 mA).

Results: Significant mode-dependent changes of V̇O2 were found (p < 0.001, η p 2 = 0.852). Subsequent post-hoc testing indicated significant difference between SIT vs. EMS_SIT (4.70 ± 0.75 vs. 10.61 ± 4.28 ml min-1 kg-1, p < 0.001), EMS_SIT vs. HANDCYCLE (10.61 ± 4.28 vs. 13.52 ± 1.40 ml min-1 kg-1, p = 0.005), and between HANDCYCLE vs. EMS_HANDCYCLE (13.52 ± 1.40 vs. 18.98 ± 4.89 ml min-1 kg-1, p = 0.001).

Conclusion: Handcycling with simultaneous lower body low-frequency EMS application elicits notably higher oxygen uptake during rest and moderately loaded handcycling and may serve as an additional cardiocirculatory training stimuli for improvements in aerobic capacity in wheelchair and rehabilitation settings.

Keywords: Cardiorespiratory fitness; EMS; Electrical muscle stimulation; Endurance; SCI; Spinal cord injury; Wheelchair.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Cattle
  • Electric Stimulation Therapy*
  • Exercise Tolerance
  • Female
  • Humans
  • Muscle, Skeletal*
  • Oxygen
  • Quadriceps Muscle
  • Young Adult

Substances

  • Oxygen

Grants and funding

This study was financially supported by the German Federal Institute of Sports Science (BISp) under Grant (ZMVI4-072003/21). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.