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

Wolfgang Kemmler; Michael Fröhlich; Oliver Ludwig; Christoph Eifler; Simon von Stengel; Sebastian Willert; Marc Teschler; Anja Weissenfels; Heinz Kleinöder; Florian Micke; Nicolas Wirtz; Christoph Zinner; Andre Filipovic; Bernd Wegener; Joshua Berger; Alexandre Evangelista; Stefano D'Ottavio; Jaskanwal Deep Singh Sara; Amir Lerman; Unai A Perez de Arrilucea Le Floc'h; Abraham Carle-Calo; Angel Guitierrez; Francisco J Amaro-Gahete

doi:10.3389/fphys.2023.1174103

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

Front Physiol. 2023 Mar 22:14:1174103. doi: 10.3389/fphys.2023.1174103. eCollection 2023.

Authors

Wolfgang Kemmler¹, Michael Fröhlich², Oliver Ludwig², Christoph Eifler³, Simon von Stengel¹, Sebastian Willert¹, Marc Teschler⁴, Anja Weissenfels⁵, Heinz Kleinöder⁶, Florian Micke⁶, Nicolas Wirtz⁷, Christoph Zinner⁸, Andre Filipovic⁹, Bernd Wegener¹⁰, Joshua Berger³, Alexandre Evangelista¹¹, Stefano D'Ottavio¹², Jaskanwal Deep Singh Sara¹³, Amir Lerman¹³, Unai A Perez de Arrilucea Le Floc'h¹⁴, Abraham Carle-Calo¹⁴, Angel Guitierrez¹⁵, Francisco J Amaro-Gahete^{14

15

16

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Affiliations

¹ Institute of Radiology, University Hospital Erlangen (UKER), Erlangen, Germany.
² Department of Sports Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany.
³ German University for Prevention and Health Management, Saarbrücken, Germany.
⁴ Department of Rehabilitation Sciences, University of Witten/Herdecke, Witten, Germany.
⁵ Institute of Sports Science, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.
⁶ Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany.
⁷ Central Library for Sport Sciences, German Sport University Cologne, Cologne, Germany.
⁸ University of Applied Sciences for Police and Administration of Hesse, Wiesbaden, Germany.
⁹ Soccer Club Paderborn 07, Paderborn, Germany.
¹⁰ Musculoskeletal University Center, Ludwig-Maximilian-University of Munich, Munich, Germany.
¹¹ Experimental Physiology and Biochemistry, Center for Physical Education and Sport, University Federal do Espírito Santo, Vitória, Brazil.
¹² Clinical Sciences and Translational Medicine Department, University of Rome, Rome, Italy.
¹³ Department of Cardiovascular Medicine, Mayo College of Medicine, Rochester, MN, United States.
¹⁴ Department of Physical Education and Sport, University of Granada, Granada, Spain.
¹⁵ Department of Physiology, University of Granada, Granada, Spain.
¹⁶ Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
¹⁷ Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.

Abstract

Whole-Body Electromyostimulation (WB-EMS) is a training technology that enables simultaneous stimulation of all the main muscle groups with a specific impulse intensity for each electrode. The corresponding time-efficiency and joint-friendliness of WB-EMS may be particularly attractive for people unable or unmotivated to conduct (intense) conventional training protocols. However, due to the enormous metabolic and musculoskeletal impact of WB-EMS, particular attention must be paid to the application of this technology. In the past, several scientific and newspaper articles reported severe adverse effects of WB-EMS. To increase the safety of commercial non-medical WB-EMS application, recommendations "for safe and effective whole-body electromyostimulation" were launched in 2016. However, new developments and trends require an update of these recommendations to incorporate more international expertise with demonstrated experience in the application of WB-EMS. The new version of these consensus-based recommendations has been structured into 1) "general aspects of WB-EMS", 2) "preparation for training", recommendations for the 3) "WB-EMS application" itself and 4) "safety aspects during and after training". Key topics particularly addressed are 1) consistent and close supervision of WB-EMS application, 2) mandatory qualification of WB-EMS trainers, 3) anamnesis and corresponding consideration of contraindications prior to WB-EMS, 4) the participant's proper preparation for the session, 5) careful preparation of the WB-EMS novice, 6) appropriate regeneration periods between WB-EMS sessions and 7) continuous interaction between trainer and participant at a close physical distance. In summary, we are convinced that the present guideline will contribute to greater safety and effectiveness in the area of non-medical commercial WB-EMS application.

Keywords: electrical muscle stimulation; international consensus; recommendations; safety; whole-body electromyostimulation.

Copyright © 2023 Kemmler, Fröhlich, Ludwig, Eifler, von Stengel, Willert, Teschler, Weissenfels, Kleinöder, Micke, Wirtz, Zinner, Filipovic, Wegener, Berger, Evangelista, D’Ottavio, Sara, Lerman, Perez de Arrilucea Le Floc’h, Carle-Calo, Guitierrez and Amaro-Gahete.