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

Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: "Arteriosclerosis, arterial circulation disorders", "Diabetes mellitus" (DM), "Tumor and cancer" (TC), "Neurologic diseases, neuronal disorders, epilepsy". Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list.

Acute metabolic, hormonal, and psychological responses to strength training with superimposed EMS at the beginning and the end of a 6 week training period.

OBJECTIVES: The aim was to determine metabolic and hormonal responses to strength training with or without superimposed electromyostimulation (EMS) at the beginning and the end of a 6 week training period. METHODS: 20 strength trained subjects were randomly assigned to two groups. The first group (S) performed 4 sets of back squats with a constantly adjusted additional load of their individual 10 repetition maximum (10 RM) twice a week over 6 weeks. The second group (S+E) did the same training program with superimposed EMS on leg and trunk muscles. Physiological responses were determined before and after the first (TS 1) and the last training session (TS 12). RESULTS: No significant differences of hormonal responses could be observed between groups and TSs. However, small to large effects on metabolism occurred between groups and TSs. Delayed onset muscle soreness (DOMS) was significantly higher 48h after TS 1 for S+E. CONCLUSIONS: Despite a higher DOMS after S+E, there is no acute effect of superimposed EMS on hormonal response to exhaustive resistance exercise. We suggest that, because of the high resistance during 10 RM bouts, most of the muscle fibers are already activated and superimposed EMS only activates few additional muscle fibers.

Cortical processes associated with continuous balance control as revealed by EEG spectral power.

Balance is a crucial component in numerous every day activities such as locomotion. Previous research has reported distinct changes in cortical theta activity during transient balance instability. However, there remains little understanding of the neural mechanisms underlying continuous balance control. This study aimed to investigate cortical theta activity during varying difficulties of continuous balance tasks, as well as examining the relationship between theta activity and balance performance. 37 subjects completed nine balance tasks with different levels of surface stability and base of support. Throughout the balancing task, electroencephalogram (EEG) was recorded from 32 scalp locations. ICA-based artifact rejection was applied and spectral power was analyzed in the theta frequency band. Theta power increased in the frontal, central, and parietal regions of the cortex when balance tasks became more challenging. In addition, fronto-central and centro-parietal theta power correlated with balance performance. This study demonstrates the involvement of the cerebral cortex in maintaining upright posture during continuous balance tasks. Specifically, the results emphasize the important role of frontal and parietal theta oscillations in balance control.

Effects of load and training modes on physiological and metabolic responses in resistance exercise.

The aim of the study was to examine the effects of three different loads (LOAD) in combination with four different exercise modes (MODE) on physiological responses during and after one fatiguing bout of bench press exercise. Ten resistance-trained healthy male subjects performed bench press exercise each at 55% (LOW), 70% (MID) and 85% (HIGH) of 1 repetition maximum (1RM) for as many repetitions as possible and in four training modes: 4-1-4-1 (4-s concentric, 1-s isometric, 4-s eccentric and 1-s isometric successive actions), 2-1-2-1, 1-1-1-1 and MAX (maximum velocity concentric). Oxygen uptake [Formula: see text] was measured during exercise and for 30-min post-exercise. Maximum blood lactate concentration (blood LA(max)) and heart rate (HR(max)) were also determined. Number of repetitions (REPS) and exercise time (EXTIME) were recorded and accumulated lifted mass (MASS), defined by REPS × lifted mass, was calculated. LOAD had a significant effect on REPS (LOW > MID > HIGH, p < 0.01). A significant increase of REPS was obtained exercising at a faster MODE except from 1-1-1-1 to MAX (p < 0.01). EXTIME significantly decreased with increasing LOAD (LOW > MID > HIGH, p < 0.01 for all) and faster MODE (4-1-4-1, 2-1-2-1, 1-1-1-1 > MAX; p > 0.01). MASS decreased significantly with increasing LOAD (p < 0.01) but increased with a faster MODE (p < 0.05) with the exception of 1-1-1-1 to MAX. MODE had a significant effect on VO(2) (4-1-4-1 > MAX; p < 0.05). LOAD had a significant effect on consumed O(2) during exercise (LOW > MID and HIGH; p > 0.01) and on blood LA(max) (LOW and MID > HIGH; p < 0.01). The data indicate that physiological responses on different resistance exercises depend on both the load and the velocity mode.

Moment-angle relations after specific exercise.

This study examined the amount and time-course of shifts in the moment-knee angle relation of the quadriceps (QF) and hamstring (HAM) muscles in response to different length-restricted strength training regimens. Thirty-two athletes were divided into three different training groups (G1-3): G1 performed isometric training at knee joint angles corresponding to long muscle-tendon unit (MTU) length for QF and HAM; G2 conducted concentric-eccentric contraction cycles that were restricted to a knee joint range of motion corresponding to predominantly long MTU length for QF and HAM; G3 combined the protocols of G1 and G2. Moment-knee angle and EMG-knee angle relations of QF and HAM were measured on five different occasions: two times before, after five and eight weeks of training and four weeks post training. Moments and EMG-data of each subject were normalized to the largest value produced at any knee joint position [% Max.]. Obtained by curve fitting, the optimal knee joint angle for QF moment production was significantly (P<0.05) shifted to longer MTU length in G1 and G3 after 5 weeks of training and in G2 after 8 weeks of training. Contrary, no significant shifts were detected for HAM. Our data suggest that the predominant MTU length during loading is a major trigger for human force-length adaptations.

Vibration training: benefits and risks.

The main results of our recent several studies, i.e. the measurements of vibration training results for single case and group studies as well as the cardiovascular parameter measurements during vibrations and the corresponding hydrodynamic analysis, are summarized. Our studies and previous work all confirm that vibration training is an effective training method in order to improve maximal strength and flexibility as well as various other factors if the training is properly designed. Some recommendations regarding the proper ranges of frequencies, amplitudes and exposure duration of vibration training are made based on the existing vibration training practice and mechanism analysis, although much work remains to be carried out in order to set up clear rules for various groups of people so that maximal training results could be expected and in the meantime potential dangerous effects could be avoided. Cardiovascular parameter measurements confirm that total peripheral resistance (TPR) to the blood flow is increased during body vibration. Hydrodynamic analysis offers the mechanism for the increase of TPR through the deformation of vessels. As a reaction of compensation, more capillaries are probably opened in order to keep a necessary level of cardiac output needed for the body, resulting in more efficient gas and material metabolism between the blood and muscle fibres. This might be one of the reasons for the various potential beneficial effects of vibration training.