Sportif Performans ve Spor-Sağlık Amacıyla Elektromiyostimülasyon Uygulamaları

Öz

Elektromiyostimülasyon (EMS), istemsiz kas kasılmaları elde etmek için kas veya periferik sinirlere elektrik akımları uygulanması ile oluşmaktadır. EMS uygulaması, birçok rehabilitasyon ortamında istemli kas aktivasyonunu desteklemek, sağlıklı bireylerde ve hastalık nedeniyle geleneksel istemli egzersizi yapamayan hastalarda zindeliği ve sağlığı iyileştirmek, kas hareketinin yeniden eğitimi, kas kasılmasının kolaylaştırılması, kas güçlendirilmesi ve uzun süreli hareketsizlik dönemleri sırasında kas kütlesinin ve gücünün korunması, kuvvet kayıplarının geri kazanılması ve sporcularda istemli egzersizi tamamlayıcı olarak, uzun süredir kullanılmaktadır. Ortopedik tedavide ve rehabilitasyon amaçlı yaygın olarak uygulanan geleneksel lokal EMS, gelişen teknoloji ile birlikte tüm beden elektromiyostimülasyon (TB-EMS) yöntemine ilerlemiştir. Artan popülaritesi, zaman verimliliği, ortak kullanım kolaylığı ve bireyselleştirilmiş uygulaması nedeniyle TB-EMS giderek daha fazla bilimsel araştırmanın konusu haline gelmiştir.Yapılan EMS uygulamasından beklenen hedefler doğrultusunda; farklı egzersiz protokolleri , EMS parametrelerindeki değişkenlerin farklı kullanımı,farklı çalışma grupları (sedanter, sporcu, hasta, yaşlı) ile birlikte uygulanan elektromiyostimülasyon uygulamasının fizyolojik olarak farklı etkiler oluşturabilmesi mümkündür.Uygulama noktasında bu değişkenlerde yapılan bir değişiklik ile farklı bulgular elde edilmesi muhtemeldir. Bulgulardaki bu tür farklılıklar, bu faktörlerin EMS etkinliği üzerindeki olası etkisini dikkate alan daha sistematik araştırmaların yapılmasını gerektirmektedir. Bu derleme çalışması ile uygulama boyutunda farklı popülasyonlar üzerinde sportif performans ve spor-sağlık yönüyle kullanılan elektromiyostimülasyon uygulamasına genel bir bakış ile birlikte güncel yaklaşımlara yönelik bilgiler, değerlendirmeler sunmak amaçlanmaktadır.

Anahtar Kelimeler

• EMS
• Elektriksel Kas Uyarımı
• Tüm Beden Elektromiyostimülasyon
• Sportif Performans

Electromyostimulation Applications for Sportive Performance and Sports-Healt

Öz

Electrical muscle stimulation (EMS) consists of applying electrical currents to muscle or peripheral nerves to produce involuntary muscle contractions. EMS has long been used in many rehabilitation settings to support voluntary muscle activation, to improve fitness and health in healthy individuals and patients who are unable to perform traditional voluntary exercise due to illness, to retrain muscle movement, to facilitate muscle contraction, to strengthen muscle and to maintain muscle mass and strength during prolonged periods of inactivity, to restore strength losses and to complement voluntary exercise in athletes. Traditional local EMS, which is widely used in orthopedic treatment and rehabilitation, has progressed to whole-body electromyostimulation (TB-EMS) with advancing technology.Due to its increasing popularity, time efficiency, ease of common use and individualized application, TB-EMS has become the subject of more and more scientific research. In line with the goals expected from the EMS application; it is possible that electromyostimulation application applied with different exercise protocols, different use of variables in EMS parameters, and different study groups (sedentary, athlete, patient, elderly) may create different physiological effects.It is possible to obtain different findings with a change in these variables at the point of application. Such differences in findings require more systematic research that takes into account the possible influence of these factors on EMS effectiveness. With this review study, it is aimed to provide an overview of the electromyostimulation application used in sports performance and sports-health aspects on different populations in the application dimension, as well as information and evaluations on current approaches.

Anahtar Kelimeler

• EMS
• Electrical Muscle Stimulation
• Whole Body Electromyostimulation
• Sportive Performance

Kaynakça

1. Álvarez-Barrio, L., Rodríguez-Pérez, V., Calvo-Lobo, C., Leirós-Rodríguez, R., Alba-Pérez, E., & López-Rodríguez, A. F. (2023). Immediate effects of whole-body versus local dynamic electrostimulation of the abdominal muscles in healthy people assessed by ultrasound: a randomized controlled trial. Biology. 12(3), 454.
2. Babault, N., Cometti, G., Bernardin, M., Pousson, M., & Chatard, J. C. (2007). Effects of electromyostimulation training on muscle strength and power of elite rugby players. The Journal of Strength & Conditioning Research. 21(2), 431-437.
3. Baker, C., Wederich, D., McNeal, C., Newsam, R., & Waters, R. (2000). Guidelines for adjustment of stimulation parameters. Neuromuscular Electrical Stimulation: A Practical Guide. 4th edition. Downey, CA: Los Amigos Research & Education Institute.
4. Baker, L. L., Bowman, B. R., & Mcneal, L, D. R. (1988). Effects of waveform on comfort during neuromuscular electrical stimulation. Clinical Orthopaedics and Related Research. (1976-2007), 233, 75-85.
5. Banerjee, P., Caulfield, B., Crowe, L., & Clark, A. (2005). Prolonged electrical muscle stimulation exercise improves strength and aerobic capacity in healthy sedentary adults. Journal of applied physiology. 99(6), 2307-2311.
6. Bax, L., Staes, F., & Verhagen, A. (2005). Does neuromuscular electrical stimulation strengthen the quadriceps femoris? A systematic review of randomised controlled trials. Sports Medicine. 35, 191-212.
7. Berger, J., Ludwig, O., Becker, S., Kemmler, W., & Fröhlich, M. (2020). Effects of an 8-week whole-body electromyostimulation training on cycling performance, back pain, and posture of a 17-year-old road cyclist. International Journal of Athletic Therapy and Training. 26(2), 96-100.
8. Bergquist, A. J., Clair, J. M., Lagerquist, O., Mang, C. S., Okuma, Y., & Collins, D. F. (2011). Neuromuscular electrical stimulation: implications of the electrically evoked sensory volley. European journal of applied physiology. 111, 2409-2426.

9. Binder‐Macleod, S. A., Lee, S. C., Russ, D. W., & Kucharski, L. J. (1998). Effects of activation pattern on human skeletal muscle fatigue. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 21(9), 1145-1152.
10. Chisari, E., Pavone, V., Sessa, G., Ravalli, S., & Musumeci, G. (2019). Electromyostimulation and whole-body vibration effects infielder sarcopenic patients. Muscles Ligaments Tendons J. 9, 433-441.
11. Collins, D. F. (2007). Central contributions to contractions evoked by tetanic neuromuscular electrical stimulation. Exercise and sport sciences reviews. 35(3), 102-109.
12. Crowe, L., & Caulfield, B. (2012). Aerobic neuromuscular electrical stimulation—an emerging technology to improve haemoglobin A1c in type 2 diabetes mellitus: results of a pilot study. BMJ open, 2(3), e000219.
13. De Kroon, J. R., IJzerman, M. J., Chae, J., Lankhorst, G. J., & Zilvold, G. (2005). Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke. Journal of Rehabilitation Medicine. 37(2), 65-74.
14. Di Cagno, A., Buonsenso, A., Centorbi, M., Manni, L., Di Costanzo, A., Casazza, G., ... & WB-EMS Parkinson’s Group. (2023). Whole body-electromyostimulation effects on serum biomarkers, physical performances and fatigue in Parkinson’s patients: A randomized controlled trial. Frontiers in Aging Neuroscience, 15, 1086487.
15. Doucet, B. M., Lam, A., & Griffin, L. (2012). Neuromuscular electrical stimulation for skeletal muscle function. The Yale journal of biology and medicine. 85(2), 201.
16. Dudley, G. A., Castro, M. J., Rogers, S., & Apple Jr, D. F. (1999). A simple means of increasing muscle size after spinal cord injury: a pilot study. European journal of applied physiology and occupational physiology. 80, 394-396.
17. Erickson, M. L., Ryan, T. E., Backus, D., & McCully, K. K. (2017). Endurance neuromuscular electrical stimulation training improves skeletal muscle oxidative capacity in individuals with motor‐complete spinal cord injury. Muscle & nerve, 55(5), 669-675.
18. Fernández-Elías, V. E., Tobía, D., Recarey, A., Fernández, Á., Clemente-Suárez, V. J., & Burgos-Postigo, S. (2022). Acute effects of whole-body electromyostimulation during a single maximal strength training session. International Journal of Environmental Research and Public Health, 19(21), 13753.
19. Filipovic, A., Grau, M., Kleinöder, H., Zimmer, P., Hollmann, W., & Bloch, W. (2016). Effects of a whole-body electrostimulation program on strength, sprinting, jumping, and kicking capacity in elite soccer players. Journal of sports science & medicine, 15(4), 639.
20. Filipovic, A., Kleinöder, H., Dörmann, U., & Mester, J. (2011). Electromyostimulation—a systematic review of the influence of training regimens and stimulation parameters on effectiveness in electromyostimulation training of selected strength parameters. The Journal of Strength & Conditioning Research, 25(11), 3218-3238.
21. Filipovic, A., Kleinöder, H., Dörmann, U., & Mester, J. (2012). Electromyostimulation—a systematic review of the effects of different electromyostimulation methods on selected strength parameters in trained and elite athletes. The Journal of Strength & Conditioning Research, 26(9), 2600-2614.
22. Filipovic, A., Kleinöder, H., Plück, D., Hollmann, W., Bloch, W., & Grau, M. (2015). Influence of whole-body electrostimulation on human red blood cell deformability. The Journal of Strength & Conditioning Research, 29(9), 2570-2578.
23. Galvan, M.J., Sanchez, M.J., McAinch, A.J., Covington, J.D., Boyle, J.B., & Bajpeyi, S. (2022). Four weeks of electrical stimulation improves glucose tolerance in a sedentary overweight or obese Hispanic population. Endocrine Connections, 11(2).
24. Gondin, J., Cozzone, P.J., & Bendahan, D. (2011). Is high-frequency neuromuscular electrical stimulation a suitable tool for muscle performance improvement in both healthy humans and athletes?. European journal of applied physiology, 111, 2473-2487.
25. Grill, W. M., & Mortimer, J. T. (1996). The effect of stimulus pulse duration on selectivity of neural stimulation. IEEE Transactions on Biomedical Engineering. 43(2), 161-166.
26. Hamada, T., Hayashi, T., Kimura, T., Nakao, K., & Moritani, T. (2004). Electrical stimulation of human lower extremities enhances energy consumption, carbohydrate oxidation, and whole body glucose uptake. Journal of Applied Physiology. 96(3), 911-916.
27. Hamada, T., Sasaki, H., Hayashi, T., Moritani, T., & Nakao, K. (2003). Enhancement of whole body glucose uptake during and after human skeletal muscle low-frequency electrical stimulation. Journal of Applied Physiology. 94(6), 2107-2112.
28. Herrero, J.A., Izquierdo, M., Maffiuletti, N. A., & Garcia-Lopez, J. (2005). Electromyostimulation and plyometric training effects on jumping and sprint time. International journal of sports medicine. 533-539.
29. Holzer, R., Schulte-Körne, B., Seidler, J., Predel, H. G., & Brinkmann, C. (2021). Effects of acute resistance exercise with and without whole-body electromyostimulation and endurance exercise on the postprandial glucose regulation in patients with type 2 diabetes mellitus: a randomized crossover study. Nutrients, 13(12), 4322.
30. Jabbour, G., Belliveau, L., Probizanski, D., Newhouse, I., McAuliffe, J., Jakobi, J., & Johnson, M. (2015). Effect of low frequency neuromuscular electrical stimulation on glucose profile of persons with type 2 diabetes: a pilot study. Diabetes & metabolism journal. 39(3), 264.
31. Janssen, T. W., Bakker, M., Wyngaert, A., Gerrits, K. H., & De Haan, A. (2004). Effects of stimulation pattern on electrical stimulation-induce leg cycling performance. Journal of rehabilitation research and development. 41(6A), 787-796.
32. Kebaetse M. B, Turner AE, Binder-Macleod S. A. (2002). Effects ofstimulation frequencies and patterns on performance of repetitive, nonisometric tasks. J Appl Physiol. 92(1), 109-16.
33. Kebaetse, M. B., Lee, S. C., & Binder‐Macleod, S. A. (2001). A novel stimulation pattern improves performance during repetitive dynamic contractions. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 24(6), 744-752.
34. Kemmler, W., Bebenek, M., Engelke, K., & von Stengel, S. (2014). Impact of whole-body electromyostimulation on body composition in elderly women at risk for sarcopenia: the Training and ElectroStimulation Trial (TEST-III). Age, 36, 395-406.
35. Kemmler, W., Shojaa, M., Steele, J., Berger, J., Fröhlich, M., Schoene, D., & Kohl, M. (2021). Efficacy of whole-body electromyostimulation (WB-EMS) on body composition and muscle strength in non-athletic adults. A systematic review and meta-analysis. Frontiers in physiology. 12, 640657.
36. Kemmler, W., Teschler, M., Weißenfels, A., Bebenek, M., Fröhlich, M., Kohl, M., & von Stengel, S. (2016). Effects of whole-body electromyostimulation versus high-intensity resistance exercise on body composition and strength: a randomized controlled study. Evidence-Based Complementary and Alternative Medicine.
37. Kemmler, W., Von Stengel, S., Schwarz, J., & Mayhew, J. L. (2012). Effect of whole-body electromyostimulation on energy expenditure during exercise. The Journal of Strength & Conditioning Research. 26(1), 240-245.
38. Kemmler, W., Weissenfels, A., Willert, S., Shojaa, M., von Stengel, S., Filipovic, A., & Fröhlich, M. (2018). Efficacy and safety of low frequency whole-body electromyostimulation (WB-EMS) to improve health-related outcomes in non-athletic adults. A systematic review. Frontiers in physiology. 9, 573.
39. Kots, Y.M., & Xvilon, V.A. (1971). Trenirovka mishechnoj sili metodom elektrostimuliatsii: soobschenie 2, trenirovka metodom elektricheskogo razdrazenii mishechi. Teor Pract Fis Cult. 4, 66-72.
40. Kralj, A., & Bajd, T. (2022). Functional electrical stimulation: standing and walking after spinal cord injury. Routledge.
41. Langeard, A., Bigot, L., Chastan, N., & Gauthier, A. (2017). Does neuromuscular electrical stimulation training of the lower limb have functional effects on the elderly?: A systematic review. Experimental gerontology. 91, 88-98.
42. Lee, G. J., Cho, H., Ahn, B. H., & Jeong, H. S. (2019). Effects of electrical muscle stimulation for preventing deltoid muscle atrophy after rotator cuff repair: preliminary results of a prospective, randomized, single-blind trial. Clinics in Shoulder and Elbow, 22(4), 195.
43. Maffiuletti, N. A. (2006). The use of electrostimulation exercise in competitive sport. International journal of sports physiology and performance. 1(4), 406-407.
44. Maffiuletti, N. A., Gometti, C., Amiridis, I. G., Martin, A., Pousson, M., & Chatard, J. C. (2000). The effects of electromyostimulation training and basketball practice on muscle strength and jumping ability. International journal of sports medicine. 21(06), 437-443.
45. Martínez-López, E.J., Benito-Martínez, E., Hita-Contreras, F., Lara-Sánchez, A., & Martínez-Amat, A. (2012). Effects of electrostimulation and plyometric training program combination on jump height in teenage athletes. Journal of sports science & medicine. 11(4), 727.
46. Mesin, L., Merlo, E., Merletti, R., & Orizio, C. (2010). Investigation of motor unit recruitment during stimulated contractions of tibialis anterior muscle. Journal of Electromyography and Kinesiology. 20(4), 580-589.
47. Micke, F., Kleinöder, H., Dörmann, U., Wirtz, N., & Donath, L. (2018). Effects of an eight-week superimposed submaximal dynamic whole-body electromyostimulation training on strength and power parameters of the leg muscles: a randomized controlled intervention study. Frontiers in physiology. 9, 414805.
48. Niels, T., Kersten, J., Tomanek, A., & Baumann, F. (2020). Pilot Case-Series: Can Short-Term WB-EMS be Effective in Cancer Patients?. Oncol. Res. Treat. 43, 245-246.
49. Nishida, M. M., Tsuboyama, T., Moritani, T., & Arai, H. (2016). Review of the evidence on the use of electrical muscle stimulation to treat sarcopenia. European Geriatric Medicine. 7(3), 267-271.
50. Pano-Rodriguez, A., Beltran-Garrido, J.V., Hernández-González, V., & Reverter-Masia, J. (2019). Effects of whole-body electromyostimulation on health and performance: A systematic review. BMC complementary and alternative medicine. 19, 1-14.
51. Parker, M. G., Bennett, M. J., Hieb, M. A., Hollar, A. C., & Roe, A. A. (2003). Strength response in human quadriceps femoris muscle during 2 neuromuscular electrical stimulation programs. Journal of Orthopaedic & Sports Physical Therapy. 33(12), 719-726.
52. Porcari, J.P., McLean, K.P., Foster, C., Kernozek, T., Crenshaw, B., & Swenson, C. (2002). Effects of electrical muscle stimulation on body composition, muscle strength, and physical appearance. The Journal of Strength & Conditioning Research, 16(2), 165-172.
53. Raja Hussain, R. N. J., & Shari, M. (2021). Effects of Resistance Training and Whole-Body Electromyostimulation on Muscular Strength in Female Collegiate Softball Players. Pertanika Journal of Social Sciences & Humanities. 29(3).
54. Ricci, P. A., Di Thommazo-Luporini, L., Jürgensen, S. P., André, L. D., Haddad, G. F., Arena, R., & Borghi-Silva, A. (2020). Effects of whole-body electromyostimulation associated with dynamic exercise on functional capacity and heart rate variability after bariatric surgery: a randomized, double-blind, and sham-controlled trial. Obesity surgery. 30, 3862-3871.
55. Rodrigues-Santana, L., Adsuar, J. C., Denche-Zamorano, Á., Vega-Muñoz, A., Salazar-Sepúlveda, G., Contreras-Barraza, N., & Louro, H. (2022). Bibliometric analysis of studies on whole body electromyostimulation. Biology. 11(8), 1205.
56. Rodrigues-Santana, L., Hugo, L., Pérez-Gómez, J., Hernández-Mocholí, M. A., Carlos-Vivas, J., Saldaña-Cortés, P., & Adsuar, J. C. (2023). The effects of whole-body muscle stimulation on body composition and strength parameters: A PRISMA systematic review and meta-analysis. Medicine. 102(8), e32668.
57. Rose, B., Lankisch, M., Herder, C., Röhrig, K., Kempf, K., Labrenz, S., ... & Martin, S. (2008). Beneficial effects of external muscle stimulation on glycaemic control in patients with type 2 diabetes. Experimental and clinical endocrinology & diabetes, 577-581.
58. Salhi, A., Ouerghi, N., Zouhal, H., Baaziz, M., Salhi, A., Ben Salah, F. Z., & Ben Abderrahman, A. (2024). The Effect of Whole-Body Electromyostimulation Program on Physical Performance and Selected Cardiometabolic Markers in Obese Young Females. Medicina, 60(2), 230.
59. Schink, K., Herrmann, H. J., Schwappacher, R., Meyer, J., Orlemann, T., Waldmann, E., & Zopf, Y. (2018). Effects of whole-body electromyostimulation combined with individualized nutritional support on body composition in patients with advanced cancer: a controlled pilot trial. BMC cancer. 18, 1-17.
60. Schuhbeck, E., Birkenmaier, C., Schulte-Göcking, H., Pronnet, A., Jansson, V., & Wegener, B. (2019). The influence of WB-EMS-training on the performance of ice hockey players of different competitive status. Frontiers in Physiology. 10, 1136.
61. Stevens, J. E., Mizner, R. L., & Snyder-Mackler, L. (2004). Neuromuscular electrical stimulation for quadriceps muscle strengthening after bilateral total knee arthroplasty: a case series. Journal of Orthopaedic & Sports Physical Therapy. 34(1), 21-29.
62. Tanaka, S., Kamiya, K., Matsue, Y., Yonezawa, R., Saito, H., Hamazaki, N., & Ako, J. (2022). Effects of electrical muscle stimulation on physical function in frail older patients with acute heart failure: a randomized controlled trial. European Journal of Preventive Cardiology. 29(8), e286-e288.
63. Thrasher, T. A., & Popovic, M. R. (2008). Functional electrical stimulation of walking: function, exercise and rehabilitation. In Annales de réadaptation et de médecine physique. 51(6), No. 6, 452-460.
64. Van Buuren, F., Horstkotte, D., Mellwig, K. P., Fründ, A., Vlachojannis, M., Bogunovic, N., ... & Niebauer, J. (2015). Electrical myostimulation (EMS) improves glucose metabolism and oxygen uptake in type 2 diabetes mellitus patients—results from the EMS study. Diabetes technology & therapeutics, 17(6), 413-419.
65. Von Stengel, S., Bebenek, M., Engelke, K., & Kemmler, W. (2015). Whole-body electromyostimulation to fight osteopenia in elderly females: the randomized controlled training and electrostimulation trial (TEST-III). Journal of osteoporosis.
66. Willoughby, DS., & Simpson, S. (1996). The effects of combined electromyostimulation and dynamic muscular contractions on the strength of college basketball players. The Journal of Strength & Conditioning Research. 10(1), 40-44.
67. Willoughby, D. S., & Simpson, S. (1998). Supplemental EMS and dynamic weight training: effects on knee extensor strength and vertical jump of female college track & field athletes. The Journal of Strength & Conditioning Research. 12(3), 131-137.
68. Zink-Rückel, C., Kohl, M., Willert, S., von Stengel, S., & Kemmler, W. (2021). Once-weekly whole-body electromyostimulation increases strength, stability and body composition in amateur golfers. a randomized controlled study. International Journal of Environmental Research and Public Health. 18(11), 5628.