Electrical Muscle Stimulation Increased Strength, Endurance

Whole-body electromyostimulation (WB-EMS) to trigger muscle contractions, improved upper and lower body strength, endurance, and hand-eye coordination in a small group of people with early Parkinson’s disease who did not engage in regular exercise programs.

The study with that finding, “A Single Session of Whole-Body Electromyostimulation Increases Muscle Strength, Endurance and proNGF in Early Parkinson Patients,” was published in the International Journal of Environmental Research and Public Health. 

Parkinson’s disease is characterized by a progressive loss of coordination and movement due to the death of nerve cells in the brain that play a role in muscle movement. Primary motor impairments include posture and walking instability, difficultly in starting body movements, and slowness in maintaining activity. 

Exercise programs are recommended for people with Parkinson’s to help maintain fitness and mental well-being. However, due to physical and mental limitations, many tend to lead a sedentary lifestyle. That’s why it is necessary to find types of physical activity more suitable for people with the condition. 

WB-EMS, also called electrical muscle stimulation, is the activation of muscle contractions using electrical impulses. EMS has been used as a strength training tool for athletes and has been suggested as a rehabilitation strategy for partially or totally immobilized patients.

WB-EMS induces a global-body electrical muscle stimulation, activating up to eight to 10 different muscle groups at the same time. Furthermore, exercise alongside WB-EMS has been shown to affect blood proteins such as the neurotrophin brain-derived neurotrophic factor (BDNF), a protein important in promoting the survival of nerve cells affected in Parkinson’s. 

Researchers based at the University of Molise in Italy designed a study to test the effects of WB-EMS and exercise on the physical performance and blood levels of neurotrophic factors in a small group of Parkinson’s patients.

“WB-EMS has not previously been applied to an exercise program for PD patients,” the team wrote. “The initiative to develop WB-EMS training protocols was motivated by the awareness that Parkinson’s patients are unable or unwilling to perform traditional exercise programs.”

The study included six men and four women, with a mean age of 72.6 years. Participants had a diagnosis of Parkinson’s in the early stages from 1 (mild) to 3 (moderate) as assessed by the Hoehn and Yahr scale, and did not attend physical exercise programs.

The intervention first included WB-EMS; then, it was repeated with no WB-EMS as a control condition after four weeks. In both scenarios, after a warm-up, participants underwent a 20-minute exercise session guided by a certified instructor, which consisted of five voluntary strength exercises: half squat, full squat, bent over, core rotation, and crunch. 

Before the WB-EMS, a general level of physical activity was assessed using a questionnaire that recorded activity over the previous week during leisure time, household, and work activities. Tremors were evaluated along with strength exercises, including arm curls with weights, handgrip test, sit-to-stand test for lower limbs, and the soda pop test for manual dexterity. 

Physical assessments and blood tests were conducted before WB-EMS and the no WB-EMS condition, and after both. 

The analysis showed participants were able to perform significantly more repetitions in the sit-to-stand test after WB-EMS, compared to before or after the no WB-EMS condition, assessed four weeks later. 

Similarly, patients performed significantly faster on the soda pop test post-WB-EMS than after no-WB-EMS and before WB-EMS.

In the arm curl assessment, participants could perform significantly more repetitions post-WB-EMS than in the post-no WB-EMS and in the pre-WB-EMS. 

The handgrip test showed patients were stronger after WB-EMS intervention than after the control condition and before WB-EMS. 

There was no impact on the blood levels of growth factors BDNF, FGF21, and mature neuro-growth factor (mNGF). In contrast, significantly higher levels of immature NGF (proNGF) were found 60 minutes after WB-EMS than in the no-WB-EMS condition at the pre-intervention assessment. 

Finally, no differences were seen between the WB-EMS and no WB-EMS conditions in the Unified Parkinson Disease Rating Scale (UPDRS), a tool to measure Parkinson’s progression. 

“The results revealed a positive impact of the WB-EMS protocol proposed in this study, on several physical functioning parameters, improving upper and lower limb strength, hand-eye coordination and clinical outcomes associated with WB-EMS-induced variations in serum proNGF levels,” the researchers concluded. 

“WB-EMS application could be an advisable strategy for Parkinson’s patients to increase their adherence to [physcial activity] programs since it is a time-efficient and feasible methodology to improve their physical condition,” they added.