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marylin monroe
Showing posts with label electro stimulation. Show all posts
Showing posts with label electro stimulation. Show all posts

Intensify Your Training, Increase Your Gains W/ Combined EMG + Regular Training For 30% Greater Muscle Size Gains

Voluntary & NMES contractions for Monster Quads?
You are always looking for new ways to improve your training outcome? Scientists from the Department of Physiotherapy at the University Cardenal Herrera-CEU might have something for you, then. In their latest study, V. Benavent-Caballer, P. Rosado-Calatayud, E. Segura-Ortí, J.J. Amer-Cuenca, and J.F. Lisón tried to elucidate, whether conducting low intensity resistance training in conjunction with  neuromuscular electrical stimulation (NMES) would provide not just an additional growth stimulus, but also corresponding increases in physical performance, muscle cross-sectional area (CSA) and the capacity to perform daily tasks 22 in exactly those subjects researchers will resort to, when they're looking for generous funding for studies the outcome of which is not going to pay off in form of scripts for a new patentable drug: Older adults living in a geriatric nursing home.
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What? Yeah... I have to admit, the subjects are not exactly bodybuilders and a regular high intensity control is missing, but even if it wasn't for the necessary fact that you'll belong to the group of "older adults" in 50 years from now, the results of the study at hand would still have a certain relevance for younger trainees. Why? Well, something that makes the elderly grow will certainly do the same in young people. Whether it does so at the same or even higher rates than "regular" strength training will obviously have to be elucidated in future studies.
Table 1: Subject characteristics;  VC = volitional contraction; NMES = neuromuscular electrical stimulation; NMES+ = NMES superimposed onto voluntary contraction. SD = standard deviation (Benavent-Caballer. 2014)
For now, all I can tell you is that the three weekly supervised 30-35 min exercise sessions the 89 participants of the study at hand performed in the course of this 16-week study lead to significantly more pronounced strength and size gains, when the exercise was performed using both voluntary contractions and the forced contractions, the researchers produced by attaching their subjects to the surface electrodes of a portable NMES devices (TensMed S82).
Beware of NMES only training! In as much as a combination of voluntary contractions and NMES  may make sense, you should not fall for the fallacious promises of "couch workout" advocates. Previous studies suggest that the strength increases of EMS are - just like any form of training - stimulus specific, the "incomplete muscle activation after training with electromyostimulation" will thus make your muscle stronger on the couch (during your NMES workouts), but are not necessarily going to translate into the real world (Hortobágyi. 1998).
The four adhesive surface electrodes (5 × 5 cm) were placed on the distal medial and proximal lateral portions of the subject's anterior thigh, when they performed their three sets of knee extensions (15 reps each) in a single-leg fashion with 3-minute rest between sets.
Figure 2: Changes in muscle strength (hand grup) and size (rectus femoris), as well as changes in parameters of physical functioning in response to the three training modalities (Benavent-Caballer. 2014)
The participants were instructed to raise the weight in 1 s (concentric phase), keep a full knee extension for 3 s (isometric phase) and slowly lower the weight in 2 s to the starting position (eccentric phase). Each contraction was followed by a 2-second rest period, and the training intensity was set at 40% of 1RM... and yeas, this sounds pretty much like peak contractions, an intensity technique which may in fact be the reason that the old trainees in the study at hand recorded highly significant increases in muscle size even when the peak contraction or rather the whole movement was not superimposed with NMES which was delivered with a ramp-up time of 1 s increasing intensity as the knee was extended from 90° to full extension that was followed by 3 s keeping the knee in full extension and 2 s of a ramp-down with gradually decreasing intensity (see Figure 2, yellow).
There is evidence from previous studies that a similar NEMS + VC regimen leads to non-significantly higher strength gains in the trained leg and sign. higher cross-education effects in the untrained leg of young men (Bezerra. 2009)
Bottom line: It is, as mentioned before, difficult to predict whether or not the NEMS+ training would produce superior training outcomes in younger athletes, athletes. It is yet almost certain that the combination of NEMS + voluntary contractions would pose a viable tool in the toolbox of any injured athlete who has to cut back on his / her training intensity for health reasons.

Moreover, previous trials in younger subjects confirmed that superimposing NEMS + voluntary contractions is at least on par with classic high intensity resistance training and can promote neural adaptations that lead to increased cross-education effects (strength gains in non-trained leg) in a 2009 study by Bezerra et al. (2009).

Beneficial effects of combining (N)EMS and voluntary contractions (not always superimposed, though) were also reported by Venable et al. (1991) and Dervisevic et al. (2002) for resistance training, Pichon et al. (1995) for swimming, Maffiuletti et al. () for basektball volleyball, Brocherie et al. (2005) for ice-hockey and Herrero et al (2006), Babault et al. (2007) and Paillard et al. (2008) for physical education (vertical jump, strength, etc. tested) | Comment on Facebook!
References:
  • Babault N, Cometti G, Bernardin M, et al. "Effects of electromy ostimulation training on muscle strength and power of elite rugby players." J Strength Cond Res 21 (2007): 431-7.
  • Bezerra, Pedro, et al. "Effects of unilateral electromyostimulation superimposed on voluntary training on strength and cross‐sectional area." Muscle & nerve 40.3 (2009): 430-437.
  • Brocherie F, Babault N, Cometti G, et al. "Electromyostimulation training effects on the physical performance on ice hockey players." Med Sci Sports Exerc 37 (2005): 455-60.
  • Delitto A, Brown M, Strube MJ, et al." Electrical stimulation of quadriceps femoris in an elite weight lifter: a single subject experiment." Int J Sports Med 10 (1989): 187-91.
  • Dervisevic E, Bilban M, Valencic V." The influence of low-frequency electrostimulation and isokinetic training on the maximal strength of m. quadriceps femoris." Isokinet Exerc Sci 10 (2002): 203-9. 
  • Hortobágyi, Tibor, Jean Lambert, and Kevin Scott. "Incomplete muscle activation after training with electromyostimulation." Canadian journal of applied physiology 23.3 (1998): 261-270. 
  • Maffiuletti NA, Cometti G, Amiridis IG, et al. "The effects of electromyostimulation training and basket practice on muscle strength and jumping ability. Int J Sports Med 21 (2000): 437-
    43. 
  • Malatesta D, Cattaneo F, Dugnani S, et al. "Effects of electromyostimulation training and volley practice on jumping abilities." J Strength Cond Res 17 (2003): 573-9.
  • Herrero JA, Izquierdo M, Maffiuletti N, et al. "Electromyostimu lation and plyometric training effects on jumping and sprint time." Int J Sports Med 27 (2006): 533-9.
  • Paillard, Thierry, et al. "Effects of two types of neuromuscular electrical stimulation training on vertical jump performance." The Journal of Strength & Conditioning Research 22.4 (2008): 1273-1278.
  • Pichon F, Chatard JC, Martin A, et al. "Electrical stimulation and swimming performance." Med Sci Sports Exerc 27 (1995): 1671-6.
  • Venable MP, Collins MA, O’Bryant HS, et al. "Effect of supplemental electrical stimulation on the development of strength, vertical jump performance and power." J Appl Sport Sci Res 5 (1991): 139-43

Electrical Stimulation Improves Clearance of Lactic Acid After Anaerobic Activity in Collegiate Athletes. EMS Turns Out to Be as Effective as 'Traditional' Massage Therapy.

Image 1: The EU-940 EMS device the
scientists used in their study to activate
the vastus medialis and lateralis (high-
lighted in the image) of their subjects, is
very different from the average EMS based
"abdominal toner" advertised on TV.
Even here, at the SuppVersity, news on ergogenics, i.e. things that improve (athletic) performance, are usually about a pill, a fancy plant extract or another 'superfood'. Today's news, however is about a much more "physical" means to improve anaerobic exercise performance, decrease lactate accumulation and improve regeneration: Electrical Muscle Stimulation (EMS).

EMS? Now, many of you will probably remember those TV spots, where you were told that "Abmaster" & Co would transform your pot-belly into a "six-packed" attractant for the opposite sex, if you did not miss this "unique" opportunity and bought one of those electro-shockers no sane fitness professionals would voluntarily substitute his/her good old sit-ups and leg raises for. Yet, while these battery-powered torture instruments did, or I should say, were intended to electrically stimulate muscles (in fact in many of the obese buyers of these products, the abs were probably covered by a layer of fat that was way too thick for actually "stimulation" of the abdominal muscles to occur), both the devices, as well as the EMS protocol Seo et al. (Seo. 2011) employed in their double-blind randomized controlled trial at the Sports Science Research Laboratory of Kyungwoon University in Korea were a little more sophisticated.
Did you know? The fatigue index is a concept used in the study of fatigue during anaerobic activities. It is the ratio of power decline to the length of the time interval in seconds between peak power and minimum power. This means lower fatigue indexes equate lower declines of exercise intensity per time unit. When looking at the data in figure 1, you may want to keep in mind that higher starting values / greater overall workloads will entail greater declines in anaerobic power per time unit and thus present with higher fatigue indexes
During and after 3 all out intervals on an ergometer (resistance: 0.8 x body weight Nm; active rest between intervals: 10 seconds) verbal feedback on perceived fatigue, fatigue indexes in W/s, mean power/weight, total work and lactic acid values (from serum drawn before, after and at 15 min and 25 min post exercise) were recorded in a group of 24 randomly selected collegiate Taekwando athletes (age: 19.8yrs, height; 177cm; weight: 66kg, training experience: 5yrs; mean values with non-significant differences between groups).
Figure 1: Fatigue index, mean power (primary axis) and total workload (secondary axis) during Wingate ergometer test
(data adapted from Seo. 2011)
Immediately after the exercise bout, eight athletes, each, received one of the following treatments:
    Table 1: Outline of the massage
    protocol the  athletes in the massage
    group received after having performed
    an exhaustive anaerobic Wingate
    ergometer test (according to Lee. 1998)
  • The control group received no regenerative treatment at all. 
  • The massage group was subjected to a massage protocol which had been shown to effectively improve exercise recovery in a previous study by the same authors (Lee. 1998).
  • The EMS group was attached to an interferential current unit (EU-940, ITO CO., LTD, Tokyo, Japan), which applied an interferential current with a carrier frequency of 4kHz and a pulse duration of 125µs via four vacuum electrodes (vacuum pressure: 60ppm) to the vastus medialis and the vastus lateralis of the subjects.*
    * "The current  intensity was set within the range of the minimum visible contraction of the quadriceps femoris muscle", so that the muscle of the quadriceps were maximally stimulated, while the current was not so intense that cross-over effects to neighboring muscle groups would occur.
Seo and his colleagues found "significant differences in the lactic acid concentrations in the blood among the three groups [...] at 15 min and 25 min after exercise".
Figure 2: Relative reduction in lactic acid concentration after a wingate performance test followed by massage or EMS therapy compared to untreated control (data adapted from Seo. 2011)
As the data in figure 1 shows, massage and EMS promote the clearance of lactic acid to a similar degree (+17-18% vs. control). So, if you are a professional athlete you should either make good use of your already existing six pack and attract a significant other who is a massage therapist or save some bucks and get yourself a reasonably professional EMS device, in case you intend to be a gold medalist at the 2012 Olympics in London ;-)

Edit (26 July): The lactate & Lactic acid confusion

After I posted this piece of information an interesting discussion around the physiological role of lactic acid broke lose on Facebook and I do not want to deny you the great information my buddy Sean Casey from CasePerformance brought to the table. So, here is what he had to say:
Lactic Acid is an interesting thing....During the 1970-1980’s various studies found lactic acid impaired strength and contraction velocity in samples of isolated muscle tissue (1). Based off these early findings, many researchers evaluated ...post workout recovery modalities on their ability to remove lactate from muscle tissue post workout. Similarly, coaches and athletes started employing post workout techniques aimed at removing lactate from muscular tissue. For instance, our high school track coach used to have us lie on our backs and rest our legs on an elevated surface w/ respect to our body. Usually we'd lie on the floor next to a wall & place legs on wall. The theory was that acid would “drain” out of our muscle tissue, allowing our legs to be fresher for the following day’s workout. (I know, a very bro-science approach; , but mentally felt good and you'd always get a cool tingly sensation when you set your legs down and the blood rushed back into them!)

Interestingly, it turns out that lactic acid may not be the best form of measurement with respect to evaluating the effectiveness of a PWRM [post workout recovery measures]. As pointed out by Cairns SP, it may have a much smaller effect on muscle fatigue than was previously hypothesized(1). Thanks to advances in technology, scientists are now able to study muscle tissue closer to physiological temperatures (old studies were completed at muscle tissue held at cooler temperatures, 50-68ºF). As shown by Westerblad et al., acid had little effect on contraction velocity when completed on muscle tissue held at 89ºF (2). On the other hand, a 2006 study by Knuth et al. did indicate that lactic acid decreased muscle contractile power even at warmer temperatures(3). 

Although the lactate question is still being debated amongst scientist, athletes must ask themselves if the research is even applicable to their post training recovery protocol. Although lactate may induce muscular fatigue, its quickly metabolized within the body (1/2 life: muscle- 9.5 minutes; blood- 15 minutes), and eliminated from our system 90 minutes after an exercise session has been completed (4)(5). Thus, exercise induced lactic acid from one workout is likely not even present during a subsequent workout depending on when you complete it.

All this being said, don't misinterpret my comments and think that I'm trying to put down the role of EMS. I've had to use one a fair amount due to various issues and have found it to be effective. Anything that can get a muscle contracting and increase blood flow is always a good thing ;-) 

References

1 Cairns SP. Lactic acid and exercise performance: culprit or friend? Sports Med. 2006;36(4):279-91.

2 Westerblad H, Bruton JD, Lännergren J. The effect of intracellular pH on contractile function of intact, single fibres of mouse muscle declines with increasing temperature. J Physiol. 1997 Apr 1;500 ( Pt 1):193-204.

3 Knuth ST, Dave H, Peters JR, Fitts RH. Low cell pH depresses peak power in rat skeletal muscle fibres at both 30 degrees C and 15 degrees C: implications for muscle fatigue. J Physiol. 2006 Sep 15;575(Pt 3):887-99. Epub 2006 Jun 29.

4 Karlsson J, Saltin B. Oxygen deficit and muscle metabolites in intermittent exercise. Acta Physiol Scand 1971; 82: 115-22.

5 Barnett A. Using recovery modalities between training sessions in elite athletes: does it help? Sports Med. 2006;36(9):781-96.
The only thing I would like to add to Sean's insightful dissertation is a criticism of the indiscriminate use of lactate, which is sort of 'recycled' muscle fuel, and lactic acid, which is its ugly 'degraded' relative. With the ever increasing H+ levels as they can be observed in the course of a long distance race, for example, more and more lactate gets degraded into lactic acid and thus works like a buffer similar to the beta-alanine derived intramuscular H+ buffer carnosine. Now it is no wonder that with H+ release being a measure of muscular exertion and lactic acid being a measure of H+ buffering, Faude et al. (Faude. 2009) found in what is one of the most recent reviews on the role of lactate in exercise metabolism that
[t]hirty-two studies evaluated the relationship of LTs with performance in (partly simulated) endurance events. The overwhelming majority of those studies reported strong linear correlations, particularly for running events, suggesting a high percentage of common variance between LT and endurance performance.
And, after all, it does not really matter in how far the established performance increases from massages and EMG therapy are related to their ability to accelerate lactate clearance, or more generally to their ability to increase blood flow and thus nutrient delivery and waste clearance in the respective tissue - does it?

Muscle Mass & Strength from the Convenient Outlet - Study Proves, Neuromuscular Electrical Stimulation Can Increase Muscle Size & Strength

NEMS devices are usually marketed as "ab trainers" - do you own one?
Convenience above everything! Although I personally believe that this mantra is to blame for most of the modern health issues, scientists from the Department of Biomedical Engineering and Institute for Convergence Study of Bio-Medical Wellness at the Yonsei University in Korea have now been able to demonstrate that you can counter part of the negative side effects of our post-modern convenience culture quite conveniently.

Plug an NMES device into your convenient outlet, attach it to your biceps, sit down conveniently in front of your television screen and have the device train your muscles.
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You don't believe that this works? Well, basically this is what the seven healthy male subjects who were recruited for the study did at the laboratory. The participants were trained two times per week (three subjects: Mondays and Thursdays; and four subjects: Tuesdays and Fridays) for 12 weeks. Each exercise session was performed for 30 min with no rest interval.
You could do this in front of your TV at home (image from Son. 2014)
"During the training, the subject was required to maintain a shoulder joint angle of 90° in the sagittal plane. The electrical stimulation (pulse width: 200μs; and frequency: 20 Hz (Dreibati et al., 2010)) was delivered through a pair of 5 × 5 cm gelcoated electrodes attached to the region of the biceps brachii muscle belly. The magnitude of the stimulation was determined as the subject's maximum comfortable current level, but no more than 80 mA, with complete elbowflexion from the fully extended state; the mean value was 57.00 (SD 4.28) mA." (Son. 2014)
I am not sure if this hurts, but based on my experience with a friends NMES ab trainer, I suppose it did... not convenient, ok, but still better than actually moving for most of the the members of the convenience generation, I'd guess - And I mean, you can't argue with results, right?
Figure 1: Maximal force and muscle thickness before and after the NMES training (Son. 2014)
I must admit I was quite impressed with the 8% increase in muscle size and the 23% increase in performance. Ok, the study doesn't tell us anything about the training experience of the subjects, but even if they were noobs that's more than I'd expected to see from two weekly sessions of NMES.
Figure 2: The training did not work for all participants (Son. 2014)
Bottom line: I am pretty sure there is a limit to the application of EMS as a means to increase muscle size & strength. Nevertheless two EMS sessions per week appear to be better than spending the same time on the sofa watching TV without an EMS device contracting your biceps and whatnot.

That being said, physical culturists like yourself probably benefit very little from EMS, unless you intend to stop training, these devices are probably useful only as an adjunct for those who would otherwise fry their nervous system by doing 100 sets of curls everyday... I mean, no voluntary contraction, no CNS overload; but honestly, I suspect that one or two days of full rest would be the better choice for anyone who fits into the "training junkie" category described, here.
Reference:
  • Jongsang Son, Dongyeop Lee, Youngho Kim, Effects of involuntary eccentric contraction training by neuromuscular electrical stimulation on the enhancement of muscle strength, Clinical Biomechanics, Available online 10 June 2014.

"Electro-Cut" Your Body Fat - Study Shows 5.6 cm and 4.9% Reduction in Waist & Body Fat in Young Women in 6 Weeks

No sweat, just some wires? Study shows: It does not take much effort to lose belly fat.
Liposuction is an invasive procedure that is not without risk. Against that background it's no wonder that people are marketing alternative methods like high-frequency current therapy as allegedly safe go-to methods to rid yourself of unwanted body fat. The question is: Do these currents actually help you to lose body fat? That is: Can electrocuting your belly "electro-cut" significant amounts of body fat? Practitioners who use this technology will say "yes". From a scientific standpoint, though, the question is difficult to answer, because the use of high-frequency current therapy has been given little attention in the scientific community.

As Kim et al. point out in a recent paper in the J. Phys. Ther. Sci., some previous studies have failed to provide evidence for the effectiveness of high-frequency current therapy in women with obesity, whereas more recent studies have indicated that a high-frequency current therapy decreases female abdominal obesity (Kang. 2005; Han. 2010). Accordingly, their latest study aimed to determine whether high-frequency current therapy can be effectively used to reduce female abdominal obesity.
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To this ends, the researchers recruited twenty-two female volunteers who were randomly allocated to either the experimental group (EG) (n = 12; age, 21.17 ± 0.72 years; weight, 63.17 ± 7.91 kg; height, 159.63 ± 4.56 cm) or the control group (CG) (n = 10; age, 21.10 ± 0.74 years; weight, 68.79 ± 11.73 kg; height, 161.69 ± 5.25 cm). Inclusion criteria were as follows:
  • a body mass index (BMI) of ≥23 kg/m2 and a waist-hip circumference ratio of  ≥ 0.8013
  • no past or present neurological, musculoskeletal, or cardiopulmonary disorders that would have affected health condition;
  • no smoking and drinking habits; and
  • no psychological problems.
Futhermore, pregnant women were excluded as well. The subjects of both groups were asked to keep a regular dietary habit during the experimental process. A nutritionist drew up a diet plan of 2,000 to 2,500 kcal/day across 3 meals (8 a.m., 1 p.m., and 6 p.m.) for the 6-week intervention. In addition, subjects were asked to avoid extra activities and exercises beyond daily routine activities.
Figure 1. Changes in BMI, waist circumference, subcutaneous body fat and total body fat (%) after 18 sessions of high-frequency current therapy in Korean women (Kim. 2015).
Only the subjects in the EG group were subjected to high-frequency current therapy, with a frequency of 0.5 Mhz. The treatments were performed exclusively on the abdominal region while subjects were supine using specific equipment (CWM-9200; Chungwoo Medical, Seoul, South Korea) for 60 minutes, 3 times per week, for 6 weeks (a total of 18 sessions).
"High-frequency current therapy was performed in 2 phases: 2 sets of 15-minute applications of capacitive electric transfer (CET) and resistive electric transfer (RET) with the pulsed current option (current conduction time, 0.7 seconds; rest interval, 0.3 seconds) for the fist 3 weeks, followed by a 30-minute application of the CET and RET modes with continuous current conduction in the final 3 weeks. The intensity was individualized within a range of 6–7 mA to comfortably adjust the heating sensation during the intervention. An insulated electrode and a stainless steel electrode (8 cm in diameter) were used for the CET and RET modes, respectively. Conductive gel (Body Rubbing Cream; SA’COS, Incheon, South Korea) was used to facilitate skin moisture and current conduction, and high frequency current therapy was delivered by making circular motions of the electrode over the abdominal region at a moving speed of 5 cm/s, avoiding focused pressure on therapeutic areas" (Kim. 2015)
The comparison of the pre- vs. post-data showed here significant main effects of time with respect to waist circumference, abdominal obesity, subcutaneous fat mass, and body fat percentage, which differed significantly between the groups (see Figure 1), "suggesting the effects of high-frequency current therapy in decreasing obesity" (Kim. 2015).
Bottom line: I must say that I am impressed. I haven't been there to control whether the scientists cheated, but considering the fact that the control group received the same controlled diet as the women in the experimental group, the loss of body fat and the reduction in waist circumference that was achieved within only 6 weeks in young women is impressive.

High frequency currents are also been used for cellulite treatment, but there are other options, as well | learn more
In the end, the mechanism of action is simple and is believed to rely mostly on the heat induced dilatation of subcutaneous vessels and the subsequent facilitation of the lipolytic process (Song. 2006). Which would also explain why the effect was highly localized and there were no significant inter-group difference with respect to the BMI of the women in the study at hand. A study that is yet limited by the low number of participants, a lack of safety data (no blood analyses, for example), the absence of measurements of the reductions in visceral fat and the lack of a rigid dietary and activity control as it would be possible in a metabolic chamber | Comment on Facebook!
References:
  • Han, J. S., Y. O. Park, and C. K. Zhoh. "The effect of high frequency treatment and meridian massage on the abdominal fat pattern of obesity women." J Korean Soc Esthet Cosmeceutics 6.1 (2010): 1-8.
  • Kang SO, Won YK. "The effect of high-frequency therapy on women’s obesity." Kor J Aesthet Cosmetol 3 (2005): 121–131.
  • Kim, Jin-seop, and Duck-won Oh. "Effects of high-frequency current therapy on abdominal obesity in young women: a randomized controlled trial." Journal of Physical Therapy Science 27.1 (2015): 31-33.
  • Song MY, Kim HJ, Lee MJ. "The review on the evidence: effects of nonsurgical localized fat treatments." J Korean Med Obes Res 6 (2006): 1–10.