Study/review saying EMS is awesome

Expert Discussion Strength Training
7

Giovanni,

Have you read this recent study? It was in this month’s JSC.

Restoring Muscle Work Capacity With Electrical Stimulation
http://www.ncbi.nlm.nih.gov/pubmed/22549086

It says that endurance athletes were able to improve their work capacity in their calf muscles with EMS more than the athletes that didn’t use EMS. The protocols were a bit broad, saying that it used mild impulse frequency of 20hz to 120hz, 2sec ON/2secOFF, 20-25 mA intensity for 10 minute duration, 4 hours after the training session. It states that recovery would be less effective if it were performed any less than 4hrs after the training session because the recovery metabolic changes take place 2-4 hours after loading.

Let me know what you think. Do you agree with the protocols used in the study?

Kyle

8

Kyle,
Thank you for bringing up this study. I downloaded a copy, went through it, and I’m perplexed. In a nutshell I had the impression it was not a good study. In addition I think the peer reviewers at JSCR do not understand EMS, are not current with recent research, and therefore were not knowledgeable enough to hold the study to a better standard. If I were a reviewer, I would ask to at least have language that conforms with all other papers, then I would start asking serious questions on their methods and conclusions.

The study doesn’t really explain what type of waveform they are employing (and the machine they used can’t be found on the net). They are also concluding, without supporting evidence, that if you want to obtain a good recovery you must use their settings (work/rest times etc.). But if the study doesn’t explore different settings, how can they suggest that their parameters work best? Another clue about the shoddiness of this study (and the Journal’s peer reviewer), is that in the bibliography the authors do not even mention some of the best (and more thorough) studies on recovery with EMS*.

The point you bring up about waiting 2-4 hours before performing recovery work with EMS, is something I’ve read in papers about manual massage for recovery. However, I have not seen a study yet about different time delays. If this study did it, they do not show any detail of it and their full results. I wish that with the number of practitioner that read this forum, we could have an informal peer network to crowd-experiment with optimal delay after exercise.

The 2s on, 2s off protocol also leaves me perplexed. But it’s difficult to make more comments about it without details on the waveform. They only write it has a phase width duration of 0.3 ms (300 µs), which is much weaker than what we use in the machines I import in the US. And then they write that it is an asymmetrical biphasic waveform (while we always use symmetrical), without specifying what the asymmetric part looks like. I assume they use a rectangular waveform but they do not specify, so it’s open to speculations. They also describe a trapezoid with take-off and landing size, but I suspect what they mean is the ramp-up and ramp down of current intensity (and again they do not say how long this is).

So, a lot of grey areas, which were not picked by JSCR. Unfortunately a decent article has to describe all conditions of the experiment, but this tenet was not respected, which makes the article useless.

Note*:

  1. Cortis C, Tessitore A, D’Artibale E, Meeusen R, Capranica L. Effects of post-exercise recovery interventions on physiological, psychological, and performance parameters. Int J Sports Med. 2010;31(5):327–335.
  2. Tessitore A, Meeusen R, Pagano R, et al. Effectiveness of active versus passive recovery strategies after futsal games. J Strength Cond Res. 2008;22(5):1402–12.
  3. Tessitore A, Meeusen R, Cortis C, Capranica L. Effects of different recovery interventions on anaerobic performances following preseason soccer training. J Strength Cond Res. 2007;21(3):745–50.
9

Giovanni,

I’m not very sharp in EMS studies or reading studies in general so it’s good to have your take on this study. It seems like these studies have too many issues and there aren’t enough common denominators with these studies. It would be nice if every EMS study used the same protocols, machine, etc. Thanks for looking into this for me.

10

It is true that there are many variables and therefore a lot ground for confusion and misunderstandings. The good news is that in the last half-dozen years, lead researchers have converged on rectangular wave forms, and more or less protocols of the type that Globus and Compex employ. This study though failed to even explain what waveform they used, and it positively is not a rectangular waveform of the type I just referred to.

Since you are a subscriber to the Journal of Strength and Conditioning Research (I only read on-line articles of interest at my local University), how is it possible to send a letter to the editor? Is there an e-mail there? I’d like to critique (deplore) their acceptance of the article.

11

Check your inbox, I’ve got a few addresses that you could possibly send it to.

12

Thanks. I wrote to both the official correspondent of the study, and to Prof. Bill Kraemer the editor in chief of the Journal of Strength and Conditioning Research. I’ll write an update if they reply.

13

Awesome! Keep us posted.

14

The official correspondent for the article has not replied to my request for clarification.
The editor in chief of the journal admitted that the review process is not perfect, that there may be flaws in the article, and invited to write a critique of it, that he would publish.
One scientist who has written a ton of articles on EMS in the last 10 years, agreed with my critique.
Working now with a credentialed researcher to write the critique.

15

sorry to highjack!

Does somebody ever tried subscapularis EMS?

I have done 3 session of infraspinatus and supraspinatus so far, the results have been quite spectacular, from a weakness in external rotation to been able to lift more in external than internal.

I have used hypertrophy program with premium 200 Globus.

Since now the internal are more weak, I want to try it on the subscapularis, but I wonder how to place the electrodes since it’s a very deep muscle.

Thanks in advance If someone know or have experience with It!

16

Can you show picture of pad placement of what you did?

17

pic pic pic pic

Supraspinatus + infraspinatus EMS.jpg

18

How were the leads connected?

19

Good question. Let’s hear from Adonail (my guess is that he connected one lead to the large pad and one to the small pad).

Adonail, besides being a deep muscle the subscapularis is behind the shoulder blade (scapula). So you will have to increase current intensity to a much higher level. My anatomical guess is that the position the lower pair of pads in your picture is about right for the subscapularis. Therefore, as you try to stimulate the subscapularis, you will hit the infraspinatus as well. An additional difficulty is that the bone is a significant obstacle to the passage of current.

20

I will try to put the stimulation very progressively in the axillary area

21

one lead to the large pad and one to the small pad

22

Dr William J. Kraemer is the chief editor of the JSC. Most Sport Science graduates would have Exercise Physiology textbooks by Kraemer. One of the major issues with research published in the JSC, is that a number of studies are not randomised controlled trials. Potential bias are likely to be greater for non randomised trails, so results should be viewed with caution.

23

What study are you referring to?

It is the job of the peer reviewer to reject studies or recommend corrections to the author if the study is biased or not random.

24

The American College of Sports Medicine ( ACSM) list several studies to support multi set programs to single set programs in both previously untrained subjects, untrained long subjects, and resistance-trained individuals. However, many of these studies have methodological concerns.

Berger, Effect of varied weight training programs on strength, conducted a study with no control for sets or reps, and subjects were not randomised. In fact the results demonstrated no significant difference between multi set v single set.

Sanborn, Short-Term Performance Effects of Weight Training With Multiple Sets Not to Failure vs. a Single Set to Failure in Women. Subjects were randomised. However, when testing vertical jumps, the multi set groups were given different technical instruction to the single set group.

Stone, A short term comparison of two different methods of resistance training on leg strength and power. The high set group reported to have greater improvements in squat and vertical jump. However, there was no significant difference for leg press strength, no significant increase as power (vertical jump and Lewis Formula), and no difference in lean muscle mass. No pre and post training data was provided.

Stowers, The Short Term effect of three different strength-power training methods. This study did not list intensity for the varied group v the 1 set or 3 set group.

Chief editor of the journal of strength and conditioning Dr Kramer. Published a number studies which were based on football players. The data was taken out of database over a decade later. One study didn’t have any controls, and subjects had there adherence tested by survey. Subjects used a particular protocol at home or in a gym.

Pharmaceutical companies for instance, can be very persuasive on the effectiveness of their product. A number of published studies have made various claims. For instance Vioox and came out in 1999 as new type of drug for treating Arthritis. They claimed not have side effects on gastrointestinal illness, however when later examined, one other Cox 2 inhibitor Celebrex showed no significant difference compared to Voltaren. More seriously, thousands of patients died of stroke and heart attack. Vioox was pulled from the market by Merck, conveniently after profiting three billion dollars in annual sales.

Historically there have been many other drugs (Laetrile, Interferon, etc ) which claimed to treat cancer. The studies were published, however studies were uncontrolled trials. Subsequent controlled studies showed Laetrile to be a toxic drug and not effective. Laetrile therapy gained enormous popularity in American, even though there was no proper evidence of patient benefit.

25

Sharmer,
I think you misunderstood my question. I asked “What study are you referring to?” because there are two studies that we have discussed in this thread.

I partly agree with you, and I’m not denying that there are studies that have problems. But that does not mean that every study reaches incorrect conclusions. We should judge things based on facts. If, by listing all the studies claimed to have problem, you imply that the studies we discussed in this thread have a problem too, you make the same mistake. Every study has to be judged according to facts: its merits and its faults. Please let’s try to stick to the subject of this thread which I believe are two studies about EMS.

26

I was referring to a number of other studies in the JSC. Which were published under the review chief editor Dr Kraemer. I didn’t 't mean to imply that all studies have incorrect conclusions. The criticism is in relation to Sports Science research and particular studies published in the JSC.

The first clinical trial in medicine with a properly randomised control group was for the streptomycin treatment of pulmonary tubersculosis ( 1948). Comparatively early research in Sport Science , were non randomised and with no controls. However many strength and conditioning textbooks base there guidelines on poorly designed studies.

Over the last 30 years there has been a enormous growth in properly planned, executed and reporting of research in medicine. Sport Science in contrast has been much slower to adopt the standards of research in medicine.

In regards to the two EMS studies , I am examining the findings and will provide some thoughts shortly.