EMS Research Review
Updated: Jan 27
Why Do We Care About Research?
Research is the nucleus of health and fitness. A body of evidence establishes the parameters in which we can operate within to optimize our practices for our clientele. Whether you are inquiring about EMS (Electro Muscle Stimulation) or any other topic within the realms of health and fitness, the number 1 question you should always ask is "what does the research say?". Whoever you are asking the question to should always have an answer, or at least be able to point you in the right direction. Luckily for you, I have answers.
Can EMS Increase Muscle & Strength?
Answer: Yes, but it depends.
We know that EMS alone is used to fight atrophy (1), but can it help build muscle? Well, it would depend on the strength of the stimulus (i.e. 10 Hz vs 100 Hz), the duration of the stimulation (i.e. 5 sec vs 10 sec), the frequency of stimulation (i.e. 1 day/week vs 2 days/week), and the training status of the individual (i.e. novice vs advanced), just to name a few. Research can be incredibly boring and/or difficult to decipher so I will provide snippets and summaries of the conclusions, as well as organize and compose them in a list for easy viewing!
EMS Training Improves Body Composition
Study 1: "In summary, we observed comparable or at least similar increases of muscle parameters after 16 weeks of WB-EMS [Whole-Body Electro Muscle Stimulation] compared with the reference method “HIT” [High-Intensity Training]. Thus, WB-EMS can be considered as an attractive, time-efficient, and effective option to HIT-resistance exercise for people seeking to improve general strength and body composition (10)."
Study 2: "Our results clearly demonstrate that WB-EMS . . . has a beneficial impact on muscle mass and abdominal body fat, and is also safe and feasible, at least in this cohort of lean elderly females with limited interest in exercise (11)."
Study 3: "The study clearly confirms the favorable effect of WB-EMS [Whole-Body Electro Muscle Stimulation] application on the MetS [Metabolic Syndrome] in community-dwelling women aged ≥70 years with SO [Sarcopenic Obesity](19)."
Translation: EMS training has the potential to build muscle and decrease abdominal fat in a safe and time-efficient manner for both the general population and elderly population, in addition to the obese population and those with metabolic syndrome.
EMS Training Improves Strength & Power
Study 1: "Because of the clear-cut advantages in time management, especially when whole-body EMS is used, we can expect this method to see the increasing use in high-performance sports (4)."
Study 2: "Superimposed EMS onto voluntary contractions increases strength more than voluntary training alone (5)."
Study 3: "In conclusion, this study shows that common strength training and strength training with superimposed EMS both enhance strength of knee and hip extensors, as well as jumping and pendulum sprint performance . . . However, improvements of antagonistic hamstring strength in the S+E group [group that used EMS] suggest the potential of EMS to unloaded (antagonistic) muscle groups during training (18).
Study 4: "These results suggest that supplementing dynamic contractions with EMS appears more effective than EMS only, or weight training only, for increasing knee extensor strength and VJ in female track (17)".
Study 5: "Our results indicate that NMES [Neuromuscular Electrical Stimulation] has equal potential if not in some way better than classical RT . . . for enhancement of knee muscles concentric peak torque (15)."
Study 6: "In summary, adjunct WB-EMS training significantly exceeds the effect of isolated endurance and resistance type exercise on fitness and fatness parameters. Further, we conclude that for elderly subjects unable or unwilling to perform dynamic strength exercises, electromyostimulation may be a smooth alternative to maintain lean body mass, strength, and power (9)."
Translation: EMS has the potential to improve strength and power ranging from athletes to the elderly, which also might have positive carryover to improving body composition and quality of life.
EMS Training Improves Cardiovascular Health & Aerobic Performance
Study 1: "However, the results of the series of studies . . . would appear to suggest that EMS may be an effective and novel method of producing cardiovascular exercise. It also appears safe (3)."
Study 2: "In conclusion, our results suggest that a 6-week WB-EMS training program (six training sessions) combined with a significant reduction in endurance training, improved VO2max, VT1 [ventilatory threshold 1], VT2 [ventilatory threshold 2], RE [running economy], and vertical jump, which are related to running performance in recreational runners (2)."
Study 2: "Ultimately, this study suggests that a whole-body suit equipped with an electrical muscle stimulation device may improve cardiopulmonary factors and psychophysiological indications (7)."
Translation: EMS training might be a safe alternative to improving cardiovascular health, psychophysiological indications (i.e. soreness, anxiety, fatigability, and sleeplessness), and aerobic performance in the general population.
EMS Training Alleviates Low Back Pain
Study 1: "In summary, we see our results more as a preliminary finding than definitive evidence justifying a conclusion that WB-EMS has a favorable effect in the treatment of chronic, unspecific LBP [low back pain](12)."
Translation: EMS training may be effective for reducing chronic lower back pain in an elderly population.
How EMS Can Increase Muscle & Strength
It is well documented that EMS has the potential to produce significant muscle damage (8,13,14). There are plenty of theories in support of muscle damage’s role in hypertrophy (AKA build muscle)(16). In addition, it should not be surprising that EMS can increase strength, since strength is a measure of our nervous system’s abilities to transmit electric signals and produce force. This is a system that EMS has the power to enhance (6).
Although we could always benefit from more evidence, I think the potential uses for EMS go beyond increasing muscle and strength. The existing research shows promise for a kaleidoscope of populations and scenarios. I highlight which populations would be best in this article here. If you are still on the fence about EMS training, let me remind you that the first session is free!
1) Adams V. Electromyostimulation to fight atrophy and to build muscle: facts and numbers. J Cachexia Sarcopenia Muscle. 2018;9(4):631–634.
2) Amaro-Gahete, F. J., De-la-O, A., Sanchez-Delgado, G., Robles-Gonzalez, L., Jurado-Fasoli, L., Ruiz, J. R., & Gutierrez, A. Whole-body electromyostimulation improves performance-related parameters in runners. Frontiers in physiology. 2018;9:1576.
3) Banerjee, P. Can electrical muscle stimulation of the legs produce cardiovascular exercise? Journal of Clinical & Experimental Cardiology. 211;2:134.
4) Filipovic, A., Kleinöder, H., Dörmann, U., & Mester, J. Electromyostimulation — a systematic review of the effects of different electromyostimulation methods on selected strength parameters in trained and elite athletes. J Strength Cond Res. 2012;26(9):2600–14.
5) Herrero, A.J., Martín, J., Martín, T., Abadía, O., Fernández, B., & García-López, D. Short-term effect of strength training with and without superimposed electrical stimulation on muscle strength and anaerobic performance. A randomized controlled trial. Part I. J Strength Cond Res. 2010;24(6):1609-15.
6) Hortobágyi T, Maffiuletti NA. Neural adaptations to electrical stimulation strength training. Eur J Appl Physiol. 2011;111(10):2439–49.
7) Jee, Y. The efficacy and safety of whole-body electromyostimulation in applying to human body: based from graded exercise test. Journal of Exercise Rehabilitation. 2018;14(1):49–57.
8) Jubeau, M., Sartorio, A., Marinone, P.G., Agosti, F., Van Hoecke, J., Nosaka, K., & Maffiuletti, N.A. Comparison between voluntary and stimulated contractions of the quadriceps femoris for growth hormone response and muscle damage. J Appl Physiol. 2008;104(1):75–81.
9) Kemmler, W., Schliffka, R., Mayhew, J.L., & von Stengel, S. Effects of whole-body electromyostimulation on resting metabolic rate, body composition, and maximum strength in postmenopausal women: the Training and ElectroStimulation Trial. J Strength Cond Res. 2010;24(7):1880–7.
10) Kemmler, W., Teschler, M., Weißenfels, A., Bebenek, M., Fröhlich, M., Kohl, M., & von Stengel, S. 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. 2016;16(Article ID 9236809):9.
11) Kemmler, W., & von Stengel, S. Whole-body electromyostimulation as a means to impact muscle mass and abdominal body fat in lean, sedentary, older female adults: subanalysis of the TEST-III trial. Clinical interventions in aging, 2016;8:1353–64.
12) Kemmler, W., Weissenfels, A., Bebenek, M., Fröhlich, M., Kleinöder, H., Kohl, M., & von Stengel, S. Effects of whole-body electromyostimulation on low back pain in people with chronic unspecific dorsal pain: A meta-analysis of individual patient data from randomized controlled WB-EMS trials. Evidence-based complementary and alternative medicine : eCAM. 2017:8480429.
13) Moreau, D., Dubots, P., Boggio, V., Guilland, J.C., & Cometti, G. Effects of electromyostimulation and strength training on muscle soreness, muscle damage and sympathetic activation. J Sports Sci. 1995;13(2):95–100.
14) Nosaka, K., Aldayel, A., Jubeau, M., & Chen, T.C. Muscle damage induced by electrical stimulation. Eur J Appl Physiol. 2011;111(10):2427–37.
15) Pantović, M., Popović, B., Madić, D., &Obradović, J. Effects of Neuromuscular Electrical Stimulation and Resistance Training on Knee Extensor/Flexor Muscles. Coll Antropol. 2015;39 Suppl 1:153–7.
16) Schoenfeld, B.J. Does exercise-induced muscle damage play a role in skeletal muscle hypertrophy? J Strength Cond Res. 2012 May;26(5):1441–53.
17) Willoughby, D.S., & Simpson, S. Supplemental EMS and Dynamic Weight Training: Effects of Knee Extensor Strength and Vertical Jump of Female College Track & Field Athletes. The Journal of Strength and Conditioning Research. 1998;12(3):131-137.
18) Wirtz, N., Zinner, C., Doermann, U., Kleinoeder, H., & Mester, J. Effects of loaded squat exercise with and without application of superimposed EMS on physical performance. Journal of sports science & medicine. 2016;15(1), 26–33.
19) Wittmann, K., Sieber, C., von Stengel, S., Kohl, M., Freiberger, E., Jakob, F., Lell, M., Engelke, K., … Kemmler, W. Impact of whole body electromyostimulation on cardiometabolic risk factors in older women with sarcopenic obesity: the randomized controlled FORMOsA-sarcopenic obesity study. Clinical interventions in aging. 2016;11:1697–1706.
About the author:
Alex has a B.S. in Exercise Science from Carroll University. He has achieved the gold standard certifications in both exercise as a Certified Strength And Conditioning Specialist (NSCA-CSCS) and nutrition as a Certified Sports Nutritionist (CISSN). He is currently aiming to extend his credentials, as well. In addition, Alex has a very strong background in soccer. In his free time, he is most likely writing articles, chasing his fitness goals, or growing his brand, ATPerformance.