Stay Mobile into Old Age with Whole-Body EMS-Training
Reading time: 2 minutes | Views: 38
Whole-body EMS training offers an effective and time-saving solution for the prevention and therapy of muscle atrophy and sarcopenia, especially for older people or those who are not very sporty. With individual supervision in a 1:1 or 1:2 setting, a high stimulus intensity is achieved that promotes muscle mass, strength and function, while being easier on the joints and less stressful than traditional strength training. Studies show the effectiveness of EMS in old age, particularly in terms of muscle building and maintenance.
The ageing process of the human body is not only reflected in wrinkled skin and grey hair. In youth and young adulthood, muscle mass and strength usually increase and reach maximum values, stagnate in mid-life and decrease again with advancing age.
Whole-body EMS training offers a simple and effective way to start building and maintaining muscle mass and function early on, because this is the prerequisite for counteracting muscle loss in old age or sarcopenia. Maintaining and building muscle helps to maintain quality of life in the long term [4, 5].
Extent and causes of age-related muscle loss
The ageing process is associated with a generalised and progressive loss of muscle mass and strength. From the age of 50, muscle mass decreases by around 1–2 % and muscle strength by 1.5–5 % per year [1]. The loss of fast-twitch type 2 muscle fibres is particularly rapid [2]. This is associated with a decrease in functional performance, which manifests itself, for example, in difficulties with walking, standing up or carrying. Mobility and independence are increasingly affected [2].
A variety of complex age-related processes are responsible for muscle loss, including:
- changes in hormonal balance
- changes in muscle protein synthesis and breakdown
- neurodegeneration
- increase in inflammatory factors
- insulin resistance
- reduction in the number and activation of satellite cells
- oxidative stress
Factors that promote muscle anabolism, such as insulin-like growth factor-1 (IGF-1) or testosterone, decrease. Factors that contribute to skeletal muscle breakdown, such as inflammatory cytokines, increase. In old age, connective tissue and fat are also increasingly deposited in and around the muscles [2-4].
Sarcopenia: definition and measurement methods
Sarcopenia is generally defined as an excessive, progressive, generalised loss of muscle mass, strength and function. Sarcopenia is now considered a skeletal muscle disease caused by adverse muscle changes that occur over the course of a lifetime.
Sarcopenia is common among older adults, with prevalence/incidence increasing with age. However, younger people can also suffer from it [5, 6]. Sarcopenia is considered ‘primary’ (or age-related) if no other specific cause for muscle loss can be identified beyond aging. If other causal factors are present (or in addition to aging), it is considered ‘secondary’. These include systemic diseases such as cancer, endocrine, neurological and, in particular, inflammatory diseases [5]. In addition, physical inactivity, for example due to a sedentary lifestyle or illness-related immobility, as well as poor nutrition with insufficient energy and/or protein intake, can lead to the development of sarcopenia [4, 5].
Consequences of sarcopenia
Sarcopenia is associated with a number of negative, often serious, consequences. For those affected, coping with everyday life becomes increasingly difficult. Sarcopenia leads to an increased risk of falling [7, 8], impaired mobility [9] and a progressive loss of independence [10] and quality of life [11, 12]. Sarcopenia is a major cause of the geriatric syndrome frailty [13] and is associated with osteoporosis [12], type 2 diabetes [14], heart disease [15], respiratory disease [16] and cognitive impairment [17]. Ultimately, sarcopenia is associated with disability [5], hospitalisation [18], the need for care [19] and a 3.6-fold increase in mortality [7].
Prevention and treatment of muscle loss in old age/sarcopenia
Physical activity, especially strength training, is considered the most effective intervention for the prevention and treatment of normal and excessive (sarcopenia) age-related muscle loss – and is also recommended in the guidelines. It improves muscle strength, muscle mass and physical performance. [4, 6]
To prevent or delay sarcopenia as much as possible, the musculature should be maximised in youth and young adulthood, maintained in middle age, and muscle loss minimised in old age [5, 20]. Regular strength training in middle to old age can slow muscle loss, prevent sarcopenia, and maintain physical function, mobility, independence, and quality of life for longer.
Whole-body EMS training is an ideal prevention and therapy option into old age.
Not all older people are able to achieve the comparatively high stimulus intensity required for good muscle building and maintenance in strength training, or to perform conventional high-intensity strength training. Furthermore, many people refuse to do strength training several times a week. In addition to a lack of motivation and convenience, a lack of time often plays a major role. [21, 22]
For this group of people who are not very sporty or are already weakened, whole-body EMS training is an attractive and effective option [21, 22]. It overcomes the challenges and hurdles of conventional strength training for muscle building – for people of all ages.
The application takes place under individual supervision in a 1:2 or 1:1 setting and, at once a week for about 20 minutes, is a time-saving procedure in which the effect of light, subliminal physical exercises is intensified to an effective level and a high stimulus intensity is achieved. EMS training also ensures immediate, continuous recruitment of type 2 muscle fibres [21-24]. Since no weights are used, whole-body EMS training is particularly gentle on the joints and subjectively less demanding.
The effectiveness and safety of whole-body EMS for the prevention and therapy of age-related muscle loss and sarcopenia has been demonstrated in various studies. Among other things, it has been shown to have a positive influence on muscle mass, strength, function, functional performance and abdominal fat [25-29]. At the molecular level, EMS modulates factors, particularly IGF-1, that promote muscle protein synthesis, inhibit muscle breakdown and activate satellite cells [30, 31].
References:
1 Keller K, Engelhardt M. Strength and muscle mass loss with aging process. Age and strength loss. Muscles Ligaments Tendons J. 2013; 3:346-350
2 Lang T et al. Sarcopenia: etiology, clinical consequences, intervention, and assessment. Osteoporos Int. 2010; 21:543-559
3 Frontera WR, Rodriguez Zayas A, Rodriguez N. Aging of human muscle: understanding sarcopenia at the single muscle cell level. Phys Med Rehabil Clin N Am. 2012; 23: 201-207
4 Liguori I et al. Sarcopenia: assessment of disease burden and strategies to improve outcomes. Clin Interv Aging. 2018; 13: 913-927
5 Cruz-Jenthof AJ et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019; 48:16-31
6 Dent E et al. International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnose und Management. JNutr Health Aging. 2018; 22:1148-1161
7 Beaudart C et al. Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis. PLoS One. 2017; 12: e0169548
8 Schaap LA et al. Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures: the longitudinal aging study Amsterdam. JGerontol A Biol Sci Med Sci. 2018; 73: 1199-1204
9 Morley JE et al. Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc. 2011; 12: 403-409
10 Dos Santos L et al. Sarcopenia and physical independence in older adults: the independent and synergic role of muscle mass and muscle function. J Cachexia Sarcopenia Muscle. 2017; 8: 245-250
11 Beaudart C et al. Validation of the SarQoL(R), a specific health-related quality of life questionnaire for Sarcopenia. J Cachexia Sarcopenia Muscle. 2017; 8: 238-244
12 Won Go L et al. Association between Sarcopenia, Bone Density, and Health-Related Quality of Life in Korean Men. Korean J Fam Med. 2013; 34: 281-288
13 Morley JE. Frailty and Sarcopenia: The New Geriatric Giants. Rev Invest Clin. 2016; 68:59-67
14 Sayer AA et al. Type 2 Diabetes, Muscle Strength, and Impaired Physical Function: The tip of the iceberg? Diabetes Care. 2005; 28:2541-2542
15 Bahat G, Ilhan B. Sarcopenia and the cardiometabolic syndrome: a narrative review. Eur Geriatr Med. 2016; 6: 220-223
16 Bone AE et al. Sarcopenia and frailty in chronic respiratory disease. Chron Respir Dis. 2017; 14:85-99
17 Chang KV et al. Association between sarcopenia and cognitive impairment: a systematic review and meta-analysis. J Am Med Dir Assoc. 2016; 17:1164.e7-64.e15
18 Cawthon PM et al. Clinical definitions of sarcopenia and risk of hospitalization in community-dwelling older men: the osteoporotic fractures in men study. J Gerontol A Biol Sci Med Sci. 2017; 72:1383-1389
19 Akune T et al. Incidence of certified need of care in the long-term care insurance system and its risk factors in the elderly of Japanese population-based cohorts: the ROAD study. Geriatr Gerontol Int. 2014; 14:695-701
20 Sayer AA et al. The developmental origins of sarcopenia. J Nutr Health Aging. 2008; 12:427-432
21 Blockl J, KemmlerW, Schone D. Ganzkorper-EMS bei alteren, vulnerablen Menschen. Zeitschrift fur Physiotherapeuten. Juli 2021
22 Paillard T. Muscle plasticity of aged subjects in response to electrical stimulation training and inversion and/or limitation of the sarcopenic process. Ageing Research Reviews. Ageing Res Rev. 2018; 46:1-13
23 Gregory CM, Bickel CS. Recruitment patterns in human skeletal muscle during electrical stimulation. Phys Ther. 2005; 85:358-364
24 Jubeau M et al. Comparison between voluntary and stimulated contractions of the quadriceps femoris for growth hormone response and muscle damage. J Appl Physiol. 2008; 104, 75-81
25 Kemmler W et al. Whole-body electromyostimulation to fight sarcopenic obesity in community-dwelling older women at risk. Results of the randomized controlled FORMOsA-sarcopenic obesity study. Osteoporos Int. 2016; 26:3261-3270
26 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. Clin Interv Aging. 2013; 8:1353-1364
27 Teschler M et al. Four weeks of electromyostimulation improves muscle function and strength in sarcopenic patients: a three‐arm parallel randomized trial. J Cachexia Sarcopenia Muscle. 2021; 12:843-854
28 Kemmler W et al. Efficacy and Safety of Low Frequency Whole-Body Electromyostimulation (WB-EMS) to Improve Health-Related Outcomes in Non-athletic Adults. A Systematic Review. Front Physiol. 2018; 9:573
29 Kemmler W, Schliffka R, 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; 24:1880-1887
30 Kern H et al. Electrical Stimulation Counteracts Muscle Decline in Seniors. Front Aging Neurosci. 2014; 6:189
31 Barberi L, Scicchitano BM, Musaro A. Mechanisms of Muscle Aging and Sarcopenia and Effects of Electrical Stimulation in Seniors. Eur J Transl Myol. 2015; 25:5227
Picture: Vesnaandjic -Getty Images