Guidelines for optimum application of Whole-Body EMS: Safety first!

Whole-body electromyostimulation Training (WB-EMS) is now established as a highly time-efficient method for improving physical fitness, performance and health. Current findings compare the effects of WB-EMS favorably with HIT training, a highly intensive training method for improving muscular-skeletal factors. Many people are unable or unwilling to do HIT due to the high mechanical stress and orthopaedic limitations involved.

WB-EMS Training has proven to be a sufficiently safe and effective training method that is also quite suitable for sport novices or people with health issues. Unfortunately, there are still some negative reports about ‘health-threatening’ incidents. Those are caused by over-intensive (initial) WB-EMS applications, exposing the otherwise very safe and (joint-) sparing WB-EMS to criticism. The specific feature of WB-EMS, offering the possibility of generating supramaximal stimulus intensity for each individual region of the body, must therefore be used in a very responsible manner and in line with scientific criteria. Unfortunately, there has been uncertainty in the past about key aspects of how to use EMS both safely but without impairing its effectiveness. For this reason, guidelines have been drawn up by sports medical scientists researching into WB-EMS at the universities of Cologne, Kaiserslautern and Erlangen. The guidelines take up suggestions raised during a consensus event with representatives from science, education and equipment manufacturers and apply for the future use of WB-EMS. They are directed not only towards users but also fitness studio operators and trainers.

GUIDELINES FOR SAFE AND EFFECTIVE WB-EMS IN GENERAL
Safe and effective whole-body EMS Training must always be accompanied by a trained and licensed WB-EMS trainer or scientifically trained personnel familiar with this field of application.

Before the first training session of every beginner, an anamnesis of possible contraindications based on a list of questions must be taken and then documented in writing, confirmed by the client's signature and archived. Where relevant anomalies are found, a doctor is to be consulted and training only be commenced if clearance has been given.

PREPARING FOR TRAINING
As with any kind of intensive training, whole-body EMS Training must only be undertaken by people who are in a good physical condition and free of pain. This includes abstaining from alcohol, drugs, stimulants/muscle relaxants or stress ahead of the training session. Training must never be undertaken by anybody suffering from a fever.

Whole-body EMS Training leads to very high metabolic stress of the organism because of the very high volume of muscle mass addressed. This factor has to be taken into account and is met by supplying sufficient food intake that is high in carbohydrates. If this is not possible, then at least a high carbohydrate, but light snack (≈250 kcal) should be eaten, ideally about two hours before training.

So as to avoid possible renal stress (especially with undiagnosed problems) through intensive WB-EMS, additional fluids should be consumed before/during and after training (500 ml each).

Generally, medical – ideally sport-medicinal – consultation and clarification is advisable in the case of any discomfort, physical restrictions, infections or other internal, cardiological or orthopedic illnesses.

TRAINING
Regardless of physical status, sport experience and the user's wishes to that effect, under no circumstances may WB-EMS Training to exhaustion take place during the first training session or trial training. This has led in the past to undesired side effects and negative health consequences and so must be avoided at all costs.

After moderate initial WB-EMS, the stimulation level or current must be successively increased and adapted to the individual goals. The highest level is to be reached only after 8 - 10 weeks of systematic training at the earliest. Training to complete exhaustion, especially in the sense of painful, continuous tetanus during the current phase, must generally be avoided.

In addition, an initial training should always be conducted with reduced intensity. A five-minute period of impulse familiarization is advised as well as a curtailed overall training session with moderate stimulus intensity (user‘s subjective impression should be: slightly hard) and twelve minutes of intermittent load with short impulse phase (≈). Only then may the training duration be cautiously increased but should still never exceed 20 minutes.

To ensure sufficient conditioning and to minimize or rule out possible health impairments, training frequency may not exceed one training unit per week during the first 8 - 10 weeks.

Even after this conditioning phase, an interval of ≥4 days must be maintained between training units in order to avoid accumulation of muscle breakdown products, permit regeneration and adaptation and thus ensure a successful training outcome.

SAFETY ASPECTS DURING AND AFTER TRAINING

During the training session, the trainer or the trained and qualified personnel should concentrate exclusively on the interests of the user(s). Before, during and after training, the trainer verbally and visually checks the user‘s condition so as to rule out health risks and ensure effective training. Training has to be aborted immediately, if there are any contraindications.

During training, the equipment's operating controls must be directly in reach of the trainer and the user at all times. Operation/adjustment must be simple, quick and precise.

SUMMARY

In these guidelines, we have addressed supervised WB-EMS alone. In actual fact, there was a general consensus that safe and effective WB-EMS can only be assured in such a setting. We therefore strongly advise against private use of the technology without the support of a qualified and licensed trainer/instructor or correspondingly scientifically trained personnel. In this context, we are also very critical of the approach being adopted by some providers of increasing the instructor-user ratio to such a level that personalized and thus safe and effective training is no longer possible even in the light of technical progress and trainer education. When introducing courses, the Cologne-based sport scientist Ingo Froböse describes WB-EMS as a “therapeutic weapon“ which, “belongs only in the right and responsible hands“. WB-EMS is a young and aspiring training technology where much is still in flux and, without doubt, other questions are yet to emerge. Accordingly, we as scientists consider it our duty to evaluate further suitable fields of application, possible consequences and in general ensure responsible and safe use of this training technology. Therefore, we see these guidelines as a binding but, given the state of research, flexible and expandable “tool“ that can contribute to safe and effective WB training.

miha Froehlich Prof. Dr. phil. habil. Michael Fröhlich

Professor for Sport Science at Kaiserslautern University of Applied Science. Main research fields: movement and training science, health issues, intervention research. Member of several scientific associations, appraiser work for numerous national and international journals. Currently some 220 publications in the aforementioned and related fields.

miha Vatter Jens Vatter
Owner of the PT Lounge Cologne by Jens Vatter, Sport Economics Degree and European Master of Science in Health and Fitness (Univ. Bayreuth), scientific adviser for EMS Training, author of several books – EMS Training, instructor and lecturer for EMS- Training, Functional Training and Coaching and Athletics Training with a focus on sprint and jumping inter alia at Gluckerkolleg and TÜV-certified personal fitness trainer.

miha Kemmler Prof. Dr. Wolfgang Kemmler
Prof. Dr. Wolfgang Kemmler is a research director of the Institute for Medical Physics at the Friedrich Alexander University Erlangen-Nuremberg. He is a highly regarded expert in training science intervention research and in the field of alternative training technologies with a focal point on whole-body electromyostimulation.

miha Mueller Stephan Müller

Nutrition consultant, sports teacher and sport physiotherapist. In his capacity as personal fitness trainer, instructor and nutrition expert, he supports numerous world champions, Olympic gold medalists and top sportspersons and Bundesliga professionals in the fields of football, handball and volleyball. He is a member of the executive board of the federal association PT e.V. and the DSSV EMS Training committee and is the owner of Glucker-Kolleg (www.gluckerkolleg.de) and PT Lounge GmbH.

Koeln Kleinoeder Dr. Heinz Kleinöder
Dr. Heinz Kleinöder has been at the Institute of Exercise Sciences and Sport Informatics, German Sport University Cologne, Germany, since 1990. Since 2003, he has headed the department for strength diagnostics and movement research. His work focuses on the diagnostics of conditional abilities in various sport disciplines at the elite level, and strength and technique training with standard and innovative training methods. This is closely linked with long years as a trainer for elite tennis players. His key research areas are the effects of various strength training methods and tools (incl. EMS and vibration) on health and performance, which has led to a large number of publications. The practice transfer of the academic results has benefitted a wide range of sports and formed the subject of numerous presentations held at the DOSB trainer academy in Cologne.