Effects of Whole-Body Electromyostimulation on the Energy-Restriction-Induced Reduction of Muscle Mass During Intended Weight Loss

Toxoplasma gondii RAD51 recombinase is required to overcome DNA replication stress and its inactivation leads to bradyzoite differentiation

Toxoplasma gondii is an obligate intracellular parasite with a high replication rate that can lead to DNA replicative stress, in turn associated with the generation of DNA double-strand breaks (DSBs). Cells have two main pathways to repair DSBs: non-homologous end joining and homologous recombination repair (NHEJ and HRR respectively). RAD51 is the key recombinase in the HRR pathway. In this work, we achieved endogenous tagging of the RAD51 gene using the Auxin Inducible Degron (AID) system, to generate the clonal line RH RAD51 HA-AID . Here we demonstrate that RAD51 is expressed in replicative tachyzoites and establishes damage foci. Auxin-induced knock-down (KD) affects the correct replication of tachyzoites which show loss of synchronization. The use of the RAD51 inhibitor B02 also affects parasite growth, with an IC 50 of 4.8 µM. B02 produced alterations in tachyzoite replication and arrest in the S phase of the cell cycle. Additionally, B02 induced tachyzoite to bradyzoite differentiation showing small cyst-like structures. In conclusion, the HRR pathway is necessary for maintaining proper tachyzoite replication under normal growth conditions, supporting that replicative stress occurs during the cell cycle. Our findings also suggest that DNA replication stress can induce bradyzoite differentiation.

Non-Athletic Cohorts Enrolled in Longitudinal Whole-Body Electromyostimulation Trials-An Evidence Map

Whole-body electromyostimulation (WB-EMS) can be considered as a time-efficient, joint-friendly, and highly customizable training technology that attracts a wide range of users. The present evidence map aims to provide an overview of different non-athletic cohorts addressed in WB-EMS research. Based on a comprehensive systematic search according to PRISMA, eighty-six eligible longitudinal trials were identified that correspond with our eligibility criteria. In summary, WB-EMS research sufficiently covers all adult age categories in males and females. Most cohorts addressed (58%) were predominately or exclusively overweight/obese, and in about 60% of them, diseases or conditions were inclusion criteria for the trials. Cohorts specifically enrolled in WB-EMS trials suffer from cancer/neoplasm (n = 7), obesity (n = 6), diabetes mellitus (n = 5), metabolic syndrome (n = 2), nervous system diseases (n = 2), chronic heart failure (n = 4), stroke (n = 1), peripheral arterial diseases (n = 2), knee arthrosis (n = 1), sarcopenia (n = 3), chronic unspecific low back pain (n = 4), and osteopenia (n = 3). Chronic kidney disease was an eligibility criterion in five WB-EMS trials. Finally, three studies included only critically ill patients, and two further studies considered frailty as an inclusion criterion. Of importance, no adverse effects of the WB-EMS intervention were reported. In summary, the evidence gaps in WB-EMS research were particular evident for cohorts with diseases of the nervous and cerebrovascular system.

The Effect of Whole-Body Electromyostimulation Program on Physical Performance and Selected Cardiometabolic Markers in Obese Young Females

Background and Objectives: Whole-body electromyostimulation is under investigation as a potential aid for obesity-related health problems, supplementing a comprehensive, evidence-based obesity management strategy that includes lifestyle, diet, and exercise. The study investigated the impact of a whole-body electromyostimulation training program on physical performance and cardiometabolic markers in young obese females. Materials and Methods: Twenty-eight obese females, aged over 18 years with BMI over 30 and body fat over 28% and no underlying health conditions or medication, were divided into a whole-body electromyostimulation group (15 participants) and a control group (13 participants). The whole-body electromyostimulation program lasted 12 weeks, with two 20 min sessions weekly, using bipolar, rectangular current. Assessments pre and post intervention included body composition, blood pressure, lipid profile, C-reactive protein levels, maximal oxygen consumption, and jumping and sprint performance. Two-way ANOVA and t-tests were used for analysis. Results: Statistical analysis revealed significant (group × time) interactions for body composition, systolic blood pressure, maximal oxygen consumption, jumping and sprint performance, and plasma levels of lipids and C-reactive protein. Post hoc analyses for the whole-body electromyostimulation group indicated improvements in body composition indices (p < 0.01), systolic blood pressure (p = 0.003), maximal oxygen consumption (p = 0.010), and both jumping and 30 m sprint performance (p < 0.001 and p = 0.001, respectively) after the intervention. Furthermore, plasma levels of lipids (p < 0.01) and C-reactive protein (p = 0.002) showed significant improvements following the training program. In contrast, no significant changes were observed for these variables in the control group. Conclusions: A 12-week whole-body electromyostimulation program significantly improved body composition (skeletal muscle mass, body mass index, body fat, and waist circumference), physical performance (maximal oxygen consumption, jumping and sprint performance), and certain cardiometabolic (plasma level of lipids) and inflammatory markers (C-reactive protein) in obese young women. Further research is needed to explore the broader effects of whole-body electromyostimulation on physical and cardiometabolic health.

Immediate Effects of Whole-Body versus Local Dynamic Electrostimulation of the Abdominal Muscles in Healthy People Assessed by Ultrasound: A Randomized Controlled Trial

Dynamic electrostimulation consists of the application of local or global electrostimulation together with physical exercise. This study aimed to investigate the immediate effects of a dynamic electrostimulation session on the thickness of the abdominal musculature, inter-rectus distance, heart rate, blood pressure, and body temperature, and to identify possible differences in its form of application. A total of 120 healthy participants were divided into three groups: the whole-body electrostimulation group, the local electrostimulation group, and the control group without electrical stimulation. All groups performed a single session with the same dynamic exercise protocol. Muscle thickness and inter-rectus distance were evaluated ultrasonographically using the Rehabilitative Ultrasound Imaging technique both at rest and in muscle contraction (the active straight leg raise test) to find the post-intervention differences. The results showed significant differences in immediate post-intervention heart rate, with a smaller increase in the local electrostimulation group compared to the control and whole-body electrostimulation groups. No significant differences were identified between the groups after the interventions in the rest of the variables analyzed. Therefore, a local application, with the same effects as a global application on the abdominal musculature, has fewer contraindications, which makes its use more advisable, especially in populations with cardiorespiratory disorders, for which more research is needed.

The effects of whole-body muscle stimulation on body composition and strength parameters: A PRISMA systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis set out to determine the efficacy of whole-body muscle electrostimulation on body composition, strength, and muscle power in active and non-active adults (aged ≥18 years).

METHOD

This review was reported in accordance with the Protocol Statement of Preferred Reporting Element Guidelines for Systematic Reviews and Meta-Analysis included controlled trials; whole-body electromyostimulation trials with at least 1 exercise and control group; participants >18 years old. Outcome measures were defined as standardized mean differences for muscle mass, body fat mass, strength, and power. Studies were searched in the following electronic databases: PubMed, Web of Science, Scopus, SPORTDiscus, and EMBASE for all articles published up to July 30, 2021. The risk of bias was assessed by 2 independent researchers using the Physiotherapy Evidence Database scale and Grading of Recommendations, Assessment, Development and Evaluations approach. Analyses were performed using the metafor package of the statistical software R (version 4.0.3; R Core Team, 2020). Random effects models, forest, and funnel plots to quantify the asymmetry associated with publication bias were fitted using the metafor library in R. Statistical heterogeneity was assessed using I2 statistics.

RESULTS

In total, 26 studies representing 1183 participants were included (WB-electromyostimulation: n = 586 and control group: n = 597). The mean age of the participants ranged from a minimum of 20.4 to a maximum of 77.4 years old. Interventions lasted a minimum of 4 and a maximum of 54 weeks. Standardized mean difference was 0.36 (95% confidence interval [CI]: 0.16-0.57) for muscle mass, -0.38 (95% CI: -0.62-0.15) for body fat, 0.54 (95% CI: 0.35-0.72) for strength, and 0.36 (95% CI: 0.02-0.71) for power with significant differences between groups (all P < .04). I2 revealed low heterogeneity of muscle mass (15%) and power (0%) between trials and medium heterogeneity of body fat (45%) and strength (55%).

CONCLUSION

We concluded that WB-electromyostimulation has significant positive effects on muscle mass, body fat, strength, and power.

Effects of whole-body electromyostimulation training on upper limb muscles strength and body composition in moderately trained males: A randomized controlled study

Resistance training has been known to have a positive effect on muscle performance in exercisers. Whole-body electromyostimulation (WB-EMS) is advertised as a smooth, time-efficient, and highly individualized resistance training technology. The purpose of this study is to evaluate the effects of WB-EMS training on maximum isometric elbow muscle strength and body composition in moderately trained males in comparison to traditional resistance training. The study was a randomized controlled single-blind trial. Twenty, moderately trained, male participants (25.15 ± 3.84, years) were randomly assigned to the following groups: a WB-EMS training group (n = 11) and a traditional resistance training group (the control group [CG]: n = 9). Both training intervention programs consisted of 18 training sessions for six consecutive weeks. All subjects performed dynamic movements with the WB-EMS or external weights (CG). The primary outcome variables included maximum isometric elbow flexor strength (MIEFS), maximum isometric elbow extensor strength (MIEES) and surface electromyography amplitude (sEMG_RMS). Secondary outcomes involved lean body mass, body fat content, arm fat mass, and arm lean mass. ANOVAs, Friedman test and post hoc t-tests were used (P = 0.05) to analyze the variables development after the 6-week intervention between the groups. Significant time × group interactions for MIEFS (η² = 0.296, P _Bonferroni = 0.013) were observed, the increase in the WB-EMS group were significantly superior to the CG [23.49 ± 6.48% vs. 17.01 ± 4.36%; MD (95% CI) = 6.48 (1.16, 11.80); d = 1.173, P = 0.020]. There were no significant differences were observed between interventions regarding MIEES, sEMG_RMS and body composition. These findings indicate that in moderately trained males the effects of WB-EMS were similar to a traditional resistance training, with the only exception of a significantly greater increase in elbow flexor strength. WB-EMS can be considered as an effective exercise addition for moderately trained males.

Iron Beats Electricity: Resistance Training but Not Whole-Body Electromyostimulation Improves Cardiometabolic Health in Obese Metabolic Syndrome Patients during Caloric Restriction-A Randomized-Controlled Study

Caloric restriction (CR) and exercise are cornerstones in the treatment of obesity and cardiometabolic disorders. Recently, whole body electromyostimulation (WB-EMS) has emerged as a more time-efficient alternative to traditional resistance training (RT). However, the effects of WB-EMS compared to RT on cardiometabolic health in obese metabolic syndrome (MetS) patients performed during CR are still unclear. In total, 118 obese MetS patients (52.7 ± 11.8 years, BMI: 38.1 ± 6.9 kg/m²) undergoing CR over 12 weeks (aim: −500 kcal deficit/day) were randomly allocated to either WB-EMS, single-set RT (1-RT), 3-set RT (3-RT) or an inactive control group (CON). Primary outcome was MetS severity (MetS z-score). Secondary outcomes were body composition, muscle strength and quality of life (QoL). All groups significantly reduced body weight (~3%) and fat mass (~2.6 kg) but only 1-RT and 3-RT preserved skeletal muscle mass (SMM). All exercise groups increased muscle strength in major muscle groups (20–103%). However, only the two RT-groups improved MetS z-score (1-RT: −1.34, p = 0.003; 3-RT: −2.06, p < 0.001) and QoL (1-RT: +6%, p = 0.027; 3-RT: +12%, p < 0.001), while WB-EMS and CON had no impact on these outcomes. We conclude that traditional RT has superior effects on cardiometabolic health, SMM and QoL in obese MetS patients undergoing CR than WB-EMS.

Efficacy of Whole-Body Electromyostimulation (WB-EMS) on Body Composition and Muscle Strength in Non-athletic Adults. A Systematic Review and Meta-Analysis

This systematic review and meta-analysis set out to determine the efficacy on whole-body electromyostimulation (WB-EMS) on body composition and strength parameters in non-athletic cohorts. A systematic review of the literature according to the PRISMA statement included (a) controlled trials, (b) WB-EMS trials with at least one exercise and one control group, (c) WB-EMS as primary physical intervention, (d) WB-EMS with at least six electrodes covering most muscle groups, (e) non-athletic cohorts. We searched eight electronic databases up to June 30, 2020, without language restrictions. Standardized mean differences (SMD) for muscle mass parameters, total body fat mass, maximum leg extension, and trunk extension strength were defined as outcome measures. In summary, 16 studies with 19 individual WB-EMS groups representing 897 participants were included. Studies vary considerably with respect to age, BMI, and physical conditions. Impulse protocols of the studies were roughly comparable, but training frequency (1-5 sessions/week) and intervention length (6-54 weeks) differed between the studies. SMD average was 1.23 (95%-CI: 0.71-1.76) for muscle mass, 0.98 (0.74-1.22) for maximum leg, and 1.08 (0.78-1.39) for maximum trunk extension strength changes (all p < 0.001). SMD for body fat changes (-0.40, [-0.98 to 0.17]), however, did not reach significance. I ² and Q-statistics revealed substantial heterogeneity of muscle and fat mass changes between the trials. However, rank and regression tests did not indicate positive evidence for small-study bias and funnel plot asymmetries. This work provided further evidence for significant, large-sized effects of WB-EMS on muscle mass and strength parameters, but not on body fat mass. Clinical Trial Registration: ClinicalTrials.gov, PROSPERO; ID: CRD42020183059.