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Electrical muscle stimulation (EMS)

also known as neuromuscular electrical stimulation (NMES), is the elicitation of muscle contraction using electric impulses. The impulses are generated by a device and delivered through electrodes on the skin over the muscles to be stimulated. The impulses mimic the action potential coming from the central nervous system,
causing the muscles to contract.

EMS became popular in the ’60s when Soviet sport scientists used it in the training of elite athletes, claiming 40% force gains 1. Recent medical physiology research 2, 3, 4 has pinpointed the mechanisms by which electrical stimulation causes adaptation of cells of muscles, blood vessels 5, 6, 7 and nerves.

Because of the characteristics of skeletal muscle fibers, different types of fibers can be activated to differing degrees by different types of EMS.8 These patterns, referred to as protocols or programs, will cause a different response from contraction of different fiber types. Some programs will improve fatigue resistance (endurance), while others will increase force production.9

EMS can be used both as a training 10, 11, 12 and a therapeutic 13, 14 tool. In rehabilitation, for instance, EMS is used in the prevention of disuse muscle atrophy. Some manufacturers of EMS make claims of fat burning and weight loss. However, EMS devices cause a calorie burning that is marginal at best (calories are burnt in significant amount only when most of the body is involved in physical exercise – whereby several muscles, the heart and the respiratory system are all engaged).

Uses for EMS include :

  • Relaxation of muscle spasms;
  • Prevention or retardation of disuse atrophy;
  • Increasing local blood circulation;
  • Muscle re-education;
  • Muscle toning.

Contraindications, warnings, precautions and adverse reactions of EMS, include : no use for wearer of pacemaker; no use on vital parts, such as carotid sinus nerves, across the chest, or across the brain; caution in the use during pregnancy, menstruation, and other particular conditions that may be affected by muscle contractions; potential adverse effects include skin irritations and


  1. A. Ward, N. Shkuratova – 2002. Russian Electrical Stimulation: The Early Experiments. Physical Therapy . Volume 82 . Number 10
  2. G. Vrbová, T. Gordon, and R. Jones, Nerve-Muscle Interaction (Chapman & Hall, London, 1995)
  3. S. Salmons, and G. Vrbová, The influence of activity on some contractile characteristics of mammalian fast and slow muscles, J. Physiol. 201:535-549 (1969)
  4. D. Pette, and G. Vrbová, What does chronic electrical stimulation teach us about muscle plasticity? Muscle Nerve 22:666-677 (1999)
  5. C. G. Blomqvist, and B. Saltin, Cardiovascular adaptations to physical training, Annu. Rev. Physiol. 45:169-189 (1983).
  6. M. Cabric, H. J. Appell, and A. Resic, Stereological analysis of capillaries in electrostimulated human muscles. Int. J. Sports. Med. 8:327-330 (1987).
  7. B.A. Harris, The influence of endurance and resistance exercise in muscle capillarisation in the elderly: a review. Acta Physiol. Scand. 185:89-97 (2005).
  8. S. Salmons and Gerta Vrbová; The influence of activity on some contractile characteristics of mammalian fast and slow muscles; J Physiol. 1969 May; 201(3): 535-549.1
  9. Dirk Pette, Gerta Vrbová; does chronic electrical stimulation teach us about muscle plasticity?; Muscle & Nerve, May 1999, vol.22 666-677
  10. N. Babault, G. Cometti, M. Bernardin, M. Pousson, and J. C. Chatard, Effects of electromyostimulation training on muscle strength and power of elite rugby players. J. Strength Cond. Res. 21: 431-437 (2007).
  11. P. Banerjee, B. Caulfield, L. Crowe, and A. Clark, Prolonged electrical muscle stimulation exercise improves strength and aerobic capacity in healthy sedentary adults, J. Appl. Physiol. 99:2307-2311 (2005).
  12. J.P. Porcari, J. Miller, K. Cornwell, C. Foster, M. Gibson, K. McLean, and T. Kernozek, The effects of neuromuscular stimulation training on abdominal strength, endurance and selected anthropometric measure, J. Sports Sci. Med. 4:66-75 (2005).
  13. D.A. Lake, Neuromuscular electrical stimulation. An overview and its application in the treatment of sports injuries, Sports Med. 13:320-336 (1992).
  14. A. Delitto, S.J. Rose, J.M. McKowen, R.C. Lehman, J.A. Thomas, and R.A. Shively, Electrical stimulation versus voluntary exercise in strengthening thigh musculature after anterior cruciate ligament surgery, Phys. Ther. 68:660-663 (1988).
  15. FDA Guidance Document for Powered Muscle Stimulator, standard indications for use, page 4; contraindications, p.7; warnings and precautions, p.8.

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