Ganzkörper-Elektromyostimulation und Sarcopenic Obesity

Zusammenfassung

Einleitung

Ein aufwendiges und intensives Körpertraining zur Therapie der “Sarcopenic Obesity (SO)” kann oder möchte von vielen der älteren Betroffenen nicht mehr durchgeführt werden. Die zeiteffiziente, gelenkschonende und individualisierbare GanzkörperElektromyostimulation (WB-EMS) könnte hier eine geeignete Option darstellen.

Material und Methoden

75 selbstständig lebende Frauen mit einer SO wurden randomisiert einer WB-EMS-Gruppe (n = 25), einer WB-EMS-Gruppe mit proteinreichen Ernährungssupplementen (WB-EMS&P: n = 25) und einer nichttrainierenden Kontroll-Gruppe (KG: n = 25) zugeteilt. Die WB-EMS-Gruppen führten über 26 Wochen einmal je Woche eine niederfrequente WB-EMS-Applikation in liegender/sitzender Position durch. Primäre Studienendpunkte waren appendikuläre skelettale Muskelmasse (ASMM) und Körperfettmasse.

Ergebnisse

Beide WB-EMS-Gruppen zeigten vergleichbare (p = 0,532), signifikante Verbesserungen (p ≤ 0,003) der ASMM, die sich signifikant (p < 0,001) von den Ergebnissen in der KG (p = 0,050) unterschieden. Keine signifikanten Effekte (p = 0,628) konnten indes für die Körperfettmasse erfasst werden.

Fazit

Die vorliegende Untersuchung zeigt signifikante Effekte einer WB-EMS- Applikation auf Sarkopeniegrößen, jedoch, im Gegensatz zu vorhergehenden Studien, keine korrespondierenden Effekte auf die Körperfettmasse.

Summary

Introduction

Sarcopenic obesity (SO) is characterized by the combination of low muscle and high fat mass. Physical exercise may prevent or even restore SO, however, sports participation of most elderly people failed to reach corresponding exercise recommendations. The aim of the study was to determine the effect of time efficient and joint-friendly Whole-Body Electromyostimulation (WB-EMS) on SO in community-dwelling women ≥ 70 years with SO.

Material and methods

A randomized controlled trial over 6 months was conducted with community-dwelling women of 70 years and older with SO (skeletal muscle mass index: < 5,75 kg/m², body-fat > 35 %) living in Erlangen, Germany. 75 eligible women were randomly assigned (1 : 1 : 1) to three study groups (a) WB-EMS (b) WB-EMS and protein-rich supplements (WB-EMS&P) and (c) non-training control (CG). WB-EMS was applied once weekly over 20 min sitting/lying in a supine position using an intermitted EMS-protocol (4 s of EMS, 4 s of rest; 85 Hz, 30 µs, direct impulse-raise) performed with moderate to high intensity. Dietary supplementation consisted of 40 g powder/d (600 kJ) with 56 % protein content (i. e. 22 g/d). Body composition assessments using Dual-Energy x-Ray Absorptiometry (DXA) and functional tests that focussed on the lower limbs (i. e. power and maximum leg strength, chair rising) were conducted. Researchers were blinded with respect to participants’ group affiliation. Primary study endpoints were appendicular skeletal muscle mass (ASMM; kg/m²) and body fat mass (kg). Secondary study endpoints were dynamic maximum leg extensor strength, chair rising test and jumping power.

Results

Intention-to-treat analysis determined a comparable (p = 0,53) increase of ASMM in both WB-EMS groups (WB-EMS: 2.5 ± 2.7 % and WB-EMS&P: 2.0 ± 2.7 %, p ≤ 0.003) compared to baseline (BL). The WB-EMS groups differed significantly (p < 0.001) from the CG which significantly lost ASMM (1.2 ± 3.3 %, p = 0.050). Body fat mass reductions compared to BL of the WBEMS group (−1.0 ± 2.6; p = 0.121) and WBEMS& P group (−1.4 ± 2.1 %, p = 0.021) were slightly more pronounced compared to the CG (−0.8 ± 2.5 %, p = 0.185), however, these effects remained non-significant (p = 0.628) in between-group comparison. Maximum leg-extensor strength as assessed by an isokinetic leg press, chair rising test and jumping height as determined on a force plate comparably increased in both WBEMS groups (p < 0.001 to 0.008) and maintained in the CG. However, corresponding significant effects between groups were determined only for maximum leg extensor strength (p = 0.002).

Conclusion

WB-EMS is a safe and attractive method for increasing muscle mass and functional capacity in this cohort of women ≥ 70 with SO, whereas the effect on body fat is minor. The latter finding, along with the weak results for the more complex chair rising and counter movement jump test, may be referred to the unspecific WB-EMS application. Protein did not increase the effects of WB-EMS, however, the baseline protein consumption was rather high in all subgroups (1.03–1.09 g/kg bodymass/d).

Schlüsselwörter

WB-EMS - Sarkopenie - Adipositas - Muskelkraft - Training

Keywords

WB-EMS - sarcopenia - obesity - muscle strength - exercise training

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