von Stengel S, Fröhlich M, Ludwig O, Eifler C, Berger J, Kleinöder H, Micke F, Wegener B, Zinner C, Mooren F C, Teschler M, Filipovic A, Müller S, England K, Vatter J, Authenrieth S, Kohl M, Kemmler W
Institute of Radiology, University Hospital Erlangen, Erlangen, Germany.
Department of Sports Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Kaiserslautern, Germany.
Front Sports Act Living. 2024 Apr 16;6:1371723. doi: 10.3389/fspor.2024.1371723. eCollection 2024.
Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: "Arteriosclerosis, arterial circulation disorders", "Diabetes mellitus" (DM), "Tumor and cancer" (TC), "Neurologic diseases, neuronal disorders, epilepsy". Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list.
全身肌电刺激已被证明是传统抗阻训练的一种高效替代方法。然而，由于过去出现的不良反应，商业性非医疗全身肌电刺激（WB-EMS）市场设置了非常广泛的禁忌症。鉴于近期的积极创新，例如联邦法规、强制性培训师教育、修订后的指南以及关于WB-EMS应用的新科学研究，我们认为需要仔细修订对WB-EMS非常严格的禁忌症。这一点尤为重要，因为到目前为止，许多传统运动选择有限的人群被排除在外。在基于证据的共识过程的第一次会议上，来自不同背景（如研究、教育、应用）的利益相关者确定了修订禁忌症的优先事项。我们决定专注于四类绝对禁忌症：“动脉硬化、动脉循环障碍”、“糖尿病”（DM）、“肿瘤与癌症”（TC）、“神经系统疾病、神经元疾病、癫痫”。基于对该类别疾病的科学研究、质量标准、安全方面以及效益/风险评估，糖尿病和肿瘤与癌症被移至相对禁忌症目录，而动脉硬化/动脉循环障碍以及神经系统疾病/神经元疾病/癫痫仍被视为绝对禁忌症。虽然缺乏证据表明应维持神经系统疾病/神经元疾病作为绝对禁忌症的现状，但风险/效益比不支持在患有动脉硬化/动脉循环疾病的人群中应用WB-EMS。尽管进行了这些非常谨慎的修改，但对于非医疗WB-EMS结构限制较少的国家，在实施当前修订之前应审慎考虑我们的方法。进一步考虑到WB-EMS试验数量大幅增加，我们建议定期更新当前的禁忌症清单。
