title: Electrical stimulation of unloaded muscles causes cardiovascular exercise by increasing oxygen demand.
abstract: BACKGROUND
  The development of new strategies to encourage increased levels of physical activity can help to reduce the incidence of cardiovascular disease. A new system of electrical muscle stimulation (EMS) has been developed that attempts to cause an increase in energy expenditure by mimicking the action of shivering in the body. The purpose of this study was to show that this form of EMS is capable of eliciting a cardiovascular exercise response in healthy adults.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  Ten healthy volunteers completed a maximal treadmill test and four EMS sessions using a hand-held EMS device that delivered current to the body via five silicone rubber electrodes on each leg. At each session subjects completed 3 min stimulation at each of four stimulation outputs (10, 20, 30 and 40% of maximum output) while cardiopulmonary gas exchange and heart rate (HR) were measured. Physiological responses at increasing levels of stimulation were evaluated.
  
  
  RESULTS
  Average (+/-SD) HR and oxygen consumption (VO2) levels of 67+/-11 bpm and 4.7+/-1.2 ml/kg per min at rest, respectively, were increased to 186+/-10 bpm and 44.9+/-9.8 ml/kg per min at peak exercise intensity on treadmill testing. The electrical stimulation was generally well tolerated by the subjects. Subjects demonstrated statistically significant increases in all physiological variables measured with successive increases in stimulation intensity. Peak HR and VO2 at 40% stimulation intensity were 101+/-12 bpm and 14.9+/-4.3 ml/kg per min, respectively.
  
  
  CONCLUSIONS
  These results demonstrate that this form of EMS is capable of producing a physiological response consistent with cardiovascular exercise at mild to moderate intensities. It achieves this without producing gross movement of the limbs or loading of the joints. This EMS-induced cardiovascular exercise response could be used to promote increased levels of physical activity in populations unable to participate in voluntary exercise.
authors.affiliation: Department of Academic Cardiology, University of Hull, Castle Hill Hospital, Cottingham, Kingston-upon-Hull, UK.
authors.forename: Prithwish
authors.initials: P
authors.lastname: Banerjee
authors.forename: Andrew
authors.initials: A
authors.lastname: Clark
authors.forename: Klaus
authors.initials: K
authors.lastname: Witte
authors.forename: Louis
authors.initials: L
authors.lastname: Crowe
authors.forename: Brian
authors.initials: B
authors.lastname: Caulfield
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control*; D004558:Electric Stimulation; D004734:Energy Metabolism; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D010101:Oxygen Consumption / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology; D011659:Pulmonary Gas Exchange; D013997:Time Factors