EMS Fitness and Nutritional Support for Cancer Cachexia: A Pilot Study Summary
Cancer has long been on the list of absolute contraindications when it comes to exercising with EMS fitness. However, more research is coming out showing not only that it is safe, but also advisable in some cases, to do EMS workouts despite a cancer diagnosis. This pilot study investigated the effects of a combined intervention of whole-body electro muscle stimulation and individualized nutritional support on skeletal muscle mass in advanced-stage cancer patients undergoing treatment.
Cachexia is a “wasting” disorder that causes extreme weight loss and muscle wasting, and can include loss of body fat. It typically occurs in the late stage of serious conditions, including COPD and cancer.
I’ve summarized the study in bullet points for ease:
Patients:
- Included: Adults over 18 years old with advanced solid tumors, ongoing anti-cancer therapy, and a Karnofsky performance index between 60 and 100. The Karnofsky Performance Scale (KPS) is a standard way to measure the functional status of a patient, particularly those with serious illnesses like cancer. It helps healthcare professionals assess a patient’s ability to perform everyday activities and their need for assistance. A KPS index of 60 to 100 means patients are mostly able to function normally.
- Excluded: Patients already in other exercise or nutrition studies, with recent cardiovascular events, taking anabolic drugs, pregnant, or with epilepsy, severe neurological diseases, skin lesions near electrodes, recent cancer surgery, thrombosis, pacemakers, or conductive implants. In other words, all the other absolute contraindications of working out with EMS.
Study Design:
- Allocation: Patients were assigned to either an EMS fitness group or a control group based on their ability to attend the EMS training twice a week for 12 weeks.
- Duration: 12 weeks for all patients.
- Blinding: Neither patients nor those administering the intervention or assessing outcomes were blinded. There is no possible way to blind or double blind a study with electrical muscle stimulation.
Interventions:
- Both Groups:
- Individualized nutritional support:
- Dietary intake monitored by 24-hour dietary records at baseline and at the end.
- Dietary advice provided by a dietician to achieve a daily protein intake of >1.0g/kg body weight and a total energy intake based on resting energy requirements, activity level, and nutritional status.
- Nutritional support with protein supplements or enteral/parenteral nutrition for patients with insufficient oral intake.
- Individualized nutritional support:
- WB-EMS Group Only:
- EMS training twice a week for 12 weeks (total of 24 sessions).
- Light dynamic physical exercises performed with a video tutorial and supervised by certified trainers.
- Seven exercises repeated six times each for a total of 1 minute per exercise.
- Electrical muscle stimulation applied with bipolar impulses at a frequency of 85 Hz and a pulse width of 350 μs, inducing a 6-second muscle stimulation followed by a 4-second rest period.
- Current intensity gradually increased to a comfortable but challenging level.
Study Outcomes:
- Primary Outcome: Change in skeletal muscle mass assessed by bioelectrical impedance analysis (BIA) at baseline and after 4, 8, and 12 weeks.
- Secondary Outcomes:
- Body composition (body weight, fat mass percentage, hydration, phase angle) assessed by BIA.
- Physical function (hand grip strength, six-minute walk test).
- Performance status (Karnofsky Index).
- Quality of life and fatigue (questionnaires).
- Blood samples analyzed for inflammatory markers, nutritional markers, renal function, and hematological parameters.
- Exercise adherence rate in the EMS fitness group.
Key Findings:
- WB-EMS is safe and effective: The combined therapy was found to be safe and more effective in preserving skeletal muscle mass compared to nutritional support alone.
- Improved physical function: Patients in the EMS fitness group experienced a significant increase in walking distance, suggesting improved physical function.
- Positive impact on quality of life: Both groups showed improved quality of life, but the WB-EMS group experienced more significant improvements in emotional functioning.
- Nutritional support: Both groups achieved adequate protein and calorie intake, but the difference in muscle mass was attributed to the EMS workout group and not nutrition.
- Muscle damage: WB-EMS caused a moderate increase in muscle enzymes but did not lead to significant kidney issues.
Limitations
- The study was a pilot trial with a non-randomized design and unequal group size.
- Potential bias due to patient allocation and assessor blinding. Complete blinding is impossible with electrical muscle stimulation.
- High dropout rates in both groups due to disease progression and other factors.
The study provides preliminary evidence that WB-EMS is a promising exercise technique for advanced-stage cancer patients. The combination of WB-EMS and nutritional support shows potential benefits for muscle health, physical function, and quality of life. Larger randomized controlled trials are needed to confirm these findings as is typical with new research studies.
I was very excited to see this study getting published and confirming our own training protocols that we use under our strength program.
We hope to see you soon at our flagship Newport Beach studio:
419 E 17th Street, Costa Mesa, CA, 92627.
If you want to try EMS, please book an intro session at our Newport Beach studio or contact us at info@bodybuzzfit.com. We also offer at-home EMS personal training in Los Angeles and San Diego.
Conrad
Managing Director
Bodybuzz