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Our aim was to compare structural changes of knee OA between patients treated with WB-EMS and a control group (CG) treated with a standard of care approach.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Material and methods<\/jats:title>\n            <jats:p>Seventy-two overweight participants with symptomatic knee OA were assigned to either WB-EMS or CG. MRIs were acquired at baseline and 7\u00a0months using a 3\u00a0T system. MRIs were read according to the MRI Osteoarthritis Knee Score (MOAKS) instrument. Between-group differences in regard to change in cartilage, bone marrow lesions (BMLs), osteophytes, meniscus damage and extrusion, and markers of inflammation were analyzed using Fisher\u2019s Exact and Wilcoxon Rank Sum tests.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Fewer knees in the WB-EMS groups showed cartilage worsening compared to the CG (18% vs. 40%, <jats:italic>p<\/jats:italic>\u2009=\u20090.046). There were fewer knees in the WB-EMS group showing an increase in BML size score of\u2009\u2265\u20091 (30% vs 46%, <jats:italic>p<\/jats:italic>\u2009=\u20090.43). Regarding prevalent BMLs that showed improvement, no change, or worsening, no differences were seen (<jats:italic>p<\/jats:italic>\u2009=\u20090.56). Little osteophyte and meniscal changes were observed during the observational period. Differences regarding change in inflammatory markers were not significant.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>While there was a difference with fewer subregions showing worsening cartilage damage in the WB-EMS group, no significant differences were observed for change in BMLs, inflammation, osteophytes, and meniscal parameters. The observed improvement in clinical outcome parameters in favor of the WB-EMS group is likely due to other effects than improvement or less worsening of structural changes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00256-025-04984-5","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T07:50:03Z","timestamp":1753170603000},"page":"2579-2588","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Structural effects of whole body electromyostimulation on knee osteoarthritis: the EMSOAT Study"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9238-7350","authenticated-orcid":false,"given":"Frank W.","family":"Roemer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Kast","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Kemmler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie E.","family":"Collins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Engelke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Guermazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Uder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"von Stengel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"4984_CR1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/S0140-6736(24)02322-5","volume":"405","author":"M Kloppenburg","year":"2025","unstructured":"Kloppenburg M, Namane M, Cicuttini F. 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The RCT was approved by the FAU ethics committee (Nr. 352_20 B) and all participants provided written informed consent prior to enrolment. The project fully complies with the Helsinki Declaration and was prospectively registered at clinicaltrials.gov, NCT05672264, on 05\/01\/2023.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"FWR is shareholder of Boston Imaging Core Lab (BICL), LLC. and is consultant to Gr\u00fcnenthal GmbH. JEC is consultant to Boston Imaging Core Lab (BICL),LLC. AG has received consultancies, speaking fees, and\/or honoraria from Galapagos, Pfizer\/Lilly, Roche, AstraZeneca, Merck Serono, and TissuGene and is President and shareholder of Boston Imaging Core Lab (BICL), LLC a company providing image assessment services.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}