{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:39:07Z","timestamp":1760233147976,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Whole-body electromyostimulation (WB-EMS) is an innovative training method that stimulates large areas simultaneously. In order to determine the spatial distribution of WB-EMS with respect to volume involvement and stimulation depth, we determined the extent of intramuscular edema using magnetic resonance imaging (MRI) as a marker of structural effects. Intense WB-EMS first application (20 min, bipolar, 85 Hz, 350 \u00b5s) was conducted with eight physically less trained students without previous WB-EMS experience. Transversal T2-weighted MRI was performed at baseline and 72 h post WB-EMS to identify edema at the mid-thigh and lower leg. The depth of the edema ranged from superficial to maximum depth with superficial and deeper muscle groups of the mid-thigh or lower leg area approximately affected in a similar fashion. However, the grade of edema differed between the muscle groups, which suggests that the intensity of EMS-induced muscular contraction was not identical for all muscles. WB-EMS of the muscles via surface cuff electrodes has an effect on deeper parts of the stimulated anatomy. Reviewing the spatial and volume distribution, we observed a heterogeneous pattern of edema. We attribute this finding predominately to different stimulus thresholds of the muscles and differences in the stress resistance of the muscles.<\/jats:p>","DOI":"10.3390\/s222410017","type":"journal-article","created":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T01:36:02Z","timestamp":1671500162000},"page":"10017","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Spatial Distribution of Muscular Effects of Acute Whole-Body Electromyostimulation at the Mid-Thigh and Lower Leg\u2014A Pilot Study Applying Magnetic Resonance Imaging"],"prefix":"10.3390","volume":"22","author":[{"given":"Marina","family":"G\u00f6tz","sequence":"first","affiliation":[{"name":"Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-N\u00fcrnberg, 91052 Erlangen, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2897-5411","authenticated-orcid":false,"given":"Rafael","family":"Heiss","sequence":"additional","affiliation":[{"name":"Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany"}]},{"given":"Simon","family":"von Stengel","sequence":"additional","affiliation":[{"name":"Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9238-7350","authenticated-orcid":false,"given":"Frank","family":"Roemer","sequence":"additional","affiliation":[{"name":"Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2241-9174","authenticated-orcid":false,"given":"Joshua","family":"Berger","sequence":"additional","affiliation":[{"name":"German University for Prevention and Health Management, 66123 Saarbr\u00fccken, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0948-1421","authenticated-orcid":false,"given":"Armin","family":"Nagel","sequence":"additional","affiliation":[{"name":"Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany"}]},{"given":"Michael","family":"Uder","sequence":"additional","affiliation":[{"name":"Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3515-0669","authenticated-orcid":false,"given":"Wolfgang","family":"Kemmler","sequence":"additional","affiliation":[{"name":"Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-N\u00fcrnberg, 91052 Erlangen, Germany"},{"name":"Institute of Radiology, University Hospital Erlangen, 91054 Erlangen, Germany"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"640657","DOI":"10.3389\/fphys.2021.640657","article-title":"Efficacy of Whole-Body Electromyostimulation (WB-EMS) on body composition and muscle strength in non-athletic adults. A systematic review and meta-analysis","volume":"12","author":"Kemmler","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Van Kerkhof, P. (2022). Evidenzbasierte Elektrotherapie [Evidence-Based Electrotherapy], Springer.","DOI":"10.1007\/978-3-662-63536-0"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"523","DOI":"10.3389\/fphys.2020.00523","article-title":"Editorial: Whole-Body Electromyostimulation: A Training Technology to Improve Health and Performance in Humans?","volume":"11","author":"Kemmler","year":"2020","journal-title":"Front. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kemmler, W., Eifler, C., and Fr\u00f6hlich, M. (2022). Ganzk\u00f6rper-Elektromyostimulation: Effekte, Limitationen, Perspektiven einer Innovativen Trainingsmethode, Springer-Spektrum.","DOI":"10.1007\/978-3-662-65206-0"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2165\/00007256-198806020-00004","article-title":"Rhabdomyolysis, myoglobinuria and exercise","volume":"6","author":"Milne","year":"1988","journal-title":"Sport. Med."},{"key":"ref_6","first-page":"22841","article-title":"Very high creatine kinase CK levels after WB_EMS. Are there implications for health","volume":"9","author":"Teschler","year":"2016","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Konrad, K.L., Baeyens, J.-P., Birkenmaier, C., Ranker, A.H., Widmann, J., Leukert, J., Wenisch, L., Kraft, E., Jansson, V., and Wegener, B. (2020). The effects of whole-body electromyostimulation (WB-EMS) in comparison to a multimodal treatment concept in patients with non-specific chronic back pain\u2014A prospective clinical intervention study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0236780"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"664991","DOI":"10.3389\/fphys.2021.664991","article-title":"Similar Pain Intensity Reductions and Trunk Strength Improvements following Whole-Body Electromyostimulation vs. Whole-Body Vibration vs. Conventional Back-Strengthening Training in Chronic Non-specific Low Back Pain Patients: A 3-armed randomized controlled trial","volume":"13","author":"Micke","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.2147\/JPR.S164904","article-title":"Effects of whole-body electromyostimulation on chronic nonspecific low back pain in adults: A randomized controlled study","volume":"11","author":"Weissenfels","year":"2018","journal-title":"J. Pain Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/BF00581062","article-title":"Evaluation of methods for electrical stimulation of human skeletal muscle in situ","volume":"398","author":"Hultman","year":"1983","journal-title":"Pflug. Arch."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2451","DOI":"10.1007\/s00421-011-2047-4","article-title":"Transcutaneous neuromuscular electrical stimulation: Influence of electrode positioning and stimulus amplitude settings on muscle response","volume":"111","author":"Gobbo","year":"2011","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Zink-R\u00fcckel, C., Chaudry, O., Engelke, K., Ghasemikaram, M., Kohl, M., Uder, M., and Kemmler, W. (Front. Physiol., 2021). Once weekly whole-body electromyostimulation enhance muscle-quality in men. Data of the randomized controlled Franconian EMS and Golf (FREMGO) study, Front. Physiol., submitted.","DOI":"10.3389\/fphys.2021.700423"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1007\/s00223-018-0424-2","article-title":"Effects of Combined Whole-Body Electromyostimulation and Protein Supplementation on Local and Overall Muscle\/Fat Distribution in Older Men with Sarcopenic Obesity: The Randomized Controlled Franconia Sarcopenic Obesity (FranSO) Study","volume":"103","author":"Kemmler","year":"2018","journal-title":"Calcif. Tissue Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1589\/jpts.32.395","article-title":"Whole-body electromyostimulation in physical therapy: Do gender, skinfold thickness or body composition influence maximum intensity tolerance?","volume":"32","author":"Berger","year":"2020","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1148\/radiol.2017174038","article-title":"Imaging of Muscle Injuries in Sports Medicine: Sports Imaging Series","volume":"285","author":"Guermazi","year":"2017","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"278","DOI":"10.5960\/dzsm.2019.401","article-title":"Recommended Contraindications for the Use of Non-Medical WB-Electromyostimulation","volume":"70","author":"Kemmler","year":"2019","journal-title":"Dtsch. Z Sportmed."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1007\/s00421-011-2093-y","article-title":"Atlas of the muscle motor points for the lower limb: Implications for electrical stimulation procedures and electrode positioning","volume":"111","author":"Botter","year":"2011","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"573","DOI":"10.3389\/fphys.2018.00573","article-title":"Efficacy and safety of low frequency Whole-Body Electromyostimulation (WB-EMS) to improve health-related outcomes in non-athletic adults. A systematic review","volume":"9","author":"Kemmler","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1600-0838.2005.00448.x","article-title":"A comparison between three rating scales for perceived exertion and two different work tests","volume":"16","author":"Borg","year":"2006","journal-title":"Scand. J. Med. Sci. Sport."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1007\/s00415-020-10254-2","article-title":"Quantitative (1)H and (23)Na muscle MRI in Facioscapulohumeral muscular dystrophy patients","volume":"268","author":"Gerhalter","year":"2021","journal-title":"J. Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1093\/hmg\/ddy364","article-title":"MRI-informed muscle biopsies correlate MRI with pathology and DUX4 target gene expression in FSHD","volume":"28","author":"Wang","year":"2019","journal-title":"Hum. Mol. Genet."},{"key":"ref_22","first-page":"325","article-title":"The effect of habitual physical activity, non-athletic exercise, muscle strength, and VO2max on bone mineral density is rather low in early postmenopausal osteopenic women","volume":"4","author":"Kemmler","year":"2004","journal-title":"J. Musculoskelet Neuronal. Interact."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1007\/s00421-011-2128-4","article-title":"Motor unit recruitment during neuromuscular electrical stimulation: A critical appraisal","volume":"111","author":"Bickel","year":"2011","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_24","first-page":"7622","article-title":"Neuromuscular electrical stimulation training results in enhanced activation of spinal stabilizing muscles during spinal loading and improvements in pain ratings","volume":"2011","author":"Coghlan","year":"2011","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1097\/00002060-200206000-00009","article-title":"MRI quantification of muscle activity after volitional exercise and neuromuscular electrical stimulation","volume":"81","author":"Ogino","year":"2002","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/BF00201021","article-title":"Detection of motor unit action potentials with surface electrodes: Influence of electrode size and spacing","volume":"67","author":"Fuglevand","year":"1992","journal-title":"Biol. Cybern."},{"key":"ref_27","unstructured":"Denegar, C., Saliba, E., Saliba, S., Denegar, C., and Saliba, S. (2009). Therapeutic Modalities for Musculoskeletal Injuries, Human Kinetics."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00421-010-1502-y","article-title":"Physiological and methodological considerations for the use of neuromuscular electrical stimulation","volume":"110","author":"Maffiuletti","year":"2010","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/mus.22050","article-title":"Effect of gender and obesity on electrical current thresholds","volume":"44","author":"Maffiuletti","year":"2011","journal-title":"Muscle Nerve"},{"key":"ref_30","unstructured":"Bossert, F.P., Jenrich, W., and Vogedes, K. (2006). Leitfaden Elektrotherapie, Urban und Fischer."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1055\/s-2007-965075","article-title":"Random motor unit activation by electrostimulation","volume":"28","author":"Jubeau","year":"2007","journal-title":"Int. J. Sport. Med."},{"key":"ref_32","first-page":"280","article-title":"Effect of Prolonged Sitting on Hamstring Muscle Flexibility and Lumbar Lordosis in Collegiate Student","volume":"10","author":"Yadav","year":"2020","journal-title":"Int. J. Health Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"7115","DOI":"10.1073\/pnas.1911868117","article-title":"Sitting, squatting, and the evolutionary biology of human inactivity","volume":"117","author":"Raichlen","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_34","first-page":"i693","article-title":"Re: It\u2019s time to regulate the use of whole body electrical stimulation. Whole body electromyostimulation application\u2014The need for more common sense!","volume":"352","author":"Kemmler","year":"2016","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s10354-015-0394-1","article-title":"(Very) high Creatinkinase concentration after exertional whole-body electromyostimulation application: Health risks and longitudinal adaptations","volume":"165","author":"Kemmler","year":"2015","journal-title":"Wien. Med. Wochenschr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5698460","DOI":"10.1155\/2019\/5698460","article-title":"Effects of Compression Tights on Recovery Parameters after Exercise Induced Muscle Damage: A Randomized Controlled Crossover Study","volume":"2019","author":"Hettchen","year":"2019","journal-title":"Evid.\u2013Based Complement. Altern. Med."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/24\/10017\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:44:23Z","timestamp":1760147063000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/24\/10017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,19]]},"references-count":36,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["s222410017"],"URL":"https:\/\/doi.org\/10.3390\/s222410017","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2022,12,19]]}}}