Whole body-electromyostimulation effects on serum biomarkers, physical performances and fatigue in Parkinson’s patients: A randomized controlled trial

Background: Whole-body electromyostimulation (WB-EMS) was never previously
applied to Parkinson’s disease (PD) patients. This randomized controlled study aimed
to find the most effective and safe WB-EMS training protocol for this population.
Methods: Twenty-four subjects (age: 72.13 ± 6.20 years), were randomly assigned to
three groups: a high-frequency WB-EMS strength training group (HFG) (rectangular
stimulation at 85 Hz, 350 µs, 4 s stimulation/4 s rest), a low-frequency WBEMS aerobic training group (LFG) (rectangular stimulation 7 Hz, 350 µs, with a
continuous pulse duration), and an inactive control group (CG). Participants of the
two experimental groups underwent 24 controlled WB-EMS training sessions, with a
duration of 20 min each, during 12-week intervention. Serum growth factors (BDNF,
FGF-21, NGF and proNGF), α-synuclein, physical performance and Parkinson’s
Disease Fatigue Scale (PFS-16) responses were analyzed to evaluate the pre-post
variation and differences among groups.
Results: Significant interactions of Time∗Groups were detected for BDNF
(Time∗Groups p = 0.024; Time∗CG, b = −628, IC95% = −1,082/−174, p = 0.008),
FGF-21 (Time∗Groups p = 0.009; Time∗LFG b = 1,346, IC95% = 423/2268,
p = 0.005), and α-synuclein (Time∗Groups p = 0.019; Time∗LFG b = −1,572,
IC95% = −2,952/−192, p = 0.026). Post hoc analyses and comparisons of 1S (post–
pre), performed independently for each group, showed that LFG increased serum
BDNF levels (+ 203 pg/ml) and decreased α-synuclein levels (−1,703 pg/ml), while
HFG showed the opposite effects (BDNF: −500 pg/ml; α-synuclein: + 1,413 pg/ml).
CG showed a significant BDNF reduction over time. Both LFG and HFG showed
significant improvements in several physical performance outcomes and the LFG
showed better results than HFG. Concerning PFS-16, significant differences over time
(b = −0.4, IC95% = −0.8/−0.0, p = 0.046) and among groups (among all groups
p < 0.001) were found, and the LFG exhibited better results than the HFG (b = −1.0, IC95% = −1.3/−0.7, p < 0.001), and CG (b = −1.7, IC95% = −2.0/−1.4, p < 0.001) with
this last one that worsened over time.
Conclusion: LFG training was the best choice for improving or mainta