Intensify Your Training, Increase Your Gains W/ Combined EMG + Regular Training For 30% Greater Muscle Size Gains

Voluntary & NMES contractions for Monster Quads?
You are always looking for new ways to improve your training outcome? Scientists from the Department of Physiotherapy at the University Cardenal Herrera-CEU might have something for you, then. In their latest study, V. Benavent-Caballer, P. Rosado-Calatayud, E. Segura-Ortí, J.J. Amer-Cuenca, and J.F. Lisón tried to elucidate, whether conducting low intensity resistance training in conjunction with  neuromuscular electrical stimulation (NMES) would provide not just an additional growth stimulus, but also corresponding increases in physical performance, muscle cross-sectional area (CSA) and the capacity to perform daily tasks 22 in exactly those subjects researchers will resort to, when they're looking for generous funding for studies the outcome of which is not going to pay off in form of scripts for a new patentable drug: Older adults living in a geriatric nursing home.
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What? Yeah... I have to admit, the subjects are not exactly bodybuilders and a regular high intensity control is missing, but even if it wasn't for the necessary fact that you'll belong to the group of "older adults" in 50 years from now, the results of the study at hand would still have a certain relevance for younger trainees. Why? Well, something that makes the elderly grow will certainly do the same in young people. Whether it does so at the same or even higher rates than "regular" strength training will obviously have to be elucidated in future studies.
Table 1: Subject characteristics;  VC = volitional contraction; NMES = neuromuscular electrical stimulation; NMES+ = NMES superimposed onto voluntary contraction. SD = standard deviation (Benavent-Caballer. 2014)
For now, all I can tell you is that the three weekly supervised 30-35 min exercise sessions the 89 participants of the study at hand performed in the course of this 16-week study lead to significantly more pronounced strength and size gains, when the exercise was performed using both voluntary contractions and the forced contractions, the researchers produced by attaching their subjects to the surface electrodes of a portable NMES devices (TensMed S82).
Beware of NMES only training! In as much as a combination of voluntary contractions and NMES  may make sense, you should not fall for the fallacious promises of "couch workout" advocates. Previous studies suggest that the strength increases of EMS are - just like any form of training - stimulus specific, the "incomplete muscle activation after training with electromyostimulation" will thus make your muscle stronger on the couch (during your NMES workouts), but are not necessarily going to translate into the real world (Hortobágyi. 1998).
The four adhesive surface electrodes (5 × 5 cm) were placed on the distal medial and proximal lateral portions of the subject's anterior thigh, when they performed their three sets of knee extensions (15 reps each) in a single-leg fashion with 3-minute rest between sets.
Figure 2: Changes in muscle strength (hand grup) and size (rectus femoris), as well as changes in parameters of physical functioning in response to the three training modalities (Benavent-Caballer. 2014)
The participants were instructed to raise the weight in 1 s (concentric phase), keep a full knee extension for 3 s (isometric phase) and slowly lower the weight in 2 s to the starting position (eccentric phase). Each contraction was followed by a 2-second rest period, and the training intensity was set at 40% of 1RM... and yeas, this sounds pretty much like peak contractions, an intensity technique which may in fact be the reason that the old trainees in the study at hand recorded highly significant increases in muscle size even when the peak contraction or rather the whole movement was not superimposed with NMES which was delivered with a ramp-up time of 1 s increasing intensity as the knee was extended from 90° to full extension that was followed by 3 s keeping the knee in full extension and 2 s of a ramp-down with gradually decreasing intensity (see Figure 2, yellow).
There is evidence from previous studies that a similar NEMS + VC regimen leads to non-significantly higher strength gains in the trained leg and sign. higher cross-education effects in the untrained leg of young men (Bezerra. 2009)
Bottom line: It is, as mentioned before, difficult to predict whether or not the NEMS+ training would produce superior training outcomes in younger athletes, athletes. It is yet almost certain that the combination of NEMS + voluntary contractions would pose a viable tool in the toolbox of any injured athlete who has to cut back on his / her training intensity for health reasons.

Moreover, previous trials in younger subjects confirmed that superimposing NEMS + voluntary contractions is at least on par with classic high intensity resistance training and can promote neural adaptations that lead to increased cross-education effects (strength gains in non-trained leg) in a 2009 study by Bezerra et al. (2009).

Beneficial effects of combining (N)EMS and voluntary contractions (not always superimposed, though) were also reported by Venable et al. (1991) and Dervisevic et al. (2002) for resistance training, Pichon et al. (1995) for swimming, Maffiuletti et al. () for basektball volleyball, Brocherie et al. (2005) for ice-hockey and Herrero et al (2006), Babault et al. (2007) and Paillard et al. (2008) for physical education (vertical jump, strength, etc. tested) | Comment on Facebook!
References:
  • Babault N, Cometti G, Bernardin M, et al. "Effects of electromy ostimulation training on muscle strength and power of elite rugby players." J Strength Cond Res 21 (2007): 431-7.
  • Bezerra, Pedro, et al. "Effects of unilateral electromyostimulation superimposed on voluntary training on strength and cross‐sectional area." Muscle & nerve 40.3 (2009): 430-437.
  • Brocherie F, Babault N, Cometti G, et al. "Electromyostimulation training effects on the physical performance on ice hockey players." Med Sci Sports Exerc 37 (2005): 455-60.
  • Delitto A, Brown M, Strube MJ, et al." Electrical stimulation of quadriceps femoris in an elite weight lifter: a single subject experiment." Int J Sports Med 10 (1989): 187-91.
  • Dervisevic E, Bilban M, Valencic V." The influence of low-frequency electrostimulation and isokinetic training on the maximal strength of m. quadriceps femoris." Isokinet Exerc Sci 10 (2002): 203-9. 
  • Hortobágyi, Tibor, Jean Lambert, and Kevin Scott. "Incomplete muscle activation after training with electromyostimulation." Canadian journal of applied physiology 23.3 (1998): 261-270. 
  • Maffiuletti NA, Cometti G, Amiridis IG, et al. "The effects of electromyostimulation training and basket practice on muscle strength and jumping ability. Int J Sports Med 21 (2000): 437-
    43. 
  • Malatesta D, Cattaneo F, Dugnani S, et al. "Effects of electromyostimulation training and volley practice on jumping abilities." J Strength Cond Res 17 (2003): 573-9.
  • Herrero JA, Izquierdo M, Maffiuletti N, et al. "Electromyostimu lation and plyometric training effects on jumping and sprint time." Int J Sports Med 27 (2006): 533-9.
  • Paillard, Thierry, et al. "Effects of two types of neuromuscular electrical stimulation training on vertical jump performance." The Journal of Strength & Conditioning Research 22.4 (2008): 1273-1278.
  • Pichon F, Chatard JC, Martin A, et al. "Electrical stimulation and swimming performance." Med Sci Sports Exerc 27 (1995): 1671-6.
  • Venable MP, Collins MA, O’Bryant HS, et al. "Effect of supplemental electrical stimulation on the development of strength, vertical jump performance and power." J Appl Sport Sci Res 5 (1991): 139-43
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