BACKGROUND/AIM:We conducted a systematic review with network meta-analyses (NMA) summarizing the effects and safety of lifestyle interventions containing nutrition (NUT; e.g., calorie restriction), exercise (EX; e.g., aerobic/resistance exercise) and behavior change interventions (BCI; e.g., behavioral therapy) on physical function, body composition, quality of life, psychosocial outcomes, health and adverse events in community-dwelling older adults with obesity. METHODS:We used the methodology proposed by Cochrane and searched six databases and one trial registry for eligible randomized controlled trials (RCTs; intervention duration ≥ 12 weeks) up to May 2022 with a full new search in MEDLINE and a re-assessment of previously identified eligible trial registry entries in October 2025. Random-effects NMA ((standardized) mean difference ((S)MD), 95% confidence intervals) were conducted if possible. RESULTS:We included 72 RCTs (n = 6716) for descriptive summaries and 54 RCTs (n = 4249) for NMA. NUT+EX+BCI improved physical function (performance batteries) compared to control (SMD 3.37 [1.76;4.97]; high certainty of evidence). NUT+EX+BCI may reduce body (MD -8.69 [-13.14;-4.25]) and fat mass (MD -6.58 [-10.44;-2.73]) while not negatively affecting fat-free mass (MD -1.38 [-3.52;0.76]) or bone mineral density (MD -0.01 [-0.05;0.02]) (evidence very uncertain). Other interventions (single/combined) may also be effective; however, effects were often imprecise. For psychosocial outcomes, quality of life, and health events, data were insufficient or too heterogeneous to derive clear results. CONCLUSION:The evidence suggests that NUT+EX+BCI interventions are most suitable for the management of obesity in older adults. Nevertheless, further RCTs-especially in frail populations and on patient-relevant outcomes-are needed.

Exercise is considered a cornerstone of fracture prevention in people at increased risk of fractures. However the most effective exercise strategy for preventing fractures has yet to be determined. The primary aim of the present evidence- and consensus-based guideline was thus to derive practice recommendations for effective, feasible and safe training programs to prevent fractures in various cohorts. A novelty of our approach was the assignment of dedicated cohorts at risk for fractures to training objectives that prioritized bone strength or/and fall risk or/and fall impact reduction. In summary, bone strength exercise protocols should include periods of high loading magnitude and rate provided by impact loading and dynamic strength/power training. Fall risk should be addressed by an individualized mix of balance, perturbation, functional, stepping and interactive cognitive-motor exercises. Simple and low-risk strategies for safe landing can be advised unreservedly, however more sophisticated strategies derived from martial arts require close and experienced supervision and high safety standards. If the latter strategies are chosen in interventions, they should be reserved for dedicated training periods. Training frequency should be set at least 2 (bone strength) or 3 (fall risk) sessions/week, possibly with a (block) periodized approach with intense periods intermitted by low/regenerative phases, with varying training aims focusing on progression. Not applicable.

Background: Whole-body electromyostimulation (WB-EMS) is a training technology that enables the stimulation of all the main muscle groups with dedicated intensity, attracting many sportspeople and athletes of various disciplines. The aim of this systematic review and meta-analysis was to determine the effect of WB-EMS on maximum jump, sprint, and agility performance in exercising cohorts. Methods: Systematic literature research of five electronic databases up to March 2025, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) scheme and including interventional trials with at least one WB-EMS and one active or inactive control group that focus on maximum jump, sprint, and agility performance in sportspeople and athletes. Applying a random-effect model that includes the inverse heterogeneity model (IVhet), effects sizes (SMD), and calculates 95% confidence intervals (95%-CIs). Subgroup analyses addressed superimposed WB-EMS application vs. underlying voluntary exercise. Results: Twelve studies with 145 participants in the WB-EMS and 148 participants in the control group were included. Most trials on jumping (10 of 12) and all trials on sprinting and agility performance applied superimposed WB-EMS protocols compared with underlying voluntary exercise. We observed no significant positive effects of WB-EMS on maximum jump (12 studies, SMD: 0.34, 95%-CI: −0.35 to 1.03), sprint (8 studies, SMD: 0.07, 95%-CI: −0.66 to 0.80), and agility performance (5 studies, SMD: −0.11, 95%-CI: −1.28 to 1.06). Heterogeneity between the trial results was considerable (I2 > 80%) in all cases. Conclusions: Superimposed WB-EMS compared to the underlying predominately near-maximum to maximum intensity voluntary exercise provides only limited additional effects on jumping, sprinting, and ability performance.

Exercise is recommended by all major treatment guidelines of knee osteoarthritis (OA). However, most patients do not maintain the exercise program after cessation of the supervised training period. This study evaluated the sustainability of the positive treatment effects of a 7-month whole-body electromyostimulation (WB-EMS) intervention in overweight individuals with symptomatic knee OA. Seventy-two participants were randomly assigned to a WB-EMS group (n = 36) or a usual care control group (CG, n = 36). After 7 months, supervised WB-EMS training was discontinued, and participants were free to continue WB-EMS independently or engage in alternative exercise modalities. Analyses included only participants who did not continue or newly initiate WB-EMS or resistance training during the subsequent 6-month sustainability period (WB-EMS: n = 21 vs. CG: n = 33). Post-intervention, a significant effect in the primary outcome “pain”, assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS), was observed in favour of the WB-EMS group. However, this difference was no longer significant at the 6-month sustainability follow-up. Likewise, WB-EMS–induced effects were not maintained for most secondary outcomes, including the remaining KOOS subscales, the 7-day pain diary and hip/leg extensor strength. The only exception was the 30-s sit-to-stand test (p < 0.001). Overall, benefits in knee pain and function largely diminished after training cessation, underscoring the importance of long-term exercise adherence.

BACKGROUND:Given its practical advantages in terms of time efficiency, joint compatibility and extensive adaptability, whole-body electromyostimulation (WB-EMS) has gained considerable attention as a training method among athletes and sportspeople across numerous disciplines. The present systematic review and meta-analysis aimed to determine the impact of WB-EMS on maximum hip/lower-extremity strength and power. METHODS:A systematic search of five literature databases was carried out up to 30 March 2025 in accordance with the PRISMA scheme. Effect sizes (SMD) and 95-confidence intervals (95-CI) were derived using a random-effect model incorporating the inverse heterogeneity approach. RESULTS:Nineteen WB-EMS and 21 control groups were included. Overall, we observed favorable effects of this novel training technology on maximum strength (18 trials, SMD: 0.62, 95-CI: 0.08 to 1.16, I2 = 86%)) and power (8 trials, SMD: 0.38, 95-CI: 0.06 to 0.70, I2 = 15%). Subgroup analyses examining superimposed WB-EMS relative to voluntary exercise alone yielded low to moderate, yet statistically non-significant, effects on maximum strength (12 trials, 0.44, -0.20 to 1.08, I2 = 85%) and power (7 trials, 0.39, -0.02 to 0.81, I2 = 35%). Studies addressing the comparison of superimposed or non-superimposed WB-EMS against traditional dynamic resistance exercise reported largely equivalent outcomes for both strength and power development. CONCLUSION:Contingent upon the mode of application (superimposed, additional or optional), WB-EMS may exert a positive influence on maximum strength and power in sportspeople and athletes.

The study evaluates the effects of different types of popular exercises on muscle mass reduction during diet-induced body mass loss in overweight and obese women. Participants were randomly allocated to three exercises (Whole-Body Electromyostimulation (WB-EMS), Pilates, Yoga) combined with nutritional guidance and one nutritional guidance-only group (control). All exercise protocols specified a 2 x 50 min (Pilates, Yoga) or 2 x 20 min (WB-EMS) training, respectively. Weekly applied nutritional guidance focused on -500 kcal/d of energy restriction but increased protein intake. A total 221 overweight/obese women 19-65 years old and largely compliant with the exercise and nutritional guidance protocol were included. We observed significant decreases in body mass in all groups (-3.9 to 6.0 kg, all p < 0.001), with the most pronounced reduction in the nutritional guidance-only group. Apart from WB-EMS (-166 +/- 799 g, p = 0.14), all the other groups significantly lost muscle mass (Pilates -343 +/- 774 g, p = 0.003; Yoga: -507 +/- 801 g, p < 0.001), however, compared to control (-1113 +/- 881 g, p < 0.001), all the groups showed significantly more favorable results. WB-EMS, Pilates, and Yoga were associated with a reduced loss of muscle mass during diet-induced weight loss, indicating their potential role as adjunctive interventions in overweight and obese individuals.

Background/Objectives: Gymnastic exercises exert positive effects on chronic neck pain. Growing evidence suggests that combining cervical spine exercises with temporomandibular joint (TMJ) relax pads may enhance outcomes on pain, discomfort, and functional limitations. To evaluate the additive effect of silicone TMJ relax pads worn in the molar region during cervical spine exercises on reducing neck pain and selected mobility outcomes. Methods: In this study, 52 sedentary middle-aged adults working on video display unit (VDU) workstations were randomly assigned to two groups. Both groups performed a specific cervical spine exercise program (3 × 3 min/day) for three months. One group used bilateral TMJ relax pads during exercise (EX-RP) while the control group applied the identical exercises without pads (EX). Neck pain intensity was assessed using a one-week pain protocol prior to and after a 12-week intervention. Functional assessments included cervical/thoracic and shoulder mobility tests, and thoracic kyphosis angle measurement. An intention-to-treat analysis with multiple imputations was performed. Results: Data from 47 participants (EX-RP: n = 25; EX: n = 22) were analyzed. Neck pain decreased in both groups, with a significantly greater reduction in the EX-RP compared to the EX group (p = 0.046). Neck Disability Index (NDI) scores improved in both groups (p < 0.001), with no significant difference between groups (p = 0.514). EX-RP showed greater improvements in cervical extension (p = 0.044) and trunk rotation (p = 0.019); however, the results for other mobility outcomes were inconsistent. Conclusions: Adding TMJ relax pads to cervical exercises (alone) favorably affects the pain intensity and might enhance mobility outcomes in individuals with chronic neck pain. TMJ relax pads appear to be a feasible and low-threshold adjunct to exercise-based interventions.

Osteoporosis has become a global public health concern making prevention and treatment essential to reduce severe consequences for individuals and health systems. This systematic review with meta-analysis aimed to determine the effects of combined protein and exercise interventions compared to (a) exercise alone and (b) protein alone on bone mineral content (BMC) or density (BMD) in middle-aged and older adults. We systematically searched Medline, CINAHL, CENTRAL, Web of Science, and SPORTDiscus until 24th January 2023. Pairwise random-effects meta-analyses were performed to calculate weighted mean differences (WMD) with 95

Introduction The S3 guideline "Physical training for fracture prevention" is evidence- and consensus-based, taking into account factors such as clinical effectiveness, scientific reliability, applicability, benefit/risk considerations and cost-effectiveness when making recommendations. Method This guideline focuses on postmenopausal women and men aged 45 years and older. Systematic literature searches were conducted to generate evidence in areas of unclear evidence. Evidence level and grade of recommendation was determined in accordance with the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Fourteen societies and institutions participated in the AWMF-moderated consensus conferences and unanimously adopted the 73 recommendations after two rounds. Results Initially, patient target groups categorized according to their dominant fracture risk profile were assigned to three training goals, i.e. "maintaining/improving bone strength", "reducing the risk of falls", and "improving the fall process". In the area of "bone strengthening", intensive weight-bearing exercises and dynamic resistance exercise (DRT) are recommended, which should be intermitted by phases of low mechanical strain. High strain rates realized by high movement speed should be limited to DRT in cases of joint problems. Depending on the individual fall risk factors, a multimodal training protocol is recommended, which should include complex balance, perturbation, functional (strength), stepping, Tai Chi, and/or interactive cognitive-motor training content. In the area of "improving the fall process", the guideline recommends safe and less complex techniques that do not simulate the fall process per se. More demanding and complex (fall) techniques are recommended where close and competent supervision and high safety standards are ensured. In the area of training components, the recommendation of 2 (bone strengthening) or 3 training (fall reduction) sessions per week should be considered mandatory. Discussion The guideline presented follows a dedicated exercise science and practical application driven approach aimed at facilitating its use by exercise specialists. Despite the guideline nature of the work, we would like the recommendations to be understood primarily as guide and evidence-based decision-making support but not as mandatory standards.

BACKGROUND:Exercise is an effective intervention for preventing low-trauma fractures, but optimized training recommendations for different target groups are not available in terms of the desired level of detail or with the desired practical orientation. TRAINING TARGETS:The primary aim of this evidence- and consensus-based guideline was, therefore, to derive personalized practice recommendations for effective, safe, and transferable training programs for fracture prevention. The present approach is based on assigning training goals according to the determinants of fracture risk that are relevant to the individual, such as bone strength, fall risk, and risk of fall-related injury. EXERCISES:Training protocols for maintaining or improving bone strength should generally include phases of intensive mechanical loading, which can be achieved through weight-bearing exercises and dynamic strength training. The fall risk should be addressed through an individualized combination of balance training, including perturbation training, step training, and interactive cognitive-motor and functional strength training. Simple, low-risk strategies for landing safely during or after a fall can be recommended without reservation; however, more demanding falling techniques require close supervision by experienced staff and high safety standards. Ideally, the frequency of training should be three sessions per week across all training goals. We advise (block) periodized approaches with phases of different focus, as well as consistent, individual adaptation and progression throughout the training process.

Körperliches Training ist eine effektive Intervention zur Prophylaxe niedrigtraumatischer Frakturen, allerdings liegen optimierte Trainingsempfehlungen für unterschiedliche Zielgruppen nicht in der wünschenswerten Ausführlichkeit und praxisrelevanten Ausrichtung vor. Das primäre Ziel der vorliegenden evidenz- und konsensbasierten Leitlinie, war daher die Ableitung von individualisierten Praxisempfehlungen für effektive, sichere und transferierbare Trainingsprogramme zur Frakturprävention. Der zugrundeliegende Ansatz basiert auf der Zuweisung von Trainingszielen entsprechend der individuell relevanten Determinanten des Frakturrisikos wie Knochenfestigkeit, Sturzrisiko und sturzbedingtes Verletzungsrisiko. Trainingsprotokolle zum Erhalt oder zur Verbesserung der Knochenfestigkeit sollen grundsätzlich Trainingsphasen mit intensiver mechanischer Belastung beinhalten, die durch gewichtstragende Belastung und dynamisches Krafttraining realisiert werden können. Das Sturzrisiko soll durch eine individualisierte Komposition aus Gleichgewichts-, inklusive Perturbations‑, Schritt- und interaktiv kognitiv-motorisch sowie funktionalem Krafttraining adressiert werden. Einfache und risikoarme Strategien zur sicheren Landung bei/nach Sturz können vorbehaltlos empfohlen werden, während anspruchsvollere Falltechniken eine enge und erfahrene Überwachung und hohe Sicherheitsstandards erfordern. Für alle Trainingsziele übergreifend soll die Trainingshäufigkeit idealerweise bei drei Einheiten/Woche liegen. (Block‑)periodisierte Ansätze mit Trainingsphasen unterschiedlicher Ausrichtung und Belastungskomposition sowie eine konsistente, individuelle Anpassung der Trainingsgrößen im Trainingsverlauf werden nahegelegt.

IntroductionPhysical exercise favorably affects visceral adipose tissue (VAT), which is a risk factor for cardiometabolic diseases. However, many people are unable or unwilling to conduct frequent and intensive exercise programs that have favorable effects on VAT. The present study aimed to determine the effect of time-efficient and joint-friendly whole-body electromyostimulation (WB-EMS) technology on VAT volume in overweight-to-obese adults with osteoarthritis of the knee.MethodsIn total, 46 women and 26 men (58.4 ± 7.0 years; BMI: 30.2 ± 4.2 kg/m2) with femuro-tibial knee osteoarthritis were randomly allocated to WB-EMS (n = 36) with 1.5 × 20 min/week for 29 weeks or a usual care control group (CG: n = 36) with six sessions of physiotherapy. Magnetic resonance imaging (MRI) using a non-contrast enhanced two-point Dixon gradient echo volumetric interpolated breath-hold examination determined the VAT from mid L2 to mid L3.ResultsIn summary, VAT volume increased non-significantly in the CG (p = 0.246) and decreased non-significantly in the WB-EMS group (p = 0.143). We failed to determine significant WB-EMS-induced effects, i.e., group differences for absolute changes in the VAT volume (p = 0.090). However, we observed gender differences with significantly higher effects in men than in women (p = 0.032).DiscussionWe conclude that low volume, non-superimposed WB-EMS is not a perfect tool for decreasing VAT, particularly in overweight-to-obese women.

Background Diabetes prevention programs focus on people with prediabetes because they have a greater risk of developing type 2 diabetes mellitus than people with normal blood glucose levels. Weight management can reduce this risk. However, in our largely sedentary society, there is less enthusiasm for regular exercise. Whole-body electromyostimulation (WB-EMS) is a training technology that provides exercise-like effects by inducing muscle contractions using electrical currents. There is evidence that local EMS can improve glucose metabolism. Several studies investigated the effect of WB-EMS on cardiometabolic risk factors including blood glucose control in a population of individuals with metabolic syndrome. However, to the best of our knowledge, there is no randomized controlled trial examining the preliminary efficacy of WB-EMS on hemoglobin A1c (HbA1c) levels in individuals with prediabetes. Objective The objective of this randomized controlled trial is to pilot procedures for a randomized controlled trial testing WB-EMS training on glycemic changes in sedentary adults with prediabetes. Methods A total of 60 community-dwelling sedentary adults aged 40-65 years with prediabetes will be randomized to one of 3 arms: WB-EMS + an activity tracker and a lifestyle education program (LEP) focusing on diabetes prevention, an activity tracker and LEP, or LEP only, with 20 individuals in each arm. The WB-EMS training will consist of 1.5×20 minutes per week. The intervention will last 16 weeks. As a pilot study, our main outcomes concern the number of participants who will be recruited, and comply with intervention and follow-up. The primary efficacy outcome of interest includes hemoglobin A1c. The intention-to-treat analysis will be conducted with the objective of providing CI estimation of treatment effects. Results The recruitment of study participants started in February 2024. At the time of submission of this protocol for publication, the recruitment was still ongoing. As of October 2024, a total of 42 participants were allocated to the study groups. The anticipated date of recruitment completion is July 2025. Conclusions The results of this trial will provide valuable evidence for future investigations comparing the efficacy of the WB-EMS intervention with traditional exercise training to improve glycemic control in this population. Trial Registration ClinicalTrials.gov NCT06188481; https://clinicaltrials.gov/study/NCT06188481 International Registered Report Identifier (IRRID) DERR1-10.2196/68761

Many people with osteoarthritis of the knee suffer from overweight, obesity, and cardiometabolic conditions. In the present subanalysis of a randomized controlled trial of the effect of whole-body electromyostimulation (WB-EMS) on knee osteoarthritis in overweight Caucasians, we focus on participants with Metabolic Syndrome (MetS). Based on previous research, we hypothesized that WB-EMS significantly improves the Metabolic Syndrome Z score (MetS-Z score) compared with non-training controls. Thirty-two of the initial 72 overweight adults (58 ± 6 years, body mass index: 31 ± 4 kg/m2) with knee osteoarthritis, randomly allocated to a 29-week standard WB-EMS application or to a non-exercising control group (CG) and suffering from MetS, were included. The primary outcome was the MetS-Z score, based on the criteria of the International Diabetes Federation. Secondary outcomes were MetS components, i.e., waist circumference, mean arterial blood pressure, fasting glucose, triglycerides, and HDL-cholesterol. Based on the intention-to-treat principle, analysis of covariance determines differences between the groups (i.e., "effects"). In total, three participants were lost to 29-week follow-up. The attendance rate averaged 89% ± 9% in the WB-EMS group. Adverse effects related to the intervention were not observed. WB-EMS (n = 17) induced a non-significant, medium-size effect (p = 0.061; η 2 = 0.13) on the MetS-Z score compared with non-exercise CG (n = 15). In addition, no significant effects (p ≥ 0.146) were observed for MetS components. In the present study, we observed a moderate, although non-significant effect on the MetS-Z score. Given that the WB-EMS application was well-tolerated and accepted by the participants, we conclude that this exercise technology may offer (limited) benefits for MetS treatment. Nevertheless, further studies should address this issue with higher statistical power.

Whole-body electromyostimulation (WB-EMS) might be an alternative option to conventional strength training for patients with knee osteoarthritis (OA). 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. Seventy-two overweight participants with symptomatic knee OA were assigned to either WB-EMS or CG. MRIs were acquired at baseline and 7 months using a 3 T 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’s Exact and Wilcoxon Rank Sum tests. Fewer knees in the WB-EMS groups showed cartilage worsening compared to the CG (18

Background/Objectives: Fatty infiltration of muscle is a predictor of degeneration. The present study determined the effect of an active spinal orthosis on muscle quality as determined by fatty infiltration in paraspinal muscles in older women with vertebral fractures and kyphosis. Methods: Twenty-one community-dwelling women ≥65 years with chronic back pain and vertebral fractures ≥3 months were randomly allocated to a group which wore the Spinomed active orthoses 2 × 2–3 h/d for 16 weeks (SOG: n = 11) or an untreated control group (CG: n = 10). Outcomes of the present study were parameters related to fatty infiltration of the musculi erector spinae and psoas major as determined by Magnetic Resonance Imaging (MRI). We applied a per protocol analysis; data were consistently adjusted for baseline values applying an ANCOVA. Results: Despite positive trends for all MRI parameters, no significant effects of the active spinal orthosis on fat infiltration of the musculus erector spinae were observed. Significant positive effects were, however, determined for musculus psoas major intra-fascial volume (p = 0.021; d’: 1.18) and muscle tissue volume (p = 0.001; d’: 1.80). No further significant effects on m. psoas major intra-fascial or muscle tissue average fat fraction or m. psoas major intramuscular adipose tissue volume were assessed. Of importance, no changes in variables that might have confounded the present result were reported. Conclusions: In line with recent exercise studies, the present high-volume, low-intensity back-strengthening intervention, induced by an active spinal orthosis, failed to generate significant effects on MRI measures of the m. erector spinae. On the other hand, significant effects on m. psoas major hypertrophy, albeit not fatty muscle infiltration, were determined. This new and unexpected finding should be confirmed by future studies.

Objectives Muscular imbalance and weak back muscles are considered to be key triggers for non-specific chronic low back pain (NCLBP). Whole-body electromyostimulation (WB-EMS) is a safe, joint-friendly and time-effective training technology with considerable evidence of positive effects on NCLBP. The primary hypothesis of the study was that WB-EMS and the recognized Medical Training Therapy (MTT) show equivalent effects on the severity of NCLBP in an ambulatory clinical setting. Material and Methods A total of 26 participants with NCLBP, 40-70 years old were randomly assigned to a WB-EMS (n=13) or a MTT (n=13) group. In the WB-EMS group, low-frequency EMS training was performed 1x 20 min/week, the MTT group performed back-specific strength/stabilization training on devices 1x 45 min/week, both for 10 weeks. The primary outcome was the change in pain intensity of NCLBP as determined by a 7-day diary. Secondary study endpoints were changes in the Roland MorrisDisability Questionnaire (RMDQ) and isometric maximum strength of the back extensors. Results No participant was lost to follow-up or reported adverse events. WB-EMS and MTT showed "equivalent" positive changes in NCLBP. In detail, both groups revealed significant improvements in pain intensity (WB-EMS: - 1.02 +/- 0.49 vs MTT: - 0.93 +/- 0.43 pts.), disability (- 2.46 +/- 0.78 vs. - 2.85 +/- 1.02 items) and back extensor strength (7.2 +/- 3.3 vs. 9.0 +/- 3.5 kg), each without relevant between-group differences. Conclusion In summary, WB-EMS can be considered an effective and safe option to established MTT for the treatment of NCLBP an ambulatory setting.

The guidelines on physiotherapy and exercise for osteoporosis from 2008 have recently been extensively revised on the basis of new scientific findings and possible applications. The S3 guidelines have not yet been approved by consensus and the planned completion date (Association of the Scientific Medical Societies in Germany, AWMF online, registry number 183-002) is autumn 2024. Based on the publication in Issue 3 Osteology (August 2023), key points of the guidelines on physical training and fracture prophylaxis are summarized in abridged form. These are practice-oriented, evidence-based recommendations for optimal training for fracture prevention.

Whole-body electromyostimulation (WB-EMS) has become a time-efficient train-ing method with positive effects on maximum strength, back pain and strength endurance of the lower extremities. Therefore, the aim of the present study was to analyze the influence of a WB-EMS intervention on strength endurance parameters and subjectively perceived back pain in a multicentric implementation. 148 participants (35.2 ± 12.5years, 173.3 ± 9.4cm, 76.6 ± 15.9kg, BMI 25.4 ± 4.6) were divided into an intervention group with a 6-week WB-EMS in-tervention (EMS, n = 81) and an inactive control group (CON, n = 67). Primary outcome measure was strength endurance of the trunk, secondary outcome measures were subjectively perceived back pain and strength endurance of the plan. A two-way analysis of variance (ANOVA) with repeated measures (2 groups x 2 times) was applied for all var-iables. Statistical analysis revealed a significant main effect of time (p < .001, ηp² = .490) and time x group (p < .001, ηp² = .614). Furthermore, significant time effects were detected for VAS24 (p < .001), VAS7 (p < .001), lateral flexion of the right side (p < .001), left side (p < .001), trunk flexion (p < .001), -extension (p < .001) and plank position (p < .001) with significant group differences. WB-EMS leads to significant changes in parameters of strength endurance and subjectively perceived backpain after a 6-week intervention in commercial WB-EMS facilities.