Quick Overview

We always provide direct links to the original research at the end of every article so you can review the evidence yourself.

The Extra Spark: What 24 Trials Say About Adding EMS to Training

Picture a squat.
Your legs already work hard.
Now imagine a timed pulse joining that effort.
That idea sits at the heart of this research.

Purpose

This paper asked a simple training question.
Does EMS on top of a real muscle effort beat ordinary training?
Scientists call that combo NMES+.
They wanted to know if it could lift muscle strength.
They also looked at muscle mass.
They compared it with voluntary training alone.
They also compared it with passive stimulation alone.

The work is a systematic review.
That means the team did not run one small lab test.
They hunted every fitting trial they could find.
Then they judged the evidence as a whole.

Why this source is solid

Four sport scientists led the review.
Riccardo Borzuola, Luciana Labanca and Andrea Macaluso work in Rome.
Their base is the University of Rome Foro Italico.
That university specialises in movement and sport science.
Luca Laudani works in Cardiff.
His base is Cardiff Metropolitan University.
That is a British sport and health faculty.

Italy and the United Kingdom have long research traditions.
This paper went through peer review.
It appeared in 2023 in the European Journal of Sport Science.
Taylor & Francis published it.
That is a major academic publisher in the United Kingdom.
The team followed PRISMA review rules.
They also registered the plan on PROSPERO.
Those steps are standard for serious evidence reviews.

What they gathered

The search ran to 10 March 2022.
They used PubMed, Cochrane Library and Web of Science.
After screening, 24 randomised controlled trials made the cut.
Training blocks lasted from 2 to 12 weeks.
Session counts ranged from 6 to 40.
Every included protocol lasted at least two weeks.
Stimulation sat above motor threshold.
In plain terms, the current made the muscle twitch.

People in the trials were not all the same.
Some were healthy young adults.
Some were healthy older adults.
Some were active young women.
Two trials studied male soccer players.
Other groups included people after ACL surgery.
One trial included people with low muscle in later life.
One trial included people with kneecap pain.
So the evidence is not only about one gym tribe.

What they measured

The main score was strength.
Tests included isometric force.
They also used concentric and eccentric tests.
Some trials tracked power, jumps and sprints.
A smaller set tracked muscle size.
Four papers used MRI for cross-sectional area.
One soccer study used biopsy for type II fibre size.

The bright pattern

Every NMES+ group got stronger than at the start.
That is the first clear signal.
In ten trials, EMS plus effort beat the comparison training.
The extra lift showed up in force and power scores.
The best extra gains came on submaximal work.
That means hard training, not an all-out lockout every time.
The pulse was timed with both the lift and the lower.
Those are the concentric and eccentric phases.

Soccer trials sit in that brighter pile.
Filipovic and colleagues trained male soccer players for seven weeks.
Whole-body EMS sat on max squat jumps.
The NMES+ group beat voluntary training for strength.
It also beat a no-extra-training control.
Type II fibre diameter rose more with NMES+.
Ludwig and colleagues used a 10-week soccer strength block.
Knee, trunk and hip scores favoured the EMS add-on.

Power sports fans should note the jump and sprint work.
Micke and colleagues used eight weeks of strength, jump and sprint drills.
Leg extension force and power rose more with whole-body NMES+.
Dörmann and colleagues saw the same pattern in active young women.
Max force and max power favoured the EMS add-on.

Closed-chain work also featured.
Labanca and colleagues used sit-to-stand after ACL surgery.
Knee extension and flexion strength rose more with NMES+.
A later Labanca trial added step-ups and squats.
Again, the EMS group posted bigger strength gains.
Herrero and colleagues used knee-extension sets in young men.
NMES+ beat voluntary training and a control group.
Pantović and colleagues used plyometric work.
Quadriceps concentric scores favoured NMES+.

Older adults were not left out.
Amiridis and colleagues trained ankle dorsiflexion in older adults.
The NMES+ group beat a no-training control.
Bezerra and colleagues found extra knee strength in older adults.
Benavent-Caballer and colleagues tracked quadriceps size.
After a long block, CSA rose more with NMES+.
Pano-Rodriguez and colleagues studied postmenopausal women.
Peak power favoured whole-body NMES+.
Teschler and colleagues studied people with low muscle.
Overall mean strength favoured whole-body EMS over part-body EMS.
Both beat voluntary work alone.

Muscle size was thinner, but not empty

Only five trials tracked mass well.
Bezerra found a quadriceps size lift in young adults.
Benavent-Caballer found a size lift in very old adults.
Filipovic found thicker type II fibres in soccer players.
That is not a full hypertrophy sweep.
It is still a useful bright note for training talk.

What “better EMS use” looked like

The review did not crown one gadget.
It did point to better-looking methods.
Frequencies often sat from 50 to 120 Hz.
Pulse widths often sat from 150 to 450 microseconds.
Many strong trials used a high tolerated current.

Whole-body trials often used about 60 to 90 percent of max tolerated current.
Electrodes sat on muscle bellies or motor points.
Timing mattered.
Gains looked better when the pulse matched the movement.
Gains looked weaker when current was low.
Gains also looked weaker when the pulse ignored the lift cycle.

When mentioned, people finished the sessions.
The review reported no safety scare in those notes.
That is compliance, not a medical guarantee.

Sports this speaks to first

Soccer is the clearest sport in the set.
Jump, sprint and squat blocks sit next in line.
Strength circuits and gym machines also feature.
Cycling appeared too, with a flatter extra-strength result.
So the cleanest sports read is this.
EMS on top of strength, jump and change-of-direction work is where the review saw extra spark.

Other sports and other users

The paper did not test every sport.
The outcomes still travel.
Any sport that lives on strength and power can study this file.
Think court sports, field sports, track sprints and gym sports.
The user list is wider than elite men.
Healthy young adults showed mixed but often positive strength change.
Active women showed power gains with whole-body work.
Older adults showed strength and, in some work, size gains.
People rebuilding after knee surgery showed extra strength in function drills.
People with low muscle showed extra strength in short whole-body blocks.

That is the honest spread.
Not every trial won.
Seven studies found no extra strength versus voluntary training.
The review still judged the overall strength story as greater or equal.
The bright reading is simple.
Adding well-timed EMS to real effort can stack more strength work into the same session.

How to read this as a training story

Do not treat this as a magic shirt.
Treat it as extra drive on top of a real lift.
The review’s best scenes share one plot.
The person still trains.
The current joins that effort.
The effort stays submaximal enough to leave room.
The pulse hits both the up and the down.
That is the “more” that looked useful.
More signal on the muscle you are already using.

A straight note on claims

This blog walks through a published review.
It is not medical advice.
It does not sell a device.
It does not say EMS treats injury or disease.
Strength scores are training scores.
If you have pain, surgery or a health condition, speak with a qualified professional.
In Australia, device claims sit under strict rules.
A research summary is not a treatment pitch.

The takeaway still has bounce.
Trusted sport labs in Italy and the United Kingdom pulled 24 trials together.
A peer-reviewed European sport journal printed the result.
Across those trials, EMS added to voluntary work often raised strength.
In selected studies it also raised power, jump force and some muscle-size marks.
Soccer players, gym athletes, older adults and rebuilding knees all appear in that brighter file.
Other strength sports can take the same lesson and test it in their own work.

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Research Summary

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