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Feasibility of Lower-Body EMS Combined With Resistance Training in Postmenopausal Women: A Pilot Randomized Controlled Trial (LB-EMS-Pilot)

1. juni 2026 opdateret af: Kyungho Kim, Seoul National University

Feasibility and Preliminary Effects of Lower-Body Electrical Muscle Stimulation Combined With Resistance Training on Body Composition, Muscle Function, Arteriosclerotic Indices, and Autonomic Function in Postmenopausal Women: A Pilot Randomized Controlled Trial

This pilot randomized controlled trial evaluates whether combining lower-body electrical muscle stimulation (EMS) with resistance training is feasible and beneficial for physically inactive postmenopausal women, who experience concurrent declines in muscle strength, body composition, arterial elasticity, and cardiac autonomic balance.

Sixteen physically inactive postmenopausal women aged 50-70 years are randomly assigned (1:1) to either (A) supervised resistance training combined with lower-body EMS (applied to 6 muscle groups: lower back, lower abdomen, glutes, quadriceps, hamstrings, and calves) or (B) supervised resistance training alone. Both groups complete twelve 50-minute sessions (consisting of a 10-minute warm-up, 30-minute main exercise, and a 10-minute cool-down) over 6 weeks (twice weekly). Assessments before and after the intervention include body composition, lower-body muscle function, arterial stiffness, and 5-minute heart rate variability.

The primary aim is to determine the feasibility of the protocol(recruitment, retention, session attendance, and intervention dose delivery) to inform a future definitive trial. Preliminary estimates of intervention effects on the measured outcomes are reported as secondary aims.

Studieoversigt

Detaljeret beskrivelse

BACKGROUND AND RATIONALE Postmenopausal women often experience physiological declines in muscle function, body composition, and cardiovascular health. While resistance training is an established countermeasure, maximizing its efficiency and adherence remains a challenge. Applying lower-body electrical muscle stimulation (EMS) during resistance training may enhance physiological adaptations and overall training effectiveness. This study aims to evaluate the feasibility of combining lower-body EMS with resistance training in physically inactive postmenopausal women to inform the design of a future definitive trial.

STUDY DESIGN This is a pilot randomized controlled trial. Participants will be randomly assigned to either an intervention group receiving combined lower-body EMS and resistance training or a control group receiving resistance training alone. Clinical and physiological outcomes will be assessed before and after the intervention period to evaluate preliminary effects.

PRIMARY FEASIBILITY OUTCOMES

The primary objective is to evaluate the feasibility of the study protocol. Feasibility will be determined by assessing several key components, including:

Recruitment: The ability to recruit the target population within the planned timeframe.

Retention: The proportion of participants who complete the study and post-intervention assessments.

Adherence: Participant attendance and compliance with the scheduled exercise sessions.

Intervention Fidelity: The successful delivery of the exercise intensity and EMS protocol as intended.

These components will be evaluated against pre-established progression criteria to determine whether the protocol can proceed to a larger trial or requires modification.

STATISTICAL APPROACH Feasibility outcomes will be summarized primarily using descriptive statistics. For secondary physiological and clinical outcomes, appropriate statistical methods will be utilized to estimate the preliminary effects of the intervention, comparing changes between the groups while adjusting for baseline measurements. Effect sizes and confidence intervals will be calculated to provide preliminary evidence and to assist with sample size calculations for future large-scale trials.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

16

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Seoul
      • Seoul, Seoul, Sydkorea, 08826
        • Rekruttering
        • Seoul National University
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ja

Beskrivelse

Inclusion Criteria:

  • Women aged 50 to 70 years.
  • Menopause for at least 1 year with no current menstruation.
  • Physically inactive (have not participated in resistance training more than twice a week for the past 6 months)

Exclusion Criteria:

  • Currently receiving hormone replacement therapy (HRT).
  • Presence of implanted electrical medical devices.
  • Severe or uncontrolled medical conditions.
  • Any surgery within the past 6 months.
  • Acute illness with fever, infection, or active inflammation.
  • Severe peripheral arterial disease or abdominal/inguinal hernia.
  • Severe psychiatric disorders requiring medication, or current substance abuse.
  • Deemed physically or mentally unfit to participate in the exercise program by the investigator.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Andet
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: A Group: EMS + Resistance Training
Lower-body EMS combined with 8 machine-based resistance exercises for 6 weeks, 2 sessions per week.
Electrical muscle stimulation (85 Hz, 350 μs, cycle 11, duty approx 1:2) applied to 6 muscle groups: lower back (erector spinae), lower abdomen, glutes, quadriceps, hamstrings, and calves.
A 50-minute session consisting of a 10-minute warm-up, 30 minutes of main exercise (8 machine-based lower-body resistance exercises, 3 sets of 8-12 repetitions), and a 10-minute cool-down.
Aktiv komparator: B Group: Resistance Training
8 machine-based resistance exercises for 6 weeks, 2 sessions per week without EMS.
A 50-minute session consisting of a 10-minute warm-up, 30 minutes of main exercise (8 machine-based lower-body resistance exercises, 3 sets of 8-12 repetitions), and a 10-minute cool-down.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Composite Feasibility Outcome (Recruitment, Retention, Session Attendance, and Intervention Dose Delivery)
Tidsramme: Baseline and Week 6

The primary outcome is the feasibility of the study protocol, assessed via recruitment rates, participant retention, session adherence, and targeted intervention delivery. These indicators will be evaluated against pre-defined progression criteria using descriptive statistics to determine whether to proceed with or modify the protocol for a future definitive trial.

Unit: Percentage

Baseline and Week 6

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Skeletal Muscle Mass Index (SMI)
Tidsramme: Baseline and Week 6
Appendicular skeletal muscle mass divided by height squared. Unit: kg/m².
Baseline and Week 6
Total Body Muscle Mass
Tidsramme: Baseline and Week 6
Total skeletal muscle mass of the whole body. Unit: kg
Baseline and Week 6
Total Leg Muscle Mass
Tidsramme: Baseline and Week 6
Combined left and right leg skeletal muscle mass. Unit: kg
Baseline and Week 6
Body Fat Percentage
Tidsramme: Baseline and Week 6
Body fat mass expressed as a percentage of total body weight. Unit: %
Baseline and Week 6
Total Body Fat Mass
Tidsramme: Baseline and Week 6
Absolute total body fat in kilograms. Unit: kg
Baseline and Week 6
Estimated Visceral Fat Area (eVFA)
Tidsramme: Baseline and Week 6
Estimated visceral fat area at the umbilical level. Unit: cm²
Baseline and Week 6
Waist Circumference
Tidsramme: Baseline and Week 6
Circumference measured at the level of the umbilicus. Unit: cm
Baseline and Week 6
Waist-to-Hip Ratio (WHR)
Tidsramme: Baseline and Week 6
Waist circumference divided by hip circumference. Unit: ratio
Baseline and Week 6
Body Mass Index (BMI)
Tidsramme: Baseline and Week 6
Body weight in kilograms divided by the square of height in meters. Unit: kg/m²
Baseline and Week 6
Phase Angle
Tidsramme: Baseline and Week 6

Whole-body bioimpedance phase angle derived from the arctangent of the reactance-to-resistance ratio. Marker of cellular membrane integrity and overall nutritional/health status.

Unit: degrees

Baseline and Week 6
Dominant Knee Extensor Peak Torque per Body Weight at 60°/s
Tidsramme: Baseline and Week 6

Peak concentric knee extensor torque normalized to body weight, measured at 60°/sec angular velocity on the dominant limb.

Unit: Nm/kg

Baseline and Week 6
Non-dominant Knee Extensor Peak Torque per Body Weight at 60°/s
Tidsramme: Baseline and Week 6

Peak concentric knee extensor torque normalized to body weight at 60°/sec on the non-dominant limb.

Unit: Nm/kg

Baseline and Week 6
Dominant Knee Flexor Peak Torque per Body Weight at 60°/s
Tidsramme: Baseline and Week 6

Peak concentric knee flexor (hamstring) torque normalized to body weight at 60°/sec on the dominant limb.

Unit: Nm/kg

Baseline and Week 6
Non-dominant Knee Flexor Peak Torque per Body Weight at 60°/s
Tidsramme: Baseline and Week 6

Peak concentric knee flexor torque normalized to body weight at 60°/sec on the non-dominant limb.

Unit: Nm/kg

Baseline and Week 6
Dominant Hamstring-to-Quadriceps (H/Q) Ratio at 60°/s
Tidsramme: Baseline and Week 6

Ratio of knee flexor peak torque to knee extensor peak torque at 60°/sec on the dominant limb.

Unit: ratio

Baseline and Week 6
Non-dominant Hamstring-to-Quadriceps (H/Q) Ratio at 60°/s
Tidsramme: Baseline and Week 6

Ratio of knee flexor peak torque to knee extensor peak torque at 60°/sec on the non-dominant limb.

Unit: ratio

Baseline and Week 6
Dominant Total Work Done by Knee Extensor per Body Weight at 180°/s
Tidsramme: Baseline and Week 6

Total work performed by knee extensors across the test set, normalized to body weight, at 180°/sec angular velocity on the dominant limb.

Unit: Nm/kg

Baseline and Week 6
Non-dominant Total Work Done by Knee Extensor per Body Weight at 180°/s
Tidsramme: Baseline and Week 6

Total work performed by knee extensors normalized to body weight at 180°/sec on the non-dominant limb.

Unit: Nm/kg

Baseline and Week 6
Dominant Total Work Done by Knee Flexor per Body Weight at 180°/s
Tidsramme: Baseline and Week 6

Total work performed by knee flexors normalized to body weight at 180°/sec on the dominant limb.

Unit: Nm/kg

Baseline and Week 6
Non-dominant Total Work Done by Knee Flexor per Body Weight at 180°/s
Tidsramme: Baseline and Week 6

Total work performed by knee flexors normalized to body weight at 180°/sec on the non-dominant limb.

Unit: Nm/kg

Baseline and Week 6
Average Brachial-Ankle Pulse Wave Velocity (baPWV)
Tidsramme: Baseline and Week 6

Mean of left and right brachial-ankle pulse wave velocity; primary indicator of large-artery stiffness.

Unit: cm/s

Baseline and Week 6
Highest Brachial-Ankle Pulse Wave Velocity (baPWV)
Tidsramme: Baseline and Week 6
The higher of left and right baPWV values, reflecting the most affected limb. Unit: cm/s
Baseline and Week 6
Brachial Systolic Blood Pressure (SBP)
Tidsramme: Baseline and Week 6
Brachial systolic blood pressure. Unit: mmHg
Baseline and Week 6
Brachial Diastolic Blood Pressure (DBP)
Tidsramme: Baseline and Week 6
Brachial diastolic blood pressure. Unit: mmHg
Baseline and Week 6
Pulse Pressure (PP)
Tidsramme: Baseline and Week 6
Pulse pressure calculated as systolic minus diastolic blood pressure. Unit: mmHg
Baseline and Week 6
Mean Arterial Pressure (MAP)
Tidsramme: Baseline and Week 6
Mean arterial pressure derived from systolic and diastolic blood pressure. Unit: mmHg
Baseline and Week 6
Average Ankle-Brachial Index (ABI)
Tidsramme: Baseline and Week 6
Mean of left and right ankle-brachial systolic blood pressure ratio. Unit: ratio
Baseline and Week 6
Augmentation Index (AI)
Tidsramme: Baseline and Week 6
Augmentation index derived from second-derivative photoplethysmography. Unit: unitless
Baseline and Week 6
Root Mean Square of Successive Differences (RMSSD)
Tidsramme: Baseline and Week 6

Root mean square of successive differences between adjacent normal-to-normal RR intervals.

Unit: ms

Baseline and Week 6
High-Frequency (HF) Power
Tidsramme: Baseline and Week 6

Spectral power in the high-frequency band (0.15-0.4 Hz); index of parasympathetic (vagal) activity.

Unit: ms²

Baseline and Week 6
Standard Deviation of NN Intervals (SDNN)
Tidsramme: Baseline and Week 6

Standard deviation of all normal-to-normal RR intervals; time-domain index of overall heart rate variability.

Unit: ms

Baseline and Week 6
Low-Frequency (LF) Power
Tidsramme: Baseline and Week 6
Spectral power in the low-frequency band (0.04-0.15 Hz). Unit: ms²
Baseline and Week 6
LF/HF Ratio
Tidsramme: Baseline and Week 6
Ratio of low-frequency to high-frequency spectral power. Unit: ratio
Baseline and Week 6
High-Frequency Normalized Units (HFnu)
Tidsramme: Baseline and Week 6
HF power expressed in normalized units = HF / (LF + HF) × 100. Unit: n.u.
Baseline and Week 6
Low-Frequency Normalized Units (LFnu)
Tidsramme: Baseline and Week 6
LF power expressed in normalized units = LF / (LF + HF) × 100. Unit: n.u.
Baseline and Week 6
Total Power (TP)
Tidsramme: Baseline and Week 6
Total spectral power up to 0.4 Hz. Unit: ms²
Baseline and Week 6
Very-Low-Frequency (VLF) Power
Tidsramme: Baseline and Week 6
Spectral power in the very-low-frequency band (≤0.04 Hz). Unit: ms²
Baseline and Week 6

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Dominant Knee Extensor Fatigue Index at 180°/s
Tidsramme: Baseline and Week 6

Percentage decline in knee extensor torque across the repetition set at 180°/sec on the dominant limb.

Unit: %

Baseline and Week 6
Non-dominant Knee Extensor Fatigue Index at 180°/s
Tidsramme: Baseline and Week 6

Percentage decline in knee extensor torque across the repetition set at 180°/sec on the non-dominant limb.

Unit: %

Baseline and Week 6
Dominant Knee Flexor Fatigue Index at 180°/s
Tidsramme: Baseline and Week 6

Percentage decline in knee flexor torque across the repetition set at 180°/sec on the dominant limb.

Unit: %.

Baseline and Week 6
Non-dominant Knee Flexor Fatigue Index at 180°/s
Tidsramme: Baseline and Week 6

Percentage decline in knee flexor torque across the repetition set at 180°/sec on the non-dominant limb.

Unit: %

Baseline and Week 6
Bilateral Deficit of Knee Extensors at 60°/s
Tidsramme: Baseline and Week 6

Percentage asymmetry of knee extensor peak torque between dominant and non-dominant limbs at 60°/sec.

Unit: %

Baseline and Week 6
Bilateral Deficit of Knee Flexors at 60°/s
Tidsramme: Baseline and Week 6

Percentage asymmetry of knee flexor peak torque between dominant and non-dominant limbs at 60°/sec.

Unit: %

Baseline and Week 6
Dominant Total Work Done H/Q Ratio at 180°/s
Tidsramme: Baseline and Week 6

Ratio of knee flexor to knee extensor total work done at 180°/sec on the dominant limb.

Unit: ratio

Baseline and Week 6
Non-dominant Total Work Done H/Q Ratio at 180°/s
Tidsramme: Baseline and Week 6

Ratio of knee flexor to knee extensor total work done at 180°/sec on the non-dominant limb.

Unit: ratio

Baseline and Week 6
Arterial Elasticity (AE)
Tidsramme: Baseline and Week 6
Arterial elasticity index derived from second-derivative photoplethysmography. Unit: unitless
Baseline and Week 6
Peripheral Elasticity (PE)
Tidsramme: Baseline and Week 6

Peripheral elasticity index derived from second-derivative photoplethysmography.

Unit: unitless.

Baseline and Week 6

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Yeon Soo Kim, MD, Prof, Seoul National University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juni 2026

Primær færdiggørelse (Anslået)

1. juli 2026

Studieafslutning (Anslået)

1. august 2026

Datoer for studieregistrering

Først indsendt

1. juni 2026

Først indsendt, der opfyldte QC-kriterier

1. juni 2026

Først opslået (Faktiske)

5. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. juni 2026

Sidst verificeret

1. juni 2026

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