Effect of eccentric strength testing on delayed-onset muscle pain

This investigation was designed to determine the effect of eccentric strength testing on delayed-onset muscle pain in 20 untrained university students. Initially, eccentric strength testing (5-repetition maximum [5RM]) was performed bilaterally. Next, 1 arm completed 3 sets of 10 eccentric repetitions to induce delayed-onset muscle pain. Then, in a subsequent session, whichever arm previously performed only the 5RM test completed the 5RM test a second time and the 3 sets of 10 eccentric repetitions. Statistical analyses supported significantly increased pain intensity and unpleasantness across 48 hours post-5RM test alone. However, pain intensity and unpleasantness after the eccentric training bouts were significantly lower in the arm that performed 2 5RM tests than the arm that performed only 1. Thus, the eccentric strength testing produced delayed-onset muscle pain and protected against future delayed-onset muscle pain. These effects should be considered when such testing is used in baseline strength assessments.     

Effects of a protease supplement on eccentric exercise-induced markers of delayed-onset muscle soreness and muscle damage

This investigation examined the effects of a protease supplement on selected markers of muscle damage and delayed-onset muscle soreness (DOMS). The study used a double-blinded, placebo-controlled, crossover design. Twenty men (mean +/- SD age = 21.0 +/- 3.1 years) were randomly assigned to either a supplement group (SUPP) or a placebo group (PLAC). All subjects were tested for unilateral isometric forearm flexion strength, hanging joint angle, relaxed arm circumference, subjective pain rating, and plasma creatine kinase activity and myoglobin concentration. The testing occurred before (TIME1), immediately after (TIME2), and 24 (TIME3), 48 (TIME4), and 72 (TIME5) hours after a bout of eccentric exercise. During these tests, the subjects in the SUPP group ingested a protease supplement. The subjects in the PLAC group took microcrystalline cellulose. After testing at TIME5 and 2 weeks of rest, the subjects were crossed over into the opposite group and performed the same tests as during visits 1-5, but with the opposite limb. Overall, isometric forearm flexion strength was greater (7.6%) for the SUPP group than for the PLAC group, despite nearly identical (difference = 0.14 N.m, p = 0.940) mean strength values before (TIME1) the eccentric exercise protocol. There were no between-group differences for hanging joint angle, relaxed arm circumference, subjective pain ratings, and plasma creatine kinase activity and myoglobin concentration from TIME1 to TIME5. These findings provided initial evidence that the protease supplement may be useful for reducing strength loss immediately after eccentric exercise and for aiding in short-term strength recovery. The protease supplement had no effect, however, on the perception of pain associated with DOMS or the blood markers of muscle damage.     

Elimination of delayed-onset muscle soreness by pre-resistance cardioacceleration before each set

We compared delayed-onset muscle soreness (DOMS) induced by anaerobic resistance exercises with and without aerobic cardioacceleration before each set, under the rationale that elevated heart rate (HR) may increase blood perfusion in muscles to limit eccentric contraction damage and/or speed muscle recovery. In two identical experiments (20 men, 28 women), well-conditioned athletes paired by similar physical condition were assigned randomly to experimental or control groups. HR (independent variable) was recorded with HR monitors. DOMS (dependent variable) was self-reported using Borg's Rating of Perceived Pain scale. After identical pre-training strength testing, mean DOMS in the experimental and control groups was indistinguishable (P > or = 0.19) for musculature employed in eight resistance exercises in both genders, validating the dependent variable. Subjects then trained three times per week for 9 (men) to 11 (women) weeks in a progressive, whole-body, concurrent training protocol. Before each set of resistance exercises, experimental subjects cardioaccelerated briefly (mean HR during resistance training, 63.7% HR reserve), whereas control subjects rested briefly (mean HR, 33.5% HR reserve). Mean DOMS among all muscle groups and workouts was discernibly less in experimental than control groups in men (P = 0.0000019) and women (P = 0.0007); less for each muscle group used in nine resistance exercises in both genders, discernible (P < 0.025) in 15 of 18 comparisons; and less in every workout, discernible (P < 0.05) in 32% (men) and 55% (women) of workouts. Most effect sizes were moderate. In both genders, mean DOMS per workout disappeared by the fourth week of training in experimental but not control groups. Aerobic cardioacceleration immediately before each set of resistance exercises therefore rapidly eliminates DOMS during vigorous progressive resistance training in athletes.     

Resting energy expenditure and delayed-onset muscle soreness after full-body resistance training with an eccentric concentration

The purpose of this investigation was to determine the effect of an acute bout of high-volume, full-body resistance training with an eccentric concentration on resting energy expenditure (REE) and indicators of delayed-onset muscle soreness (DOMS). Eight resistance trained (RT) and eight untrained (UT) participants (mean: age = 23.5 years; height = 180.76 cm; weight = 87.58 kg; body fat = 19.34%; lean mass = 68.71 kg) were measured on four consecutive mornings for REE and indicators of DOMS: creatine kinase (CK) and rating of perceived muscle soreness (RPMS). Delayed-onset muscle soreness was induced by performing eight exercises, eight sets, and six repetitions using a 1-second concentric and 3-second eccentric muscle action duration. A two-factor repeated-measures analysis of variance revealed that REE was significantly (p < 0.05) elevated at 24, 48, and 72 hours post compared with baseline measures for both UT and RT groups. Ratings of perceived muscle soreness were significantly elevated within groups for UT and RT at 24 and 48 hours post and for UT only at 72 hours post compared with baseline (p < 0.05). Nonparametric analyses revealed that CK was significantly increased at 24 hours post for both UT and RT and at 48 and 72 hours post for UT only compared with baseline (p < 0.05). Resting energy expenditure and indicators of DOMS were higher in UT compared with RT on all measures, but no significant differences were determined. The main finding of this investigation is that full-body resistance training with an eccentric concentration significantly increased REE up to 72 hours postexercise in UT and RT participants.     

Effects of aerobic exercise on strength performance following various periods of recovery

The purpose of this study was to determine if the type and intensity of aerobic training affects performance in a subsequent strength-training session after varying periods of recovery. Sixteen male subjects participated in the study and were divided into 2 groups based on aerobic training, high-intensity intervals (MAX n = 8) and continuous submaximal (SUB n = 8). Each subject performed 4 sets of both bench press and leg press at approximately 75% 1 repetition maximum (1RM) following aerobic training with recovery periods of 4, 8, and 24 hours, as well as once in a control condition. Both the 4- and 8-hour conditions resulted in fewer total leg press repetitions than the control and 24-hour conditions. There was no difference between both the control and 24-hour conditions. No main effect was shown with respect to the type of aerobic training. It was concluded that when aerobic training precedes strength training, the volume of work that can be performed is diminished for up to 8 hours. This impairment appears to be localized to the muscle groups involved in the aerobic training.     

Body mass bias in a competition of muscle strength and aerobic power

Recently, a fitness competition called the Pump and Run (PR) has been popularized. Composed of 2 events, a 5-km road race time (RT) in seconds and a maximal-repetition bench press (BPR) with resistance based on a percentage of body mass (M), the final score (RTadj) equals RT - 30(BPR). From published findings, the authors hypothesized that the PR would impose a bias against heavier competitors. Furthermore, the potential for age bias in this event has not been evaluated. Therefore, the purpose of this study was to investigate M and age bias in the PR for men and women. For 74 female and 343 male competitors in a large PR event, RT, BPR, M, and age were collected from official competition results. Two subsamples were randomly created from the original sample: the validation (VAL) (54 women and 258 men) and the cross-validation (CVAL) (20 women and 85 men). For the VAL sample, the RTadj showed significant bias against heavier runners (women r = 0.35; men r = 0.28; P < 0.01 for both) but no age bias (women r = 0.04; men r = 0.005; P > 0.05 for both). Using allometric modeling, the authors developed a set of M-based correction factors to be multiplied by each RTadj to yield new adjusted run times (NRTadj) that would be free of M bias. As applied to the CVAL sample, the NRTadj values virtually eliminated the M bias (women r = 0.04; men r = 0.002; P > 0.05 for both) of the current PR scoring system and retained the absence of age bias (women r = 0.02; men r = 0.0002; P > 0.05 for both). The authors recommend the use of the NRTadj scores for future PR competitions.     

Oxidative stress and delayed-onset muscle damage after exercise

Reactive oxygen species (ROS) produced during exercise may be involved in delayed-onset muscle damage related to inflammation. To investigate this hypothesis, we studied whether oxidative stress increases nuclear translocation of nuclear factor-kappaB and chemokine expression in skeletal muscle using myotube L6 cells. We also assessed whether prolonged acute exercise could increase these parameters in rats. In L6 cells, H(2)O(2) induced nuclear translocation of p65 and increased the expression of cytokine-induced neutrophil chemoattractant-1 (CINC-1) and monocyte chemoattractant protein-1 (MCP-1), whereas preincubation with alpha-tocopherol limited the increase in these proteins. Sprague Dawley rats were divided into the following groups: rested control, exercised, rested with a high alpha-tocopherol diet, and exercised with a high alpha-tocopherol diet. After 3 weeks of acclimation, both exercise groups ran on a treadmill at 25 m/min for 60 min. Exercise increased nuclear p65, CINC-1, and MCP-1 in gastrocnemius muscle cells, but these changes were ameliorated by the high alpha-tocopherol diet. Increases in myeloperoxidase and thiobarbituric acid-reactive substrates were ameliorated by a high alpha-tocopherol diet, as were the histological changes. Neutrophil activity was not altered by either exercise or a high alpha-tocopherol diet. These results indicate that delayed-onset muscle damage induced by prolonged exercise is partly related to inflammation via phagocyte infiltration caused by ROS and that alpha-tocopherol (an antioxidant) can attenuate such inflammatory changes.     

Treatment and prevention of delayed onset muscle soreness

Eccentric exercise continues to receive attention as a productive means of exercise. Coupled with this has been the heightened study of the damage that occurs in early stages of exposure to eccentric exercise. This is commonly referred to as delayed onset muscle soreness (DOMS). To date, a sound and consistent treatment for DOMS has not been established. Although multiple practices exist for the treatment of DOMS, few have scientific support. Suggested treatments for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and many more. DOMS is particularly prevalent in resistance training; hence, this article may be of particular interest to the coach, trainer, or physical therapist to aid in selection of efficient treatments. First, we briefly review eccentric exercise and its characteristics and then proceed to a scientific and systematic overview and evaluation of treatments for DOMS. We have classified treatments into 3 sections, namely, pharmacological, conventional rehabilitation approaches, and a third section that collectively evaluates multiple additional practiced treatments. Literature that addresses most directly the question regarding the effectiveness of a particular treatment has been selected. The reader will note that selected treatments such as anti-inflammatory drugs and antioxidants appear to have a potential in the treatment of DOMS. Other conventional approaches, such as massage, ultrasound, and stretching appear less promising.     

Time course of strength and echo intensity recovery after resistance exercise in women

The purpose of this study was to evaluate the time course responses of strength, delayed-onset muscle soreness (DOMS), muscle thickness (MT), circumference (CIRC), and ultrasonography echo intensity (EI) after a traditional hypertrophic isoinertial resistance training session in young women. Ten (22.0 ± 3.2 years) healthy, untrained volunteers participated in the study. The resistance exercise session consisted of 4 sets of 10 repetitions at 80% of 1 repetition maximum (1RM) of the dominant arm elbow flexors. Maximum isometric elbow flexion peak torque (PT) at 90°, MT, and EI were recorded for both arms at baseline (PRE), immediately after exercise (0 hours) and at 24, 48, and 72 hours after exercise. Comparisons were made using a 2 × 5 mixed factor analysis of variance. There was a significant (p < 0.05) loss in PT and increase in MT at 0, 24, 48, and 72 hours. In contrast, EI increased only after 24, 48, and 72 hours, not at 0 hours. There were no significant changes in PT, DOMS, MT, and EI in the nondominant (control) arm after the exercise protocol. Our data suggest that after 4 sets of 80% of 1RM of unilateral elbow flexion resistance exercise, nonresistance trained women need >72 hours to fully recover muscle strength, MT, CIRC, and EI. Furthermore, the EI appears to be a sensitive and reliable method to assess MD.     

The influence of maximal aerobic power on recovery of skeletal muscle following anaerobic exercise

Phosphorus magnetic resonance spectroscopy (³¹P-MRS) was used to investigate the influence of maximal aerobic power (˙VO _2max) on the recovery of human calf muscle from high-intensity exercise. The (˙VOO_2max) of 21 males was measured during treadmill exercise and subjects were assigned to either a low-aerobic-power (LAP) group (n = 10) or a high-aerobic-power (HAP) group (n = 11). Mean (SE) ˙VO _2max of the groups were 46.6 (1.1) and 64.4 (1.4) ml · kg⁻¹ · min⁻¹, respectively. A calf ergometry work capacity test was used to assign the same relative exercise intensity to each subject for the MRS protocol. At least 48 h later, subjects performed the rest (4 min), exercise (2 min) and recovery (10 min) protocol in a 1.5 T MRS scanner. The relative concentration of phosphocreatine (PCr) was measured throughout the protocol and intracellular pH (pH_i) was determined from the chemical shift between inorganic phospate (P_i) and PCr. End-exercise PCr levels were 27 (3.4) and 25 (3.5)% of resting levels for LAP and HAP respectively. Mean resting pH_i was 7.07 for both groups, and following exercise it fell to 6.45 (0.04) for HAP and 6.38 (0.04) for LAP. Analysis of data using non-linear regression models showed no differences in the rate of either PCr or pH_i recovery. The results suggest that ˙VO_2max is a poor predictor of metabolic recovery rate from high-intensity exercise. Differences in recovery rate observed between individuals with similar ˙VO_2max imply that other factors influence recovery. Accepted: 17 December 1996     

Effect of muscle wrapping on model estimates of neck muscle strength

Of the computational models of the cervical spine reported in the literature, not one takes into account the changes in muscle paths due to the underlying vertebrae. Instead, all model the individual muscle paths as straight-line segments. The major aim of this study was to quantify the changes in muscle moment arm, muscle force and joint moment due to muscle wrapping in the cervical spine. Five muscles in a straight-line model of the cervical spine were wrapped around underlying vertebrae, and the results obtained from this model were compared against the original. The two models were then validated against experimental and computational data. Results show that muscle wrapping has a significant effect on muscle moment arms and therefore joint moments and should not be neglected.     

The effect of pomegranate juice supplementation on strength and soreness after eccentric exercise

The purpose of this study was to determine if pomegranate juice supplementation improved the recovery of skeletal muscle strength after eccentric exercise in subjects who routinely performed resistance training. Resistance trained men (n = 17) were randomized into a crossover design with either pomegranate juice or placebo. To produce delayed onset muscle soreness, the subjects performed 3 sets of 20 unilateral eccentric elbow flexion and 6 sets of 10 unilateral eccentric knee extension exercises. Maximal isometric elbow flexion and knee extension strength and muscle soreness measurements were made at baseline and 2, 24, 48, 72, 96, and 168 hours postexercise. Elbow flexion strength was significantly higher during the 2- to 168-hour period postexercise with pomegranate juice compared with that of placebo (main treatment effect; p = 0.031). Elbow flexor muscle soreness was also significantly reduced with pomegranate juice compared with that of placebo (main treatment effect; p = 0.006) and at 48 and 72 hours postexercise (p = 0.003 and p = 0.038, respectively). Isometric strength and muscle soreness in the knee extensors were not significantly different with pomegranate juice compared with those using placebo. Supplementation with pomegranate juice attenuates weakness and reduces soreness of the elbow flexor but not of knee extensor muscles. These results indicate a mild, acute ergogenic effect of pomegranate juice in the elbow flexor muscles of resistance trained individuals after eccentric exercise.     

Effect of range of motion on muscle strength and thickness

The purpose of this investigation was to compare partial range-of-motion vs. full range-of-motion upper-body resistance training on strength and muscle thickness (MT) in young men. Volunteers were randomly assigned to 3 groups: (a) full range of motion (FULL; n = 15), (b) partial range of motion (PART; n = 15), or (c) control (CON; n = 10). The subjects trained 2 d · wk(-1) for 10 weeks in a periodized program. Primary outcome measures included elbow flexion maximal strength measured by 1 repetition maximum (1RM) and elbow flexors MT measured by ultrasound. The results indicated that elbow flexion 1RM significantly increased (p < 0.05) for the FULL (25.7 ± 9.6%) and PART groups (16.0 ± 6.7%) but not for the CON group (1.7 ± 5.5%). Also, FULL 1RM strength was significantly greater than the PART 1RM after the training period. Average elbow flexor MT significantly increased for both training groups (9.65 ± 4.4% for FULL and 7.83 ± 4.9 for PART). These data suggest that muscle strength and MT can be improved with both FULL and PART resistance training, but FULL may lead to greater strength gains.     

Inhibitory effect of fermented milk on delayed-onset muscle damage after exercise

Milk fermented with a starter containing Lactobacillus helveticus and Saccharomyces cerevisiae is drunk on a daily basis by many people in Japan and has several beneficial effects. We studied the influence of this fermented milk product on muscle damage after prolonged exercise in rats. Wistar rats were divided into four groups: rested controls, rested rats given fermented milk diet, exercised rats and exercised rats given fermented milk diet. After 3 weeks of acclimatization, both exercise groups were made to run on a treadmill at 26 m/min for 60 min. Exercise increased the serum creatine kinase level, as well as myeloperoxidase activity and the level of thiobarbituric-acid-reactive substances in the gastrocnemius muscle after 24 h. These changes were ameliorated by intake of fermented milk. An increase of CINC-1 was also ameliorated by fermented milk. Furthermore, milk diet increased the mRNA and protein levels of protective proteins such as antioxidants and chaperone proteins. These results indicate that fermented milk can ameliorate delayed-onset muscle damage after prolonged exercise, which is associated with an increased antioxidant capacity of muscles.     

Effect of radiation dose on the recovery of aerobic and anaerobic bacteria from mice

The presence of aerobic and anaerobic bacteria in the blood, spleen, and liver was investigated in mice that were exposed to 7, 8, 9, or 10 Gy 60Co radiation. Microorganisms were detected more often in animals exposed to higher doses of radiation. The number of mice that were culture positive and the number of isolates in one site increased with increasing dose. Bacteria were recovered in mice killed at various times after radiation, in 3 of 100 mice exposed to 7 Gy, in 13 of 100 irradiated with 8 Gy, in 23 of 90 exposed to 9 Gy, and in 34 of 87 irradiated with 10 Gy. The predominant organisms recovered were Escherichia coli, anaerobic Gram-positive cocci, Proteus mirabilis, Staphylococcus aureus, and Bacteroides spp. Escherichia coli and anaerobes were more often isolated in animals exposed to 10 Gy, while S. aureus was more often recovered in those irradiated with 9 Gy. These data demonstrate a relationship between the dose of radiation and the rate of infection due to enteric aerobic and anaerobic bacteria.     

Effect of rest interval on strength recovery in young and old women

This study compares the effects of rest intervals on isokinetic muscle torque recovery between sets of a knee extensor and flexor exercise protocol in physically active younger and older women. Twenty young (22.4 +/- 1.7 years) and 16 older (70.7 +/- 4.3 years) women performed three sets of eight maximum repetitions of knee extension/flexion at 60 degrees x s(-1). The rest interval between sets was 15, 30, and 60 seconds and was randomly assigned across three testing days. No significant interaction of rest by set by age group was observed. There was a significant decline in mean knee extensor torque when 15- and 30-second rest intervals were used between sets, but not when a 60-second rest interval was applied for both the young and the old women. No significant decline for mean knee flexor torque was observed in the older women when a 30-second rest interval was used, whereas a longer 60-second rest interval was required in younger women. Active younger and older women require similar rest intervals between sets of a knee extensor exercise (60 seconds) for complete recovery. However, older women recovered faster (30 seconds) than younger women (60 seconds) between sets of a knee flexor exercise. The exercise-to-rest ratio for knee extensors was similar for young and old women (1:2). Old women required only a 1:1 exercise-to-rest ratio for knee flexor recovery, whereas younger women required a longer 1:2 exercise-to-rest ratio. The results of the present study are specific to isokinetic testing and training and are more applicable in rehabilitation and research settings. Practitioners should consider age and gender when prescribing rest intervals between sets.     

Acute effect of two aerobic exercise modes on maximum strength and strength endurance

The purpose of this study was to evaluate the effects of 2 modes of aerobic exercise (continuous or intermittent) on maximum strength (1 repetition maximum, 1RM) and strength endurance (maximum repetitions at 80% of 1RM) for lower- and upper-body exercises to test the acute hypothesis in concurrent training (CT) interference. Eight physically active men (age: 26.9 +/- 4.2 years; body mass: 82.1 +/- 7.5 kg; height: 178.9 +/- 6.0 cm) were submitted to: (a) a graded exercise test to determine V(.-)O2max (39.26 +/- 6.95 ml x kg(-1) x min(-1)) and anaerobic threshold velocity (3.5 mmol x L(-1)) (9.3 +/- 1.27 km x h(-1)); (b) strength tests in a rested state (control); and (c) 4 experimental sessions, at least 7 days apart. The experimental sessions consisted of a 5-kilometer run on a treadmill continuously (90% of the anaerobic threshold velocity) or intermittently (1:1 minute at V(.-)O2max). Ten minutes after the aerobic exercise, either a maximum strength or a strength endurance test was performed (leg press and bench press exercises). The order of aerobic and strength exercises followed a William's square distribution to avoid carryover effects. Results showed that only the intermittent aerobic exercise produced an acute interference effect on leg strength endurance, decreasing significantly (p < 0.05) the number of repetitions from 10.8 +/- 2.5 to 8.1 +/- 2.2. Maximum strength was not affected by the aerobic exercise mode. In conclusion, the acute interference hypothesis in concurrent training seems to occur when both aerobic and strength exercises produce significant peripheral fatigue in the same muscle group.     

Influence of surface on muscle damage and soreness induced by consecutive drop jumps

This study compared the magnitude of muscle damage induced when consecutive drop jumps (DJs) were performed on sand vs. firm (wood) surfaces from a height of 0.6 m. Eight subjects performed DJs on a sand surface at a depth of 0.2 m (S condition), and 8 other subjects performed DJs on a wood surface (F condition). Each set consisted of 20 DJs with an interval of 10 seconds between jumps. Subjects performed 5 sets of DJs with 2 minutes between sets. Maximal isometric force, muscle soreness, and plasma creatine kinase (CK) activity were measured immediately before and immediately after the DJ exercise as well as 1, 24, 48, 72, and 96 hours after the DJ exercise. All measures changed significantly (p < 0.05) after exercise for both conditions; however, significantly (p < 0.05) smaller changes in these measures were evident for the S condition than for the F condition. These results show that DJs on a sand surface induce less muscle damage than on a firm surface. Training on sand may improve aerobic capacity or strength with a low risk of muscle damage.     

Effect of conditioning contraction intensity on postactivation potentiation is muscle dependent

We aimed to examine whether the influence of conditioning contraction intensity on the extent of postactivation potentiation (PAP) is muscle dependent. Eleven healthy males performed both thumb adduction and plantar flexion as a conditioning contraction. The conditioning contraction intensities were set at 20%, 40%, 60%, 80%, or 100% of the maximal voluntary isometric contraction (MVC).Before and after the conditioning contraction, twitch torque was measured for the respective joint to calculate the extent of PAP. In plantar flexion, the extent of PAP became significantly larger as the conditioning contraction intensity increased up to 80% MVC (p < 0.05). In contrast, the extent of PAP in thumb adduction increased significantly only up to 60% MVC (p < 0.05), but not at higher intensities.These results indicate that the influence of the conditioning contraction intensity on the extent of PAP is muscle dependent. Our results suggest that a conditioning contraction with submaximal intensity can sufficiently evoke sizable PAP in the muscle where most of muscle fibers are recruited at submaximal intensities, thereby attenuating muscle fatigue induced by the conditioning contraction.     

Prolonged electrical muscle stimulation exercise improves strength and aerobic capacity in healthy sedentary adults.

This investigation evaluated training responses to prolonged electrical muscle stimulation (EMS) in sedentary adults. Fifteen healthy subjects (10 men, 5 women) with a sedentary lifestyle completed a 6-wk training program during which they completed an average of 29 1-h EMS sessions. The form of EMS used by the subjects was capable of eliciting a cardiovascular exercise response without loading the limbs or joints. It achieved this by means of inducing rapid, rhythmical contractions in the large leg muscles. A crossover study design was employed with subjects undergoing their habitual activity levels during the nontraining phase of the study. The training effect was evaluated by means of a treadmill test to determine peak aerobic capacity [peak oxygen consumption (Vo(2))], a 6-min walking distance test, and measurement of body mass index (BMI) and quadriceps muscle strength. At baseline, the mean values for peak Vo(2), 6-min walking distance, quadriceps strength, and BMI were 2.46 +/- 0.57 l/min, 493.3 +/- 36.8 m, 360.8 +/- 108.7 N, and 26.9 +/- 3.4 kg/m(2), respectively. After training, subjects demonstrated statistically significant improvements in all variables except BMI. Peak Vo(2) increased by an average of 0.24 +/- 0.16 l/min (P < 0.05), walking distance increased by 36.6 +/- 19.7 m (P < 0.005), and quadriceps strength increased by 87.5 +/- 55.9 N (P < 0.005); we did not observe a significant effect due to training on BMI (P > 0.05). These results suggest that EMS can be used in sedentary adults to improve physical fitness. It may provide a viable alternative to more conventional forms of exercise in this population.