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A Guide on Electrical Muscle Stimulation

    Electrical Muscle Stimulation (EMS) has always been a little confusing to performance coaches and sports medicine professionals because the research is cloudy at best. Many of the reasons behind the limitations of science are the ethical boundaries you need to navigate, and the expectations you have with the results of those studies. I recently spent more time working with EMS, as more and more athletes are using EMS devices on their own and we are dealing with the hangover of injuries still lingering in the off-season. What I have learned is that the science is not perfect and there are no best practices.

    There has been a resurgence in EMS in sport over the last five years because of Bill Knowles, Derek Hansen, and Henk Kraaijenhof sharing their experiences with athletes. I believe that EMS suit inluding electrostimulation vest has a place in sports performance and the rehabilitation of athletes, but we don’t have a solid explanation of why some athletes don’t respond to it while others seem to come alive from it. In this first piece, I will review some of the current literature on EMS and present a healthy perspective on this modality. (Part 2 will be published as “The Top 6 EMS Protocols for Sports Performance.”)

    A Brief History of Electrical Muscle Stimulation in Modern Sport

    Without getting into any unnecessary background on electrotherapy (such as a retelling of the way the ancient civilizations used electric fish or citing references to Volta and Galvani), it’s valuable to know how e-stim or EMS has been part of sport in the last few decades. Outside of product design, very little innovation has occurred since the 1950s, making EMS more of an art than a science. Coaches and therapists are sometimes frustrated because transcutaneous electrical nerve stimulation, or TENS for short, gets confused with sports electrostimulation.

    To understand the difference between TENS and EMS, you need to know just a little bit about engineering and biology. TENS targets the sensory nerves, while EMS attacks the motor nerve and attempts to recruit as many muscle fibers as possible. TENS is currently used—mainly in vain, in my opinion—to manage pain. In 1965, Ronald Melzack and Patrick Wall proposed the “gate control theory” of pain. What we know about the pain experience is extremely complex and personal, making the TENS intervention for sport very dated and extremely limited for athletes. Some research has shown positive findings, but the modality method of working with athletes in pain is lazy and proven unproductive in clinical research.

    EMS focuses mainly on sending current to muscle groups in the hope of eliciting either a recovery response or a performance response later. Based on the current literature, recovery indices appear very limited, and performance benefits have shown up enough with some populations—including athletes—to be accepted as valid complementary treatments. The truth is that our understanding of electrostimulation is usually confined to a few studies on stroke victims and post-surgical wasting, and nothing I have seen has excited me.

    What interests me, instead, are the clinicians who have used EMS creatively. Some of the studies on cellular and performance outcomes are strong enough to show that EMS isn’t just a placebo. I have used the Compex systems for nearly 20 years, and have some experience with the Marc Pro, PowerDot, Globus, and ARPwave. If I had to conclude which I think works best, it will be a short answer: All of them work, so choose one based on your needs and not its features.

    If you were to go to a medical bookstore and check the physical therapy section on EMS, you would see that it tends to be a set of protocols based on pad placement, current settings, and scheduling sessions. This approach is nowhere near the same as what the modern clinician does and, since we are now entering the bionic athlete era with gait retraining, this only widens the gap between practice and research. It’s easy to shout that you’re ahead of the research, but without evidence, much of what clinicians do becomes like the dated RICE protocol that we still see people clinging to.

    A Rapid Review of Electricity for Coaches and Therapists

    Electric current can flow in different ways, such as through a wire, or something lesser known, such as a plasma state. The current generated from a muscle electrostimulator uses a conductive pad to transfer through the skin, causing the muscle to contract. The specifics of the muscle contraction will come later, but the important information is that electricity from medical muscle stimulators is more complicated than voltage and ampere. Electricity is not just about whether something is “on” or “off,” and we often take much of the technology we use for granted, especially the safety of the muscle stimulators. Most companies that get involved with e-stim devices are regulated, but it’s up to the consumer to do their homework on the quality of the product.

    Experienced coaches and therapists commonly refer to stimulation parameters and share their practices, including the use of different types of settings, such as Russian Stimulation or strength protocols. Stimulation parameters and waveforms can be the subject of their own article but, for the most part, duty cycle, frequency, intensity, and ramp details are part of electrotherapy theory, but are not very well-documented. Regardless of the intimate details, many parallels exist between classic training principles and the current clinical practices of EMS use. Cycles, or waves of energy, are part of a “unified training theory” proposed by several coaches and sport scientists. EMS should be used to improve athletes, similarly to loading the body with training or rehabilitation.

    Companies must do their job, not only to prove their machines are delivering exactly what they promise, but also to ensure that their products are used as intended. Most companies have terrible product education, and visiting their YouTube channels makes me cringe more than their highest simulator settings.

    The Science of Electrical Contractions With Muscle

    Sending electricity through a muscle group sounds like a bad science fiction movie, but that’s precisely what athletes are willing to do to get or feel better. It’s a priority to know what EMS can do physiologically and what is likely ineffective. Five years ago, pioneering researcher Nicola Maffiuletti summarized the differences between a normal muscular contraction and one from electrical stimulation in his NSCA journal article. The two types of contractions have similarities and differences that a coach should know. Overall, EMS is not going to make a major difference. However, like all things in sports training, the little things matter.

    One development that throws this concept out the window is the rise in functional electrical muscle stimulation, equipped with electrostimulation shorts, which incorporates active training with the simultaneous overlay of EMS. While we can assume that the merging of both contractions will yield a hybrid result, most of the research is with disease models and only clinical rehabilitation has shown merit with this in early post-operation subjects. I have yet to see a single study with elite athletes performing EMS in conjunction with conventional training, but the case reports and work with spinal cord injury patients is promising.

    Finally, EMS is used to help with neuromuscular adaptations and, while sessions may prevent atrophy, the improvements are from neural drive-like mechanisms, not from increased protein synthesis rates. EMS doesn’t directly create hypertrophy changes to the muscle, and a study on nutrition and e-stim showed no acute changes.

    What is also important to know is that electrically stimulated muscles are, for the most part, superficial, and that is useful for propulsive muscle groups. Some rogue therapists are using fine needle EMS with low current for deeper muscle penetration for rehabilitation purposes. Most EMS experiences are one muscle at a time, but some athletes are getting simultaneous total body sessions. Nobody knows if total bodywork is more time-efficient or if a possible synergistic benefit exists, but down the road, studies will likely discover if there is a value beyond convenience.

    The Scientific Benefits of Stimulating the Neuromuscular System

    If you were to read a catalog of features and settings for a personal e-stim device, the list would be very long, ranging from relaxation massage all the way to explosive strength. While, technically, different settings will have unique stimulation protocols from the device programming in the electrostimulation center, the reality is that only three purposes exist with EMS and the research is enough to form a realistic expectation. The three EMS benefits are strength training, rehabilitation, and a little regeneration. Distilling the benefits more, you can make an argument that EMS helps with general muscle strength and facilitates low-level recovery for travel. That’s about it, but it’s enough to warrant investing in it, especially when sport moves into the unfortunate health compromise for winning.

    Sports Performance

    EMS and strength, and the results that may lead to jump and sprint performance, are mixed in the research. However, enough research shows that if EMS is done with specific protocols, a positive result is possible, especially with the less-trained athlete. So far, much of the work has been done with soccer, and some recent investigations of youth jumping performance and plyometrics had favorable outcomes.

Advantageous characteristics of PVP

    PVP-Polyvinylpyrrolidone is a nonionic water-soluble polymer and can be applied in a variety of fields-of-use owing to following advantageous characteristics.

    1. Good solubility in water as well as various organic solvents

    2. Good affinity to various polymers and resins

    3. High hygroscopicity

    4. Good film formation property

    5. Good adhesiveness to various substrates

    6. Good chelate / complex formation property

    Polyvinylpyrrolidone (PVP) is a water-soluble polymer obtained by polymerization of monomer N-vinylpyrrolidone. PVP is an inert, non-toxic, temperature-resistant, pH-stable, biocompatible, biodegradable polymer that helps to encapsulate and cater both hydrophilic and lipophilic drugs. These advantages enable PVP versatile excipients in the formulation development of broad conventional to novel controlled delivery systems. PVP has tunable properties and can be used as a brace component for gene delivery, orthopedic implants, and tissue engineering applications. Based on different molecular weights and modified forms, PVP can lead to exceptional beneficial features with varying chemical properties. Graft copolymerization and other techniques assist PVP to conjugate with poorly soluble drugs that can inflate bioavailability and even introduces the desired swelling tract for their control or sustained release. The present review provides chemistry, mechanical, physicochemical properties, evaluation parameters, dewy preparation methods of PVP derivatives intended for designing conventional to controlled systems for drug, gene, and cosmetic delivery. The past and growing interest in PVP establishes it as a promising polymer to enhance the trait and performance of current generation pharmaceutical dosage forms. Furthermore, the scrutiny explores existing patents, marketed products, new and futuristic approaches of PVP that have been identified and scope for future development, characterization, and its use. The exploration spotlights the importance and role of PVP in the design of Povidone-iodine (PVP–I) and clinical trials to assess therapeutic efficacy against the COVID-19 in the current pandemic scenario.

    PVPP is a synthetic, high-molecular-weight clarifying agent made up of cross-linked monomer of polyvinylpyrrolidone. PVPP has long been used in the beverage industry as a polyphenol adsorbent. Although, it has been called as a “protein-like” fining agent, insoluble PVPP interacts with only few reactive groups. Hence, PVPP is used for binding and removing smaller phenolic compounds such as catechins and anthocyanins, which are responsible for causing browning and bitterness in wines. However, PVPP, along with charcoal and casein, can remove resveratrol, a component that imparts certain health benefits.

    Polyvinylpyrrolidone (PVP) is a linear polymer of 1-vinyl-2-pyrrolidone monomers used as a binder, emulsion stabilizer, film former, hair fixative, and suspending agent-nonsurfactant. The molecular weight of the polymer ranges from 10,000 to 700,000. PVP K-30, with an average molecular weight of 40,000, is typically used in cosmetic formulations. The highest concentration reported to be used is 35%. There was no significant absorption of PVP K-30 given orally to rats, and the acute oral LD50 was >100 g/kg for rats and guinea pigs. Neither toxic effects nor gross lesions were found in rats maintained for two years on a diet containing 10% PVP K-30. Short-term PVP inhalation studies produced mild lymphoid hyperplasia and fibroplasia in rats, but no inflammatory response. In animal studies, no evidence of significant ocular irritation, skin irritation, or skin sensitization was found at PVP-iodine solution concentrations of 10%. While PVP-iodine is not a cosmetic ingredient, these negative findings were considered to support the safety of the PVP component. Undiluted PVP K-30 was not a dermal irritant or sensitizer in clinical tests. No developmental toxicity was seen in vehicle controls where PVP was used as a vehicle for another agent. In certain assay systems, PVP was genotoxic, but was negative in the majority of studies. Orally administered PVP significantly decreased the rate of bladder tumors in mice exposed to bracken fern. Several studies tested the carcinogenicity of subcutaneous implants of particulate PVP in rats, mice, and rabbits. Although the majority of these studies conducted in rats were positive, tumors (sarcomas) were localized to the site of implantation. Based on the available data, it was concluded that PVP is safe as used in cosmetics.

    Polyvinylpyrrolidone (PVP) is a linear polymer of 1-vinyl-2-pyrrolidone monomers used as a binder, emulsion stabilization of suspensions, film former, hair fixative, and suspending agent-nonsurfactant. The molecular weight of the polymer ranges from 10,000 to 700,000. PVP K-30, with an average molecular weight of 40,000, is typically used in cosmetic formulations. The highest concentration reported to be used is 35%. There was no significant absorption of PVP K-30 given orally to rats, and the acute oral LD50 was >100 g/kg for rats and guinea pigs. Neither toxic effects nor gross lesions were found in rats maintained for two years on a diet containing 10% PVP K-30. Short-term PVP inhalation studies produced mild lymphoid hyperplasia and fibroplasia in rats, but no inflammatory response. In animal studies, no evidence of significant ocular irritation, skin irritation, or skin sensitization was found at PVP-iodine solution concentrations of 10%. While PVP-iodine is not a cosmetic ingredient, these negative findings were considered to support the safety of the PVP component. Undiluted PVP K-30 was not a dermal irritant or sensitizer in clinical tests. No developmental toxicity was seen in vehicle controls where PVP was used as a vehicle for another agent. In certain assay systems, PVP was genotoxic, but was negative in the majority of studies. Orally administered PVP significantly decreased the rate of bladder tumors in mice exposed to bracken fern. Several studies tested the carcinogenicity of subcutaneous implants of particulate PVP in rats, mice, and rabbits. Although the majority of these studies conducted in rats were positive, tumors (sarcomas) were localized to the site of implantation. Based on the available data, it was concluded that PVP is safe as used in cosmetics.

Power Banks – What Impact They Have On Your Phone's Battery

    Anyone who has a very busy schedule will tell you that a power bank is their lifesaver. A power bank is essentially a portable charger. Power banks are most commonly used to charge cell phones but are often also used to charge laptops, speakers, and various other chargeable devices.

    In this age, our cellphones contain our entire lives in it, be it a photographer’s photographs, to an entrepreneur’s documents. When you are on the go at most times, it’s virtually impossible to find wall outlets everywhere to charge your phone if the battery drains. A conventional power bank prevents you from running into a crisis when your phone suddenly turns off when you need it the most.

    Keep on reading further for more about power banks, and what impact they have on your phone’s battery.

    Types Of Power Banks:

    Most of the power banks available in the market consist of two types. One consists of Lithium-ions cells, while the other contains Lithium-Polymer cells.

    Lithium-ion cell power banks have a higher energy density and are cheaper than the other. However, power banks containing Lithium-ion cells lose their charging capacity over the duration they are used and are bulkier.

    On the other hand, power banks with Lithium-Polymer are expensive, but they are safer, and unlike Lithium-ion, they don’t lose their actual charging capacity with time. They also take less time to charge.

    Further, they are divided into three broad categories:

            Universal Power Bank

    The most common ones, universal power banks come in various sizes and output variations and give the end consumer a wide range to choose the best one according to their requirements.

            Solar Charged Power Bank

    These solar power bank with cable contains photovoltaic panels which are charged through sunlight. This is then converted and used to charge electronic devices.

    Although it’s an environmentally friendly device, it tends to take a lot of time to charge, and that too is limited to availability of enough sunlight.

            Battery Phone Case

    These are compact and easiest to carry along. However, they have a very low variety available in term of devices.

    So the next time you are considering buying a power bank, choose one based on the type which is more suitable for your requirements.

    How To Choose The Best Power Bank For Your Phone:

    There are some factors to consider before buying a power bank with dale cable, include:

            Capacity:

    The capacity a power bank should always be more than the capacity your phone requires. For example, a 2200 mAh wouldn’t be able to fully charge a phone with a requirement of 3000 mAh. Likewise, a power bank with 6000 mAh would be able to charge your phone fully two times. Also, there are wireless fast charging power banks.

            The Number Of Outputs:

    Some power banks have 1 output outlet; some have 2, and so on. Choosing one depends on how many devices you would need to charge at the same time.

            Output Specification:

    How much output your phone needs should also synchronize with the output the power bank gives out. Ideally, the standard output should be 5V for phones. Any more, and it would damage the phone.

    Advantages Of A Power Bank:

    The main benefit of power bank is that they are great for charging phones on the go, or when there is no electricity available.

    Aside from that, most power banks come with a large capacity, which makes them handy for charging your phone multiple times, without recharging it. And when the battery of the power bank does drain, they can be easily charged through laptops, car chargers, and wall sockets, whichever is more convenient.

    Disadvantages Of A Power Bank:

    Power banks come with their own share of disadvantages as well. Many of the power banks available are either bulky or expensive. Apart from that, they do require to be charged when their battery drains, and if their capacity is lower, then they drain faster.

    They also impact the battery of a phone in some instances, as mentioned below.

    Impact On Battery:

    While it’s extremely rare for a power bank to damage the battery of a phone, there are some instances where it might happen.  Here are some cases where you might be damaging your phone’s battery with your power bank, and how to fix them:

            You Are Using A Bad Quality Power Bank

    Quality is very important when choosing a power bank. A bad quality power bank can damage your phone’s battery, as well as your phone’s charging port. It can also create some security risks. For example, overcharging a bad quality Lithium-ion power bank can cause the power bank to explode.

            Your Power Bank Has The Wrong Voltage

    Having the wrong voltage in your power bank will lead to problems. The ideal voltage to charge a phone is 5V. If any power bank gives a voltage of 4.2V or less, it will drain your battery instead of charging it.

    Any voltage output greater than 5V will extensively damage your phone’s circuits by overloading it more than it can handle.

            You Are Overcharging:

    Power banks should essentially be used sparingly. Using power banks to constantly keep your phone at 100% charge will over time damage the battery, which will lead to your phone not being able to retain its charge for long.

    To avoid these problems, avoid using your power bank to overcharge your phone. Use it for emergencies, and even when you do use it avoid charging your phone up to 100%.

    Along with that, buy your power banks from authorized retailers, and choose the highest quality of power bank, such as PD fast charging power bank, with the right requirements for your phone. Dealna.com has a wide variety of authentic, high-quality power banks: