AUTHOR=di Cagno Alessandra , Buonsenso Andrea , Centorbi Marco , Manni Luigi , Di Costanzo Alfonso , Casazza Giusy , Parisi Attilio , Guerra Germano , Calcagno Giuseppe , Iuliano Enzo , Soligo Marzia , Fiorilli Giovanni ,  for The WB-EMS Parkinson’s Group , Lena Francesco , Modugno Nicola , Quinzi Federico 

TITLE=Whole body-electromyostimulation effects on serum biomarkers, physical performances and fatigue in Parkinson’s patients: A randomized controlled trial

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 15 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2023.1086487

DOI=10.3389/fnagi.2023.1086487

ISSN=1663-4365

ABSTRACT=Background: Whole-body electromyostimulation (WB-EMS) was never previously applied to Parkinson's disease (PD) patients. This randomized controlled study aimed to find the most effective and safe WB-EMS training protocol for this population. 
Methods: Twenty-four subjects (age: 72.13 ± 6.20 years), were randomly assigned to three groups: a high-frequency WB-EMS strength training group (HFG) (rectangular stimulation at 85 Hz, 350 µs, 4 s stimulation/4 s rest), a low-frequency WB-EMS aerobic training group (LFG) (rectangular stimulation 7 Hz, 350 µs, with a continuous pulse duration), and an inactive control group (CG). Participants of the two experimental groups underwent 24 controlled WB-EMS training sessions, with a duration of 20 min each, during 12-week intervention. Serum growth factors (BDNF, FGF-21, NGF and proNGF), α-synuclein, physical performance and Parkinson's Disease Fatigue Scale (PFS-16) responses were analysed to evaluate the pre-post variation and differences among groups.
Results: Significant interactions of Time*Groups were detected for BDNF (Time*Groups p=0.024; Time*CG, b=-628, IC95%=-1082/-174, p=0.008), FGF-21 (Time*Groups p=0.009; Time*LFG b=1346, IC95%=423/2268, p=0.005) and α-synuclein (Time*Groups p=0.019; Time*LFG b=-1572, IC95%=-2952/-192, p=0.026). Post hoc analyses and comparisons of ΔS (post–pre), performed independently for each group, showed that LFG increased serum BDNF levels (+203 pg/ml) and decreased α-synuclein levels (-1703 pg/ml), while HFG showed the opposite effects (BDNF: -500 pg/ml; α-synuclein: +1413 pg/ml). CG showed a significant BDNF reduction over time. Both LFG and HFG showed significant improvements in several physical performance outcomes and the LFG showed better results than HFG. Concerning PFS-16, significant differences over time (b=-0.4, IC95%=-0.8/-0.0, p=0.046) and among groups (among all groups p<0.001) were found, and the LFG exhibited better results than the HFG (b=-1.0, IC95%=-1.3/-0.7, p<0.001), and CG (b=-1.7, IC95%=-2.0/-1.4, p<0.001) with this last one that worsened over time.
Conclusion: LFG training was the best choice for improving or maintaining physical performance, fatigue perception and variation in serum biomarkers.