Ab stimulators, a type of electronic muscle stimulator (EMS), are marketed as a way to achieve firmer, more toned abdominal muscles through electrical stimulation. The devices send electrical signals to contract your muscles, mimicking the neurological system’s muscle activation.
Understanding Ab Stimulators
Ab stimulators are electronic muscle stimulators that focus on your core. They are often used for physical therapy or rehab. Physical therapists have used this type of training since the 1960s to improve and maintain muscle strength after surgery. Doctors can prescribe them to help people recover muscle strength after a stroke, major surgery, or serious injury. Medical muscle stimulators may also be prescribed to prevent muscle atrophy and relax muscle spasms.
Effectiveness of Ab Stimulators
While ab stimulators can make your abdominal muscles appear firmer and more toned by electronically stimulating them, they won’t help you lose weight, or get “rock hard” abs without diet and exercise. The FDA has approved ab stimulators for toning, firming, and strengthening ab muscles.
Research has shown that electrical stimulation training can boost muscle endurance as well as strength. In one small study, people using ab stimulators also saw small decreases in waist size, even when their weight stayed the same.
In a 2005 study, 24 adults were separated into two groups. One group used ab stimulators five days a week for eight weeks, while the other did not. Neither group did any abdominal exercises. Those who used ab stimulators had improved posture and a 58% increase in abdominal strength. They also saw a 100% increase in abdominal endurance and reduced their waists by an average of 3.5 centimeters (about 1 ⅓ inch). All the people who used ab stimulators said their posture had improved and that their abdominal muscles were firmer and more toned.
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Because this study was small, it’s not conclusive. A more recent study, which was also small, found that electronic muscle stimulation didn’t significantly change trained athletes’ abdominal muscles. Unless you eat healthfully and exercise regularly, there’s no evidence that using an ab stimulator will make a big change in your appearance.
Scientific Studies on EMS and Waist Circumference
A randomized, double-blind, sham-controlled trial investigated the effects of EMS on abdominal obesity. The electrical muscle stimulation group achieved a mean 5.2±2.8 cm decrease in waist circumference while the transcutaneous electrical nerve stimulation group showed only a 2.9±3.3 cm decrease (P=0.005). About 20 (70.0%) of the electrical muscle stimulation group lost more than 4 cm of waist circumference but that only 8 (33.3%) of the transcutaneous electrical nerve stimulation group did so (P=0.008). Furthermore, fasting free fasting acid levels were significantly higher in the electrical muscle stimulation than in the transcutaneous electrical nerve stimulation group at week 12 (P=0.006). In the electrical muscle stimulation group, slight decreases in visceral abdominal fat and total abdominal fat areas by computer tomography were observed at 12 weeks, but these decreases were not significant.
The study hypothesized that EMS offers an effective and safe treatment for men and women with abdominal obesity, and that EMS can decrease WC (abdominal fat), increase abdominal muscle mass, and improve biochemical markers. This double-blind, randomized, sham-controlled trial was conducted at Pusan National University Hospital (PNUH) from January 2, 2014 to June 8, 2015. The study was approved by the Institutional Review Board at PNUH (No. 2003011)and the trial was registered with ClinicalTrials.gov (no.
The study inclusion criteria included age between 18 and 65 years at screening and a WC of >90 cm for men or >80 cm for women. The exclusion criteria applied were: pregnancy, breastfeeding, taking medication for weight loss or any treatment including medication known to affect weight, a weight loss of >3% in the preceding 3 months, major surgery during the 1 year prior to study commencement, and the presence of any metal containing implant. Subjects with the following were also excluded; aspartate aminotransferase (AST) or alanine aminotransferase (ALT) greater than 2.5 fold the upper reference limit, serum creatinine (Cr) greater than the upper reference limit, a history of CHD, major organ dysfunction, cancer, a severe lung disease, severe cerebral trauma, uncontrolled hypertension, or a diagnosed psychiatric disease (including eating disorder).
Participants were treated with EMS or TENS using 66 min sessions, 5 days per week for 12 weeks by using a prototype device named TGBODY-4CH (serial number 612001 ~ 612030, 612061 ~ 612090) developed by NS-Medicom (Gimhae, South Korea) and approved by the Korea Testing Certification Medical Device Center (#2004-0042, KTC, Gunpo, South Korea). This device provided EMS and TENS programs, which were selected by pressing a button. Control group was treated by applying current regularly at a frequency of 1 Hz, which was determined basis on endorphin theory. The electric current applied during TENS can cause muscle movement, but this does not constitute an effective muscle contraction exercise. Pads were applied to the abdomen, rectus abdominis and external oblique abdominal muscle areas, so as to avoid any recent wound, infection, scar, or wart, in the supine position.
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The start of the study, subjects were asked to maintain their usual consumption and physical activity levels throughout the study period. The developments of adverse events were closely monitored, and participants were encouraged to report any potential adverse events throughout the study.
The primary outcome variable was WC and the secondary outcome variables were patient satisfaction, VAT and SAT, and laboratory data at 12 weeks follow up. The within-group comparisons were done with a paired t-test or Wilcoxon signed-rank test when appropriate. Linear mixed-effects modelling for repeated measures over time with WC, patient satisfaction, VAT, SAT, and laboratory data as the dependent variables and effects for time (baseline, 12 weeks), group (EMS, control), and time by group interaction as independent variables, with adjustment for baseline total calorie intake and physical activity as covariates.
EMS group showed a 5.2±2.8 cm loss in WC after the trial period, whereas the control group showed a 2.9±3.3 cm loss, which was a significant difference (P=0.005). The self-rated satisfaction scores were significantly greater in the EMS at study completion (3.9±0.7 vs. 2.8±1.2, P<0.001, data not shown). But no intergroup differences were found for abdominal fat distribution or other metabolic and biochemical characteristics throughout the trial period . However, fasting FFA levels were significantly higher in the EMS group than in the control group at week 12 (P = 0.006).
The present study revealed that EMS is capable of producing physiological responses similar to those of cardiovascular exercise at mild to moderate intensities, despite the fact that EMS is performed without producing gross movement of limbs or loading joints. The EMS group achieved a modestly greater decrease in WC than the control group at week 12 (5.8% vs. 3.3%, P = 0.007). Furthermore, the proportion in the EMS group that achieved a WC reduction of >4cm was twice as high as that observed in the control group.
TENS only stimulates sensory nerves, whereas EMS excites motor nerves and results in the constriction skeletal muscle fibres, which means its metabolic benefits are similar to that of exercise. According to previous studies, 12 weeks of resistance exercise reduces WCs by 2-9% depending on initial Body Mass Index (BMI) and intensity of exercise. The contraction time of abdominal muscle exercise is about 3-5 seconds, but this contraction time can be tripled using EMS to increase energy consumption as high intensity exercise.
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In the EMS group, WC declined more sharply in the latter half of the study, presumably because EMS may have the potential to cause cumulative effects on WC. As skeletal muscle builds, energy is consumed more efficiently. Fasting FFA was significantly higher in the EMS group after the trial (P = 0.006). Fasting FFA is a biomarker of lipolysis (the hydrolysis of triglycerides into glycerol and free fatty acid) in adipose tissue, although it can be considered as a risk factor for insulin resistance. This finding suggests that EMS induces lipolysis in intramuscular adipose tissue, but on the other hand, other biomarkers were not altered by EMS.
Risks Associated with Ab Stimulators
Using ab stimulators carries several risks, particularly if you use a device that hasn’t been approved by the FDA.
Unregulated Ab Stimulators
You can buy many ab stimulators on the internet that aren’t FDA-approved. They may or may not be safe. They could be improperly manufactured, designed, or labeled.
Unregulated ab stimulators carry a risk of:
- Burns
- Bruises
- Skin irritation
- Electrical shock
- Problems when you use them with other medical devices, like pacemakers
Regulated Ab Stimulators
There are risks even if you use an approved stimulator. They include interference with other medical devices such as implanted defibrillators and pacemakers.
If you have a problem with your ab stimulator, report it to the manufacturer.
FDA's Role in Regulating EMS Devices
Electrical muscle stimulators are considered devices under the Federal Food, Drug, and Cosmetic Act. The FDA is responsible for regulating the sale of all electrical muscle stimulators in the United States. Therefore, firms must comply with appropriate FDA premarket regulatory requirements before they can legally sell their stimulators. Most electrical muscle stimulators (EMS devices) that have been reviewed by FDA are intended for use in physical therapy and rehabilitation under the direction of a health care professional.
Firms that market EMS devices are required to comply with appropriate FDA premarket regulatory requirements before they may legally sell their devices. The firm must be able to demonstrate that these devices are as safe and as effective as similar devices that are legally marketed. Devices may only be marketed for uses that are established for the device or for uses that the firm can support with data.
Using a product that has not met FDA requirements isn't necessarily unsafe or dangerous. But it could be. The FDA has received reports of shocks, burns, bruising, skin irritation, pain, and interference with other critically important medical devices (e.g., pacemakers) associated with the use of unregulated products.
Ab Stimulators and Muscle Contraction
Applying electrical current to muscles may cause muscles to contract. The FDA has cleared many electrical muscle stimulators for prescription use in treating medical conditions. Doctors may use electrical muscle stimulators for patients who require muscle re-education, relaxation of muscle spasms, increased range of motion, prevention of muscle atrophy, and for treating other medical conditions which usually result from a stroke, a serious injury, or major surgery.
Alternative Approaches to Weight Loss and Abdominal Definition
Proponents of ab stimulators claim they can help improve abdominal muscle tone as they force the muscles to repetitively contract. However, they will not burn fat or cause significant weight loss.
To burn fat, a person must create a calorie deficit, using more calories through exercise and movement than they eat each day. Even if can ab stimulators can help to slightly strengthen muscles, a person will not notice a difference in their appearance if they are not also burning fat.
People who wish to improve their posture or address muscle injuries should consider physical therapy. A physical therapist offers targeted exercises and massage. They may also recommend electrical stimulation to improve muscle health.
People seeking a more muscular core or a trimmer waistline should focus on two goals:
- Burning fat by creating a caloric deficit. A person must use more calories than they eat to create a deficit. Increasing their activity level - with both intense exercise and more overall movement, such as by walking each day - can help a person gradually burn fat, including on the stomach.
- Strengthening the abdominal muscles with targeted exercises. These exercises will not burn fat, but they can improve posture and core strength while making the muscles more visible as a person loses body fat. Some of the most effective core exercises include:
- Abdominal bridges
- Planks
- Opposite arm and leg raise
Performing abdominal exercises, such as crunches, can help to strengthen and tone abdominal muscles. However, it is not possible for these exercises to specifically target and burn belly fat. Performing a variety of physical activities and following a suitable dietary plan are the best methods for managing weight.