Comparative Effects of NMES and Resistance Training on Lower Limb Strength

Abstract

This review systematically compares the effects of neuromuscular electrical stimulation (NMES) and conventional resistance training on lower limb strength development, and evaluates the transfer of strength gains to functional motor performance as well as parameter optimisation strategies. The main findings are as follows: (1) Under training volume‑matched conditions, NMES‑induced maximal lower‑limb strength gains are equivalent to those of conventional resistance training (effect size difference 0.023, p= 0.836); whole‑body electrical muscle stimulation (WB‑EMS) can achieve equivalent strength improvements within extremely short training durations, demonstrating marked time efficiency. (2) The effects of NMES on speed strength and explosive power are divergent; evidence for independent application on jumping, sprinting and agility is weak, and transfer effects may emerge only when combined with sport‑specific dynamic training (e.g., plyometric training). (3) Superimposed NMES training shows a small‑to‑moderate independent advantage in muscle hypertrophy (SMD = 0.26), but direct comparative data between standalone NMES and conventional resistance training are limited. (4) Optimisation strategies for stimulation parameters: high frequencies (50–100 Hz) favour immediate strength gains, while low frequencies (20–50 Hz) are more suitable for rehabilitation or endurance‑oriented purposes; intensity must reach the maximally tolerated level with gradual progression; contraction‑rest cycles, electrode placement, joint angle and training frequency (1–2 sessions per week) all significantly influence therapeutic efficacy.