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Background:
Systematic Review

The Impact of Electromyostimulation on Strength, Recovery, and Performance in Soccer Athletes: A Systematic Review

by
Meng-Yuan Shu
1,†,
Hyoung Suk Oh
1,†,
Young-Jin Jo
1,
Seon-Ho Eom
1,
Jian Liang
2,3,
Sang Mok Jung
4,
Ki-Wan Kim
5,
Joo-Ha Jung
6,
Chae Woo Ma
3,* and
Chul-Hyun Kim
1,*
1
Department of Sports Medicine, Soonchunhyang University, Asan 31538, Republic of Korea
2
Department of Food Science and Engineering, Xinjiang Institute of Technology, Aksu 843000, China
3
Department of Biology, Soonchunhyang University, Asan 31538, Republic of Korea
4
Research Institution for Basic Science, Soonchunhyang University, Asan 31538, Republic of Korea
5
Artificial Intelligence and Software Education Center, Soonchunhyang University, Asan 31538, Republic of Korea
6
Center for Sports Science in Chungnam, Asan 31580, Republic of Korea
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Appl. Sci. 2025, 15(14), 7950; https://doi.org/10.3390/app15147950
Submission received: 30 May 2025 / Revised: 10 July 2025 / Accepted: 12 July 2025 / Published: 17 July 2025
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Versions Notes

Abstract

Soccer, as a high-intensity sport, places significant physical demands on athletes and is associated with a high risk of injury. Electrical muscle stimulation (EMS), a training and rehabilitation technology, has gained attention for its potential benefits in sports settings. This systematic review, conducted under the PRISMA guidelines, rigorously assessed the effectiveness of EMS in improving muscle strength, promoting post-exercise recovery, and facilitating injury rehabilitation among soccer players. A comprehensive search of the PubMed, Scopus, and Web of Science databases identified 10 studies meeting the inclusion criteria. Among these, six studies demonstrated a significant improvement in athletic performance following local or whole-body EMS application. Four studies provided evidence supporting EMS’s efficacy in enhancing post-exercise recovery and reducing recovery time after injuries, with observed reductions in recovery time. However, the majority of the included studies were not double-blind, which limits the strength of the evidence. None of the included studies reported EMS-related adverse effects. Overall, the current results suggest that EMS may be a useful adjunct to improve athletic performance and facilitate recovery in soccer players. This review offers actionable insights for coaches and athletes regarding the safe and effective application of EMS in soccer training and rehabilitation programs.

1. Introduction

The physical and tactical demands of contemporary soccer have significantly evolved, especially in elite-level competition. Notably, the total running distance, high-intensity frequency, and explosive movements—such as sprinting, cutting, and jumping during matches—have markedly increased [1]. These physical requirements place substantial stress on the musculoskeletal system. Hence, attributes such as sprint speed, explosive power, and dynamic movement capacity have become crucial determinants of on-field performance. However, the cumulative effects of repeated high-intensity efforts are associated with an increased risk of muscle fatigue, soft-tissue injuries, and joint overload [2]. Injury incidence in professional soccer remains a significant concern, with approximately 30% of players retiring early due to injury-related issues [3].
Electrical muscle stimulation (EMS), also known as neuromuscular electrical stimulation (NMES), involves the delivery of intermittent electrical impulses to the superficial skeletal muscles via surface electrodes connected to specialized equipment [4]. These impulses induce involuntary muscle contractions by directly stimulating the intramuscular motor nerves [5]. EMS has been proven effective in treating muscle damage by promoting recovery and improving the function of injured muscles [6]. Further, it plays a key role in supporting muscle protein synthesis, which is essential for muscle repair and growth [7]. Additionally, EMS has helped prevent muscle atrophy during extended periods of immobilization, such as after surgery or during long periods of inactivity [8].
In recent years, EMS has gained considerable attention in sport due to its benefits in muscle strength, recovery, and overall performance [9]. It offers a potential alternative to traditional strength-training methods, especially for elite athletes, by improving muscle performance while reducing the strain that comes with conventional weight training [10,11]. However, despite its growing popularity, there is a lack of comprehensive reviews on the effectiveness of EMS specifically for soccer players. While EMS has been studied in other sports, its impact on improving strength, aiding injury recovery, and enhancing performance in soccer athletes remains underexplored. This gap in knowledge is particularly relevant given soccer’s high-intensity physical demands, which place athletes at risk for muscle fatigue and injury. As a result, understanding how EMS could contribute to these challenges in soccer is essential. This systematic review aims to address this gap by evaluating the available evidence on the application of EMS in soccer players. The focus will be on its effects on muscle strength, recovery after exercise, and injury rehabilitation, specifically looking at the potential benefits for soccer players’ on-field performance and long-term physical health. By providing a clear overview of the current research, this review hopes to guide both coaches and athletes in making informed decisions about incorporating EMS into training and recovery programs.

2. Materials and Methods

This systematic review was conducted and reported while adhering to the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework (Table S1) [12]. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration ID CRD420251015876.

2.1. The Literature Search and Selection of Studies

On 1 March 2025, two researchers (M.-Y. S. and J. L.) independently performed a comprehensive search for the English-language literature in the PubMed, Scopus, and Web of Science databases. The keywords and Boolean phrases used were “neuromuscular electrical stimulation” OR “electromyostimulation” OR “electric muscle stimulation” OR “EMS” OR “NMES” AND “soccer” OR “football”. Inclusion criteria for the literature search were (1) the study must be a randomized controlled trial (RCT) and include at least one control group that did not receive electrical stimulation; (2) the study must not be gray literature or a website article; (3) participants must be adults aged ≥18 years; (4) the study population must consist exclusively of soccer players.

2.2. Data Extraction

Two researchers (M.-Y. S. and J. L.) independently extracted the study period, number and sex of participants, athlete level, study design, results, training period, training frequency, EMS context, stimulation site, impulse width, stimulation frequency, impulse intensity, and the duration of stimulation and rest periods from the included studies. A third researcher (C.-H. K.) resolved any discrepancies that arose during data collection.

2.3. Quality Review

The revised Cochrane Risk of Bias tool (RoB 2) was used to assess the risk of bias and the quality of the included studies, involving five domains: process randomization, deviations from intended interventions, missing outcome data, outcome measurement, and reported result selection [13]. Two researchers (M.-Y. S. and J. L.) conducted independent evaluations, and a third researcher (C.-H. K.) resolved any disagreements.

2.4. Data Analysis

The extracted data were subjected to descriptive analysis and systematic synthesis to determine key results, clarify gaps in the literature, and provide practical guidance on the application of EMS for soccer players and coaches. Further, this comprehensive review lays the groundwork for future research aimed at developing safer and more effective practices for the application of EMS in soccer.

3. Results

3.1. Included Studies and Study Characteristics

A total of 222 studies were identified through the PubMed, Scopus, and Web of Science databases. The review included 10 studies after removing 86 studies as duplicates; 115 for not meeting the eligibility criteria after reviewing the titles and abstracts; 3 for including participants who were not adult athletes; 3 for not being RCTs; 3 for lacking a control group without electrical stimulation; and 2 for involving both rugby and soccer players. The flow diagram illustrates the selection process (Figure 1).
The 10 studies reviewed included 341 male soccer players (Table 1), aged between 20.9 and 25.7 years, with heights ranging from approximately 1.65 to 1.83 m, and body masses between 63.5 and 79.5 kg. The stimulation sites primarily targeted the quadriceps (vastus medialis, vastus lateralis, and rectus femoris), femoral nerve, calf muscles, glutes, thighs, hamstrings, abdominals, chest, back, and in some cases, the whole body via dermatomeral and metameric pathways (Table 2). The impulse width ranged from 240 to 2500 μs, whereas the stimulation frequency varied between 1 and 350 Hz (Table 2). The duration of the EMS interventions ranged from a single session to 14 weeks, with training frequency varying from once per week to six sessions per week (Table 2).
Among the ten included studies, EMS interventions were associated with improvements in various performance measures. Significant gains were reported in isometric, eccentric, and concentric strength (p < 0.01 to p < 0.001) [14], 30-s all-out performance (p = 0.03) [15], quadriceps strength and circumference (p < 0.05) [16], and sprint and jump performance (p < 0.001) [17]. One study reported increased muscle stiffness and decreased elasticity along with improved posture (p < 0.05) [18]. Enhanced muscle fiber diameter (p = 0.023) [19], significant strength improvements across all angular velocities with gains observed in both the dominant and non-dominant legs (p < 0.05) [20], and better performance compared to sham stimulation were also noted (p = 0.002 to p < 0.001) [21]. One studies in ACL rehabilitation contexts showed significant improvements in functional outcomes at 12 and 16 weeks (p < 0.001) [22]. One study found improved sprint time and reduced lactate levels following an EMS warm-up (p < 0.05) [23].

3.2. Risk of Bias

Table 3 and Figure 2 present the quality assessment. Most of the included studies exhibited a low risk of bias in both the randomization process and the missing outcome data domains. However, only three studies were rated as having a low risk of bias in the domain of deviations from intended interventions [15,21,23]. A total of two studies [15,20] demonstrated some concerns in the domain of outcome measurement, whereas three studies [15,16,17] exhibited some concerns in the domain of reported result selection. Overall, among the 10 included studies, 2 were rated as having a low risk of bias [21,23], 6 as having some concerns [14,15,17,18,20,22], and 2 as having a high risk of bias [16,19].

4. Discussion

4.1. The Effects of EMS on Athletic Performance

Among the 10 studies included, 6 focused on the use of EMS to improve athletic performance in soccer players [14,17,19,20,21,23]. The findings suggest that EMS has potential in enhancing physical conditioning in this population. However, the effectiveness of EMS appears to vary considerably depending on the specific stimulation protocol, application setting, and training objectives. This heterogeneity includes differences in stimulation intensity, frequency, pulse duration, electrode placement, timing relative to exercise, and intervention duration, which significantly limit the comparability of study outcomes and undermine the generalizability of findings across contexts. Some studies have reported improvements in localized muscle strength and functional outcomes when EMS was applied to specific muscle groups [24]. The underlying mechanism involves the recruitment of large, high-threshold Type II muscle fibers, which are important for generating explosive strength. This recruitment occurs through supramaximal impulses, even at moderate intensities. Unlike voluntary contractions—which follow the Henneman size principle and activate smaller Type I fibers before larger Type II fibers—EMS directly stimulates Type II fibers from the outset [19]. This results in rapid mechanical loading and metabolic stress, which may promote hypertrophy and improved neuromuscular performance.
In particular, Billot et al. (2010) [14] reported significant gains in knee extensor strength and shooting velocity following EMS application to the quadriceps, suggesting its effectiveness in enhancing specific motor patterns. Similarly, Hasan et al. (2022) [21] revealed moderate improvements in muscle strength and sprint performance among soccer players who underwent neuromuscular EMS combined with traditional strength and plyometric training, although the effect size was limited compared with traditional training alone. In contrast, Kale and Gurol (2019) [20] found that EMS applied during the competitive season did not result in significant improvements in muscle strength. It was suggested that concurrent EMS use may have disrupted the natural adaptations induced by regular training, thereby diminishing overall effectiveness [25]. These mixed findings underscore the importance of carefully planning EMS interventions, especially during high training loads or competitive periods.
WB-EMS, which stimulates multiple large muscle groups simultaneously, has been associated with broader improvements in overall athletic performance. Filipovic et al. (2016, 2019) [17,19] consistently demonstrated that WB-EMS positively affects muscle strength, explosive power, sprint performance, and kicking ability. It also induces hypertrophic adaptations in Type II muscle fibers, contributing to improved explosive performance and broader applicability in soccer. However, even among studies employing WB-EMS, considerable variations in session frequency, stimulation duration, and integration with voluntary training were noted [26]. This variability contributes to inconsistent outcomes and makes it difficult to identify optimal implementation strategies.
A recent study [21] also indicated that WB-EMS could be effectively used as a warm-up strategy, significantly improving short-term sprint performance and offering practical value for pre-match preparation. Nevertheless, Filipovic et al. (2016) [17] highlighted increased creatine kinase levels following WB-EMS sessions, indicating potential muscle damage and the need for careful management of training load and recovery [27].
Overall, EMS and WB-EMS each present distinct advantages and limitations depending on the context of application. EMS is effective for targeting specific muscle groups, reinforcing precise movement patterns, supporting recovery, and improving isolated motor functions [28]. Its low cost, operational simplicity, and broad applicability contribute to its practicality in both clinical and athletic environments [29]. However, its influence on comprehensive athletic performance may be limited—particularly during in-season periods—as improper integration could interfere with regular training adaptations. WB-EMS offers more systemic benefits for general conditioning, although its application is logistically more demanding, requiring professional supervision, specialized equipment, and careful regulation to avoid adverse outcomes such as delayed-onset muscle soreness or even exertional rhabdomyolysis [30]. When using supraphysiological electrical impulses, muscle soreness—such as delayed-onset muscle soreness (DOMS)—is a common and expected physiological response. It should not be interpreted as an indicator of improper application. DOMS typically occurs following any form of high-intensity training, including EMS, due to microscopic muscle damage and associated inflammatory processes [31]. However, if stimulation parameters such as intensity, frequency, or duration are not properly adjusted to the individual’s conditioning level, there is a potential risk of more serious adverse effects, including exertional rhabdomyolysis [32]. Determining the threshold between beneficial muscular adaptation and harmful tissue damage remains a key challenge in EMS protocol design. This issue should be addressed through individualized application and careful monitoring.
The substantial variability in EMS protocols across the included studies represents a major limitation of the current evidence base. Without standardized parameters, it is difficult to draw definitive conclusions about the effectiveness of EMS or to formulate evidence-based guidelines. Therefore, coaches and practitioners should critically evaluate the strengths and limitations of each modality, tailoring their use based on specific performance goals, athlete characteristics, and available resources. Future studies should aim to standardize EMS protocols and investigate whether combining EMS with other training modalities may produce synergistic effects. Preliminary evidence, such as the combination of EMS and plyometric training shown by Filipovic et al. (2019) [19], suggests that hybrid approaches may enhance muscle activation and promote superior performance adaptations. Further research is needed to explore these strategies and to optimize EMS applications in athletic performance enhancement.

4.2. The Effects of EMS on Sports Injury Recovery

Players are frequently required to perform rapid changes in direction, sudden stops, jumping, and forceful physical confrontations due to the high-intensity and contact-heavy nature of soccer [33]. These repetitive high-load movements place considerable stress on the knee joint, making soccer players particularly susceptible to anterior cruciate ligament (ACL) tears [34]. The two reviewed studies provide consistent indications that neuromuscular electrical stimulation (NMES) can serve as a supportive component in rehabilitation following ACL reconstruction, particularly in professional soccer players [16,22]. Labib and Sabah (2024) [22] reported notable improvements in quadriceps strength, pain levels, and daily functional performance following the application of NMES, along with measurable changes in muscle activation as assessed by needle electromyography. These findings suggest that NMES may help mitigate early postoperative quadriceps inhibition by enhancing motor unit recruitment and voluntary muscle activation [35]. Similarly, Taradaj et al. (2013) [16] provided evidence supporting the effectiveness of NMES in improving muscle strength and cross-sectional area over a short intervention period. Taken together, NMES may assist in accelerating strength recovery and potentially facilitate earlier progression to functional tasks such as running and agility training. Although the two studies differ in stimulation protocols and evaluation methods, both demonstrate favorable outcomes associated with the use of NMES in ACL rehabilitation. Nonetheless, further studies are needed to determine optimal stimulation parameters and to evaluate the long-term effects of NMES, particularly in diverse athletic populations.
The study by Barassi et al. (2019) [18] showed that electrical stimulation improves posture and muscle tone in soccer players, potentially contributing to enhanced athletic performance and reduced injury risk. However, despite improvements in muscle tone and stiffness, a decrease in muscle elasticity, particularly in the hamstrings, was observed. This reduction in elasticity might be related to increased muscle stiffness, which can make muscles less flexible and slower to recover after stretching or contraction. While increased stiffness may aid in injury prevention by enhancing joint stability, it can also impair the muscle’s capacity to stretch and rebound, which may negatively affect performance [36,37]. The intervention in this study emphasized spinal reflex activation through cutaneous receptors, modulating the myofascial system and postural control. In contrast, Bieuzen et al. (2012) [15] applied VEINOPLUS® blood-flow stimulation technology, which focused on activating the calf muscle venous pump to improve peripheral circulation and accelerate metabolite clearance. Although this approach did not significantly reduce muscle damage markers or improve maximal strength, it was associated with faster recovery of high-intensity anaerobic performance compared to passive recovery. This finding suggests its potential practical value in alleviating short-term metabolic fatigue during intermittent competition. Despite differences in underlying mechanisms, both studies demonstrated beneficial effects of specific forms of EMS on athlete recovery processes.

4.3. Risk Factors and Adverse Reactions Associated with EMS Application

None of the 10 included studies reported adverse events associated with EMS applications. However, a substantial body of the literature has documented various side effects related to electrical stimulation. Localized muscle stimulation is frequently linked to delayed-onset muscle soreness and fatigue following use [38]. When stimulation intensity is excessive, it may lead to muscle fiber damage, often indicated by elevated creatine kinase levels, and in rare cases, may result in rhabdomyolysis [39]. In addition, high-intensity stimulation can produce sharp or burning sensations at the site of application, requiring careful adjustment of parameters or gradual adaptation by the user [40]. Erythema under the electrodes is common and typically harmless, though cases of contact dermatitis have also been reported [41]. In comparison, whole-body EMS (WB-EMS)—which involves simultaneous high-intensity activation of multiple muscle groups—presents a higher risk, especially for individuals undergoing their first session [42]. Improper use during initial exposure may cause a marked increase in creatine kinase levels and, in rare circumstances, severe rhabdomyolysis [42]. Consequently, strict regulation of total stimulation intensity and session durations is essential. Moreover, if training sessions are scheduled too frequently or stimulation is applied too often, the resulting accumulation of metabolic stress may lead to symptoms associated with overtraining syndrome [43]. Due to the extensive electrode coverage, WB-EMS may also cause greater discomfort compared to localized stimulation [44].
The 10 included studies did not report any adverse events, which may be attributed to several factors. First, many of these studies used moderate stimulation levels, short treatment durations, or applied electrical stimulation to specific muscle groups. These settings result in a low likelihood of causing noticeable side effects, especially in trained populations such as soccer players. Second, most studies involved short follow-up periods; hence, they may have missed delayed effects such as increased serum creatine kinase levels or muscle soreness, which frequently occur 24–72 h after the intervention [45]. Further, underreporting of side effects is a known issue in both clinical and sports science studies [46]. This is especially true when the effects are mild, short-term, or not related to the intervention. Studies that do not include proper monitoring tools, such as lab tests, symptom checklists, or follow-up surveys, may not notice some side effects. Further, publication bias may play a role because studies with positive results and no complications are more likely to be published. Some studies have demonstrated that reports of adverse events are more prevalent in the unpublished or gray literature than in published articles [47]. Therefore, future research should consider including the gray literature to provide a more complete picture of the safety of EMS in athletic settings.

4.4. Methodological Quality

The nature of EMS interventions presents inherent challenges to the implementation of blinding, particularly among participants. Although all included studies employed randomized controlled designs, most were rated as having “some concerns” or “high risk” in the “deviations from intended interventions” domain of the Cochrane Risk of Bias tool. These ratings primarily stem from a lack of participant and/or assessor blinding.
In the context of EMS, the absence of participant blinding introduces a substantial risk of performance bias. Participants aware of their group allocation may experience altered motivation, perception of effort, or expectations of benefit, all of which may influence measured outcomes [48]. These psychological responses can lead to placebo effects that artificially inflate performance outcomes, or conversely, nocebo effects that suppress them [49]. Similarly, unblinded outcome assessors may be subject to detection bias, particularly in studies where outcome measures involve subjective judgment or participant cooperation, such as jump testing or perceived exertion ratings [50]. These methodological limitations compromise the internal validity of many included studies and reduce confidence in the reported effectiveness of EMS [48]. Therefore, interpretation of the results should be approached with caution, particularly when blinding was not implemented. Future studies should prioritize the incorporation of double-blind designs or utilize sham stimulation protocols and independent outcome assessors to minimize bias and improve the reliability and reproducibility of findings.

5. Strengths of Our Study

One of the main strengths of this review is its clear focus on RCTs, which helps provide more reliable evidence regarding the effects of EMS on soccer players. Further, this study covers a broad range of outcomes, including performance improvement and recovery from fatigue or injury. To the best of our knowledge, this is the first systematic review that concentrates specifically on EMS application in soccer according to RCT evidence, thereby providing a more focused perspective for researchers, coaches, and practitioners.

6. Limitations and Future Directions

All ten studies included in this review indicate that EMS may help improve muscle strength, support post-exercise recovery, and aid injury rehabilitation in soccer players. However, several limitations should be noted. One major issue is the inconsistency in study designs and EMS protocols. Most studies did not use high-quality randomized controlled trials, and few were single-blind, which affects the reliability and generalizability of their findings. In addition, there was considerable variation in the EMS parameters such as intensity, frequency, pulse width, and timing of application. These inconsistencies, along with the lack of standardized outcome measures, make it difficult to compare results and establish clear guidelines for practice.
Because of this variation in protocols, outcome measures, participant characteristics, and overall study quality, a meta-analysis was not feasible. Many studies also lacked key statistical data like means, standard deviations, or effect sizes, preventing a quantitative synthesis. For these reasons, we chose a descriptive approach to summarize the findings and highlight common trends and methodological concerns.
Another limitation is that most interventions were short in duration and lacked follow-up. As a result, it remains uncertain whether the benefits of EMS can be sustained over time or lead to long-term functional improvements. While some studies showed gains in measures such as strength or jump height, few examined whether these improvements had any real impact on match performance, limiting the practical value of the findings. Individual factors such as sex and athletic level may also influence how athletes respond to EMS. Differences in muscle fiber types, hormonal profiles, and neuromuscular patterns between males and females, as well as between elite and amateur athletes, could affect training outcomes [51,52]. Future studies should take these variables into account to better tailor EMS protocols.
To strengthen future research, studies should aim for higher methodological quality, including well-designed randomized controlled trials with longer follow-up periods. It is also important to include female athletes, use validated tools to measure outcomes, and assess performance in settings that reflect actual competition. These improvements would help make the findings more reliable and relevant for practical use.

7. Safety Considerations

While no adverse events were reported in the included studies, the broader literature identifies several risks associated with EMS, particularly at higher intensities or when WB-EMS protocols are applied. Reported effects include DOMS, skin redness, elevated CK levels, and, in rare instances, rhabdomyolysis [41,53]. To mitigate these risks, it is advisable to begin with low stimulation levels in early sessions and to monitor participants’ recovery and relevant biochemical markers when using high-volume EMS protocols.

8. Conclusions

The current body of evidence suggests that EMS and WB-EMS interventions may support improvements in athletic performance, post-exercise recovery, and injury rehabilitation in football players. However, the overall strength of these findings is limited due to the generally low methodological quality of the included studies. Notably, most studies lacked rigorous randomized controlled trial (RCT) designs and failed to adopt standardized protocols regarding EMS application parameters such as frequency, intensity, and duration. This heterogeneity hampers the ability to draw clear conclusions or formulate evidence-based guidelines. Furthermore, the absence of dose–response investigations and the lack of studies involving female athletes further limit the generalizability of the results. Future research should prioritize methodological rigor, protocol standardization, and the inclusion of diverse athlete populations. Additionally, systematic monitoring and reporting of potential adverse effects are essential to establish the safety profile of EMS-based interventions.

Supplementary Materials

The following supporting information can be downloaded at https://www.mdpi.com/article/10.3390/app15147950/s1, Table S1: PRISMA checklist.

Author Contributions

Conceptualization, M.-Y.S., H.S.O., K.-W.K., J.-H.J. and C.-H.K.; methodology, Y.-J.J., K.-W.K. and J.-H.J.; validation, S.-H.E., C.W.M. and C.-H.K.; formal analysis, J.L. and H.S.O.; investigation, M.-Y.S., H.S.O., S.M.J., C.W.M. and C.-H.K.; resources, J.L. and S.-H.E.; data curation, M.-Y.S., H.S.O., Y.-J.J. and J.-H.J.; writing—original draft preparation, M.-Y.S., H.S.O., S.M.J. and C.-H.K.; writing—review and editing, M.-Y.S., H.S.O., C.W.M., S.M.J. and C.-H.K.; visualization, Y.-J.J.; supervision, C.W.M. and C.-H.K.; project administration, C.W.M. and C.-H.K.; funding acquisition, C.-H.K. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by the Soonchunhyang University Research Fund. In addition, this research was supported by the ”regional innovation mega project” program through the Korea Innovation Foundation, funded by the Ministry of Science and ICT (Project Number: 2023-DD-UP-0007).

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Data will be made available upon request.

Acknowledgments

We would like to thank Xiuchang Zhang from the School of Sports Science, Hengyang Normal University, for his valuable assistance during the preparation of this manuscript.

Conflicts of Interest

The authors declare no conflicts of interest.

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Applsci 15 07950 g001
Figure 1. Flow chart for study inclusion and exclusion process based on PRISMA.
Figure 1. Flow chart for study inclusion and exclusion process based on PRISMA.
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Figure 2. Summary bar chart of the Risk of Bias (RoB) assessment across included studies.
Figure 2. Summary bar chart of the Risk of Bias (RoB) assessment across included studies.
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Table 1. Study characteristics and findings of the included literature.
Table 1. Study characteristics and findings of the included literature.
StudyParticipants (Sex)Physical CharacteristicsLevelStudy DesignResults
Billot et al., 2010 [14]20 malesElectrostimulated group (n = 10; age 20.1 ± 2.1 years; height 1.76 ± 0.06 m; mass 69.5 ± 7.4 kg); comparison group (n = 10; age 21.7 ± 3.4 years; height 1.80 ± 0.05 m; mass 70.7 ± 11.0 kg).RegionalTwo groups maintained two weekly soccer training sessions and one match (5 h total). The EMS group additionally underwent 5 weeks of EMS training.After 3 weeks of EMS training, isometric (p < 0.01) and eccentric knee extension torque (p < 0.01) and ball speed without run-up increased (p < 0.05). After 5 weeks of EMS training, eccentric, isometric, and concentric torques, along with ball speed, significantly improved (p < 0.001).
Bieuzen et al., 2012 [15]26 malesAge = 25.6 ± 5.7 years; height = 1.77 ± 0.8 m; mass = 75.0 ± 12.2 kg.ProfessionalThe athletes were divided into two groups, performed an intermittent fatiguing exercise, and then underwent a 1-h recovery period. The electrical stimulation group received 20 min of electrical stimulation during the recovery phase.The group that received electrical stimulation exhibited enhanced performance in the 30-second all-out test (p = 0.03).
Taradaj et al., 2013 [16]80 males/ProfessionalAll athletes participated in a structured exercise program three times per week for one month. Additionally, participants in Group A received NMES on both the right and left quadriceps muscles.NMES significantly improved quadriceps strength and muscle circumference compared to the control group, on both the operated and non-operated sides (p < 0.05).
Filipovic et al., 2016 [17]22 malesEMS group (n = 12; age 24.9 ± 3.6 years; height 1.84 ± 0.05 m; mass 80.6 ± 9.2 kg), comparison group (n = 10; age 26.4 ± 3.2 years; height 1.82 ± 0.07 m; mass 78.3 ± 9.3 kg).ProfessionalExperimental Group: Jump training + WB-EMS.
Comparison Group: Jump training only.		EMS training significantly increased the one-legged maximal strength on the leg press machine (p = 0.001) and improved linear sprint performance (p = 0.039), sprint with direction changes (p = 0.024), vertical jump performance (p = 0.021), and kicking velocity (p < 0.001).
Barassi et al., 2019 [18]20 malesAge: 25.5 ± 10.6 years.Semi-professional The treatment group (TR) showed a significant increase in muscular tone (p < 0.05) but also an increase in stiffness and a decrease in elasticity.
The TR group exhibited notable postural improvements (p < 0.05), whereas the control group (NTR) experienced postural deterioration.
Filipovic et al., 2019 [19]28 males/RegionalEMS Group: n = 10: WB-EMS + 3 × 10 squat jumps + soccer training (7 weeks).
Jump Training Group: n = 10: squat jumps + soccer training (no EMS).
Control Group: n = 8: only regular soccer training.		EMS training significantly improved maximal strength in leg press (p = 0.009) and leg curl (p = 0.026), along with a significant increase in Type II muscle fiber diameter (p = 0.023).
Kale and Gurol, 2019 [20]23 malesAge: 18–24 years.CompetitiveExperimental Group: n = 10: regular training + EMS.
Control Group: n = 13: regular training only.
Study duration: 6 weeks.		Significant strength increases in the control group across all angular velocities (60°/s, 180°/s, 300°/s), particularly in both dominant and non-dominant legs (p < 0.05).
Hasan et al., 2022 [21]60 malesNMES group (n = 30; age 22.20 ± 1.83 years; height 1.65 ± 0.01 m; mass 63.33 ± 2.99 kg), sham NMES group (n = 30; age 22.07 ± 1.80 years; height 1.66 ± 0.02 m; mass 65.20 ± 2.30 kg).CollegiateNMES Group (n = 30): NMES-guided strength training + plyometric training. Sham NMES group (n = 30): Sham NMES-guided strength training + plyometric training.NMES significantly improved strength (STN) (p < 0.001) and sprint performance (ST) (p = 0.002) compared to controls.
Labib and Sabah, 2024 [22]50 malesNMES group (n = 25; age 24.16 ± 4.34 years; height 1.79 ± 0.07 m; mass 63.24 ± 3.62 kg), comparison group (n = 25; age 25.32 ± 3.68 years; height 1.77 ± 0.06 m; mass 63.80 ± 3.48 kg)./NMES Group (n = 25): NMES + standard rehabilitation program. Comparison Group (n = 25): Standard rehabilitation program.NMES significantly improved functional outcomes compared to the control group at both 12 and 16 weeks post-rehabilitation (p < 0.001).
Fernández-Elías et al., 2024 [23]12 malesAge 21.75 ± 1.86 years; height 1.79 ± 0.06 m; mass 71.58 ± 6.86 kg.Semi-professionalWB-EMS Group (n = 12): WB-EMS + FIFA11 + warm-up protocol. Comparison Group (n = 12): FIFA11 + warm-up protocol.Left popliteal Tsk was significantly lower after WB-EMS warm-up compared to NO WB-EMS (p < 0.05, ES: ηp2 = 0.62). Capillary blood lactate significantly increased only in the NO WB-EMS trial (p < 0.05). The 20 m sprint time was significantly faster (0.2 s improvement) after WB-EMS warm-up compared to NO WB-EMS (p < 0.05).
Table 2. Electrical stimulation settings used in the included studies.
Table 2. Electrical stimulation settings used in the included studies.
StudyTraining PeriodTraining
Frequency		EMS ContextStimulation SiteImpulse Width (μs)Stimulation Frequency (Hz)Impulse Intensity (mA)On Time
(on, s)		Interval (off, s)
Billot et al., 2010 [14]5 weeks3 sessions per weekIn-season trainingVastus medialis and vastus lateralis40010060–120317
Bieuzen et al., 2012 [15]1 h recovery after fatiguing exercise1 sessionRecovery after intermittent fatigue exerciseMedial-central part of the calf (bilateral placement)2401 (first 5 min), 1.25 (next 5 min), 1.5 (next 5 min), 1.75 (final 5 min)Adjustable (minimum threshold set to visible, comfortable contraction)//
Taradaj et al., 2013 [16]1 month3 sessions per weekPost-ACL reconstruction rehabilitationBoth quadriceps100050 55–67 (mean = 58.89)1050
Filipovic et al., 2016 [17]14 weeks2 sessions per weekIn-season trainingChest, back, abdominal muscles, glutes, thigh muscles, and calves35080Individually adjusted using Borg scale (80–90%)4 s per jump10 s (duty cycle ~28%)
Barassi et al., 2019 [18]4 weeks4 sessions per weekIn-season trainingWhole body (via dermatomeral and metameric pathways)/15–350Modulated based on tissue 10 min per program, 20 min total per session/
Filipovic et al., 2019 [19]7 weeks3 sessions per weekPreseason trainingChest, upper and lower back, latissimus, abdominals, glutes, thighs, calves350800–120 mA, adjusted for each muscle group using Borg RPE scale (16–19, “hard to very hard”)4 s per squat jump (2 s eccentric, 1 s isometric, 0.1 s concentric, 1 s landing/stabilization)10 s rest (duty cycle ~28%)
Kale and Gurol, 2019 [20]6 weeks3 sessions per weekIn-season trainingVastus medialis, vastus lateralis, and rectus femoris400100Increased until muscle contraction was initiated (individually adjusted)103
Hasan et al., 2022 [21]8 weeks3 sessions per weekIn-season trainingFemoral nerve and quadriceps femoris 250075Max tolerated58
Labib and Sabah, 2024 [22]6 weeks6 sessions per weekPost-ACL reconstruction rehabilitationRectus femoris and vastus lateralis 250075Adjusted per individual1050
Fernández-Elías et al., 2024 [23]1 session (per trial)The two experimental sessions were separated by one weekPreseasonUpper body (chest, upper back, lower back, abs), lower body (glutes, thighs, hamstrings, calves)35020Adjusted per individual//
Table 3. The domain-specific and overall risk of bias for individual studies.
Table 3. The domain-specific and overall risk of bias for individual studies.
Randomization ProcessDeviations from Intended InterventionsMissing Outcome DataMeasurement of the OutcomeSelection of the Reported ResultOverall
Billot et al., 2010 [14]Low riskSome concernsLow riskLow riskLow riskSome concerns
Bieuzen et al., 2012 [15]Low riskLow riskLow riskSome concernsSome concernsSome concerns
Taradaj et al., 2013 [16]Low riskHigh riskLow riskLow riskSome concernsHigh risk
Filipovic et al., 2016 [17]Low riskSome concernsLow riskLow riskSome concernsSome concerns
Barassi et al., 2019 [18]Low riskSome concernsLow riskLow riskLow riskSome concerns
Filipovic et al., 2019 [19]Low riskHigh riskLow riskLow riskLow riskHigh risk
Kale and Gurol, 2019 [20]Low riskSome concernsLow riskSome concernsLow riskSome concerns
Hasan et al., 2022 [21]Low riskLow riskLow riskLow riskLow riskLow risk
Labib and Sabah, 2024 [22]Low riskSome concernsLow riskLow riskLow riskSome concerns
Fernández-Elías et al., 2024 [23]Low riskLow riskLow riskLow riskLow riskLow risk
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Shu, M.-Y.; Oh, H.S.; Jo, Y.-J.; Eom, S.-H.; Liang, J.; Jung, S.M.; Kim, K.-W.; Jung, J.-H.; Ma, C.W.; Kim, C.-H. The Impact of Electromyostimulation on Strength, Recovery, and Performance in Soccer Athletes: A Systematic Review. Appl. Sci. 2025, 15, 7950. https://doi.org/10.3390/app15147950

AMA Style

Shu M-Y, Oh HS, Jo Y-J, Eom S-H, Liang J, Jung SM, Kim K-W, Jung J-H, Ma CW, Kim C-H. The Impact of Electromyostimulation on Strength, Recovery, and Performance in Soccer Athletes: A Systematic Review. Applied Sciences. 2025; 15(14):7950. https://doi.org/10.3390/app15147950

Chicago/Turabian Style

Shu, Meng-Yuan, Hyoung Suk Oh, Young-Jin Jo, Seon-Ho Eom, Jian Liang, Sang Mok Jung, Ki-Wan Kim, Joo-Ha Jung, Chae Woo Ma, and Chul-Hyun Kim. 2025. "The Impact of Electromyostimulation on Strength, Recovery, and Performance in Soccer Athletes: A Systematic Review" Applied Sciences 15, no. 14: 7950. https://doi.org/10.3390/app15147950

APA Style

Shu, M.-Y., Oh, H. S., Jo, Y.-J., Eom, S.-H., Liang, J., Jung, S. M., Kim, K.-W., Jung, J.-H., Ma, C. W., & Kim, C.-H. (2025). The Impact of Electromyostimulation on Strength, Recovery, and Performance in Soccer Athletes: A Systematic Review. Applied Sciences, 15(14), 7950. https://doi.org/10.3390/app15147950

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