Effects of Aerobic Exercise Combined with Whole-Body Electromyostimulation on Muscular, Pulmonary, and Metabolic Health in Obese Middle-Aged Women in South Korea

Objectives/Background: Aerobic exercise serves as a fundamental component in improving metabolic health. However, because obese middle-aged women often find it difficult to maintain long-term exercise participation, more efficient alternative strategies, such as whole-body electromyostimulation (WB-EMS), need to be explored. This study investigated the effects of aerobic exercise combined with WB-EMS on muscle and pulmonary functioning and metabolic health indicators in obese middle-aged women in South Korea, where obesity rates have been steadily increasing. Methods: Women aged 40–65 years with a body mass index ≥25 kg/m2 who met at least three diagnostic criteria for metabolic syndrome were recruited. Of the 45 recruits, 36 completed the study. Participants were randomly assigned to a control (CON), aerobic exercise (EXG), or aerobic exercise with WB-EMS (WEG) group. The intervention consisted of a 12-week aerobic program performed three times per week for 40 min per session, with WB-EMS applied during the main exercise period. Muscle function, pulmonary function, and metabolic health indicators were assessed. Data were analyzed using two-way repeated-measures analysis of variance. Statistical significance was set at p < 0.05. Results: Significant group × time interaction effects were observed for muscle strength outcomes, with knee extensor and flexor peak torque at 60°/s (p < 0.001 for the right and left knee extensors; p = 0.001 for right knee flexors; p < 0.001 for left knee flexors). Post hoc comparisons indicated greater improvements in the WEG than in both the CON and EXG. Forced vital capacity (FVC) showed significant group × time interactions and time main effects (both p < 0.001), whereas forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio showed no significant group, time, or interaction effects (all p > 0.05). Regarding metabolic health, BMI and waist-to-hip ratio showed significant time effects, indicating overall reductions following the intervention without significant interaction effects. Low-density lipoprotein cholesterol (p = 0.004) and fasting plasma glucose (p = 0.004) showed significant group × time interaction effects; however, post hoc analyses revealed no significant differences between the WEG and EXG. No consistent additional metabolic benefits of WB-EMS beyond aerobic exercise alone were observed. Conclusions: The 12-week aerobic exercise program improved muscle strength, pulmonary function, and selected metabolic indicators in obese middle-aged women. Aerobic exercise combined with WB-EMS provided additional benefits primarily for muscle strength compared with aerobic exercise alone, without conferring additional metabolic advantages.