Electrical Muscle Stimulation (EMS) is increasingly used in aesthetic medicine, physiotherapy, and rehabilitation. Its effectiveness and patient compliance depend largely on the tolerance of electrical impulses, which can induce discomfort or pain. Understanding factors that influence pain thresholds is essential for optimizing treatment protocols and ensuring patient safety.

This pilot study investigated the relationship between body composition, skin parameters, and pain tolerance to EMS stimuli in women. Sixteen healthy female participants (mean age 35.9 ± 12.3 years) underwent comprehensive anthropometric assessments, bioelectrical impedance analysis (BIA), and high-frequency ultrasound of abdominal skin. EMS was applied to the abdominal region using the Evolvex system (InMode, Israel), with gradually increasing intensity until the pain threshold was reached. The maximum tolerated EMS intensity ranged from 12V to 55V (median 33V). Significant positive correlations were found between pain tolerance and body weight (R=0.76, p<0.001), hip circumference (R=0.66, p<0.001), body fat mass (R=0.61, p=0.012), visceral fat area (R=0.55, p=0.029), and skinfold thickness (R=0.61, p=0.013). No significant associations were observed with muscle mass, water compartments, or skin ultrasound parameters.

These findings suggest that tolerance to EMS is strongly influenced by adipose tissue characteristics and selected anthropometric indices, whereas muscle tissue and skin structural parameters play a negligible role. Women with higher body fat levels exhibited greater tolerance to electrical stimulation, likely due to current attenuation in adipose tissue.

This study highlights the importance of individualized EMS protocols tailored to patient body composition. Personalized adjustment of stimulation intensity may improve treatment comfort, adherence, and clinical outcomes in both aesthetic and rehabilitative settings. Future studies with larger and more diverse cohorts are warranted to confirm these preliminary observations.

Dr. Małgorzata Bożek obtained her PhD in Medical Sciences from the Medical University of Silesia in Katowice in 2010, where she also completed her master’s degree in Medical Analytics. Her doctoral work focused on assessing intraintestinal lipolytic activity using the 13C breath test. She currently serves as a researcher and lecturer in the Department of Basic Biomedical Sciences at the Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia. Her scientific interests span cosmetology, dermatology, medical biotechnology, and aesthetic medicine. Dr.Bożek has authored and co-authored numerous peer-reviewed publications in international journals. Her recent research includes studies on tolerance to electrical muscle stimulation, the development of non-invasive diagnostic methods, and quantitative imaging of skin physiology. She has been actively involved in both national and international research projects. In addition to her academic work, she is a certified laboratory diagnostician and has completed a specialization course in medical laboratory diagnostics.