Cross-education of muscle strength: cross-training effects are not confined to untrained contralateral homologous muscle


Corresponding author: Ilhan Karacan, MD, Zuhuratbaba Mah Tatlinar sk, 8/11 Bakιrköy 34147 Istanbul, Turkey. Tel: +90 212 453 1751, Fax: +90 212 621 7580, E-mail:


The aim of this study was to evaluate whether electrical muscle stimulation (EMS) on dominant wrist flexors causes an increase in the muscle strength of the contralateral wrist extensors. Twenty-three healthy, young, adult men were included in this prospective, double-blind, controlled study. Participants were randomly allocated to the EMS group or Control group. Electrodes were placed over the flexor aspect of the right forearm in both groups. In the EMS group, passive wrist extension and (EMS) that caused powerful muscle contraction were simultaneously applied. In the Control group, a conventional mode of transcutaneous electrical nerve stimulation was applied without causing any contraction. A group effect (P=0.0001) and group-by-time interaction were found (P=0.0001) for both the wrist flexor and extensor muscles, but not group-by-time-by-arm interactions. This implies that the effect of the interventions was similar in both arms, but that the response was significantly larger in the EMS than in the Control group. The results of the current study suggest that cross-education is not confined to the untrained contralateral wrist flexors and that the strength increase may also be observed in the contralateral wrist extensors.