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Cianni L, Di Gialleonardo E, Coppola D, Capece G, Libutti E, Nannerini M, Maccauro G, Vitiello R. Current Evidence Using Pulsed Electromagnetic Fields in Osteoarthritis: A Systematic Review. J Clin Med 2024; 13:1959. [PMID: 38610722 PMCID: PMC11012419 DOI: 10.3390/jcm13071959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Osteoarthritis (OA) significantly impacts patients' quality of life and negatively affects public healthcare costs. The aim of this systematic review is to identify the effectiveness of pulsed electromagnetic fields (PEMFs) in OA treatment across different anatomical districts, determining pain reduction and overall improvement in the patient's quality of life. (2) Methods: In this systematic review following PRISMA guidelines, PubMed and Google Scholar were searched for randomized controlled trials involving patients with osteoarthritis undergoing PEMF therapy. Seventeen studies (1197 patients) were included. (3) Results: PEMF therapy demonstrated positive outcomes across various anatomical districts, primarily in knee osteoarthritis. Pain reduction, assessed through VAS and WOMAC scores, showed significant improvement (60% decrease in VAS, 42% improvement in WOMAC). The treatment duration varied (15 to 90 days), with diverse PEMF devices used. Secondary outcomes included improvements in quality of life, reduced medication usage, and enhanced physical function. (4) Conclusions: Diverse PEMF applications revealed promising results, emphasizing pain reduction and improvement in the quality of life of patients. The variability in the treatment duration and device types calls for further investigation. This review informs future research directions and potential advancements in optimizing PEMF therapies for diverse osteoarthritic manifestations.
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Affiliation(s)
- Luigi Cianni
- Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.C.); (E.D.G.); (D.C.); (G.M.); (R.V.)
- Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Emidio Di Gialleonardo
- Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.C.); (E.D.G.); (D.C.); (G.M.); (R.V.)
| | - Donato Coppola
- Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.C.); (E.D.G.); (D.C.); (G.M.); (R.V.)
| | - Giacomo Capece
- Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.C.); (E.D.G.); (D.C.); (G.M.); (R.V.)
| | | | | | - Giulio Maccauro
- Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.C.); (E.D.G.); (D.C.); (G.M.); (R.V.)
- Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Raffaele Vitiello
- Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.C.); (E.D.G.); (D.C.); (G.M.); (R.V.)
- Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Su DB, Zhao ZX, Yin DC, Ye YJ. Promising application of pulsed electromagnetic fields on tissue repair and regeneration. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2024; 187:36-50. [PMID: 38280492 DOI: 10.1016/j.pbiomolbio.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/14/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024]
Abstract
Tissue repair and regeneration is a vital biological process in organisms, which is influenced by various internal mechanisms and microenvironments. Pulsed electromagnetic fields (PEMFs) are becoming a potential medical technology due to its advantages of effectiveness and non-invasiveness. Numerous studies have demonstrated that PEMFs can stimulate stem cell proliferation and differentiation, regulate inflammatory reactions, accelerate wound healing, which is of great significance for tissue regeneration and repair, providing a solid basis for enlarging its clinical application. However, some important issues such as optimal parameter system and potential deep mechanisms remain to be resolved due to PEMFs window effect and biological complexity. Thus, it is of great importance to comprehensively summarizing and analyzing the literature related to the biological effects of PEMFs in tissue regeneration and repair. This review expounded the biological effects of PEMFs on stem cells, inflammation response, wound healing and musculoskeletal disorders in order to improve the application value of PEMFs in medicine. It is believed that with the continuous exploration of biological effects of PEMFs, it will be applied increasingly widely to tissue repair and other diseases.
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Affiliation(s)
- Dan-Bo Su
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Zi-Xu Zhao
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Da-Chuan Yin
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Ya-Jing Ye
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China.
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Moretti L, Bizzoca D, Geronimo A, Abbaticchio AM, Moretti FL, Carlet A, Fischetti F, Moretti B. Targeting Adenosine Signalling in Knee Chondropathy: The Combined Action of Polydeoxyribonucleotide and Pulsed Electromagnetic Fields: A Current Concept Review. Int J Mol Sci 2023; 24:10090. [PMID: 37373237 DOI: 10.3390/ijms241210090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Chondropathy of the knee is one of the most frequent degenerative cartilage pathologies with advancing age. Scientific research has, in recent years, advanced new therapies that target adenosine A2 receptors, which play a significant role in human health against many disease states by activating different protective effects against cell sufferance and damage. Among these, it has been observed that intra-articular injections of polydeoxyribonucleotides (PDRN) and Pulsed Electromagnetic Fields (PEMF) can stimulate the adenosine signal, with significant regenerative and healing effects. This review aims to depict the role and therapeutic modulation of A2A receptors in knee chondropathy. Sixty articles aimed at providing data for our study were included in this review. The present paper highlights how intra-articular injections of PDRN create beneficial effects by reducing pain and improving functional clinical scores, thanks to their anti-inflammatory action and the important healing and regenerating power of the stimulation of cell growth, production of collagen, and the extracellular matrix. PEMF therapy is a valid option in the conservative treatment of different articular pathologies, including early OA, patellofemoral pain syndrome, spontaneous osteonecrosis of the knee (SONK), and in athletes. PEMF could also be used as a supporting therapy after an arthroscopic knee procedure total knee arthroplasty to reduce the post-operative inflammatory state. The proposal of new therapeutic approaches capable of targeting the adenosine signal, such as the intra-articular injection of PDRN and the use of PEMF, has shown excellent beneficial results compared to conventional treatments. These are presented as an extra weapon in the fight against knee chondropathy.
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Affiliation(s)
- Lorenzo Moretti
- Orthopaedics Unit-UOSD Vertebral Surgery, AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Davide Bizzoca
- Orthopaedics Unit-UOSD Vertebral Surgery, AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Ph.D. Course in Public Health, Clinical Medicine and Oncology, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Alessandro Geronimo
- Orthopaedics Unit, DiBraiN, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy
| | | | - Francesco Luca Moretti
- National Centre for Chemicals, Cosmetic Products and Consumer Protection, National Institute of Health, 00161 Rome, Italy
| | - Arianna Carlet
- Orthopaedics Unit, DiBraiN, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Francesco Fischetti
- Departement DiBraiN, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Biagio Moretti
- Orthopaedics Unit, DiBraiN, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy
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Paolucci T, Porto D, Pellegrino R, Sina O, Fero A, D'Astolfo S, Franceschelli S, Patruno A, Fusco A, Pesce M. Combined Rehabilitation Protocol in the Treatment of Osteoarthritis of the Knee: Comparative Study of Extremely Low-Frequency Magnetic Fields and Soft Elastic Knee Brace Effect. Healthcare (Basel) 2023; 11:healthcare11091221. [PMID: 37174763 PMCID: PMC10178194 DOI: 10.3390/healthcare11091221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/29/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
The investigation of this observational case-control study aimed at determining the effectiveness of a combined treatment of extremely low-frequency electromagnetic fields (ELF) with a soft elastic knee brace versus ELF alone in knee osteoarthritis (KOA) with respect to a reduction in pain and functional recovery. We hypothesized that the combined use of ELF and a soft elastic knee brace may provide better results. Thirty-five patients (N = 35, divided into Group 1 = ELF and Group 2 = ELF with the soft elastic knee brace) were analyzed. The rehabilitative protocol consisted of 10 sessions of antiphlogistic and antiedema programs (first cycle) for 2 weeks, followed by twelve sessions of bone repair and connective tissue repair programs (second cycle) in patients with knee osteoarthritis (KOA) for 4 weeks. Patient evaluations were conducted at baseline (T0) and after 2 (T1) and 4 (T2) weeks of treatment. A follow-up evaluation was conducted 6 weeks after treatment (T3). The LIMFA© Therapy System was used to create multifrequency magnetoelectric fields with an intensity of 100 µT and a low-frequency field. The Incrediwear Cred 40 knee sleeve (Incred) was used for alleviating knee pain. The Visual Analogue Scale (VAS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Lysholm score (Ls) were used as outcome measures. The results showed that pain at rest (Vr), pain in motion (Vm), KOOS, and Ls were significantly affected by ELF over time. In conclusion, Group 2 had a better response in terms of pain resolution at rest (p < 0.05) and a concurrent better response at T3 in terms of functional recovery (p < 0.05).
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Affiliation(s)
- Teresa Paolucci
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, University of G. D'Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Daniele Porto
- Unit of Physical Medicine and Rehabilitation, Don Orione Institute, 65128 Pescara, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Semmelweis University, 6912 Lugano, Switzerland
| | - Ornela Sina
- Unit of Physical Medicine and Rehabilitation, Don Orione Institute, 65128 Pescara, Italy
| | - Andi Fero
- Unit of Physical Medicine and Rehabilitation, Don Orione Institute, 65128 Pescara, Italy
| | - Sara D'Astolfo
- Unit of Physical Medicine and Rehabilitation, Don Orione Institute, 65128 Pescara, Italy
| | - Sara Franceschelli
- Department of Medicine and Aging Science, University of G. D'Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Antonia Patruno
- Department of Medicine and Aging Science, University of G. D'Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Augusto Fusco
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Mirko Pesce
- Department of Medicine and Aging Science, University of G. D'Annunzio Chieti-Pescara, 66100 Chieti, Italy
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Schaefer LV, Bittmann FN. Case report: Individualized pulsed electromagnetic field therapy in a Long COVID patient using the Adaptive Force as biomarker. Front Med (Lausanne) 2023; 9:879971. [PMID: 36714125 PMCID: PMC9874300 DOI: 10.3389/fmed.2022.879971] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
The increasing prevalence of Long COVID is an imminent public health disaster, and established approaches have not provided adequate diagnostics or treatments. Recently, anesthetic blockade of the stellate ganglion was reported to improve Long COVID symptoms in a small case series, purportedly by "rebooting" the autonomic nervous system. Here, we present a novel diagnostic approach based on the Adaptive Force (AF), and report sustained positive outcome for one severely affected Long COVID patient using individualized pulsed electromagnetic field (PEMF) at the area C7/T1. AF reflects the capacity of the neuromuscular system to adapt adequately to external forces in an isometric holding manner. In case, maximal isometric AF (AFisomax) is exceeded, the muscle merges into eccentric muscle action. Thereby, the force usually increases further until maximal AF (AFmax) is reached. In case adaptation is optimal, AFisomax is ~99-100% of AFmax. This holding capacity (AFisomax) was found to be vulnerable to disruption by unpleasant stimulus and, hence, was regarded as functional parameter. AF was assessed by an objectified manual muscle test using a handheld device. Prior to treatment, AFisomax was considerably lower than AFmax for hip flexors (62 N = ~28% AFmax) and elbow flexors (71 N = ~44% AFmax); i.e., maximal holding capacity was significantly reduced, indicating dysfunctional motor control. We tested PEMF at C7/T1, identified a frequency that improved neuromuscular function, and applied it for ~15 min. Immediately post-treatment, AFisomax increased to ~210 N (~100% AFmax) at hip and 184 N (~100% AFmax) at elbow. Subjective Long COVID symptoms resolved the following day. At 4 weeks post-treatment, maximal holding capacity was still on a similarly high level as for immediately post-treatment (~100% AFmax) and patient was symptom-free. At 6 months the patient's Long COVID symptoms have not returned. This case report suggests (1) AF could be a promising diagnostic for post-infectious illness, (2) AF can be used to test effective treatments for post-infectious illness, and (3) individualized PEMF may resolve post-infectious symptoms.
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Affiliation(s)
- Laura V. Schaefer
- Regulative Physiology and Prevention, Department of Sports and Health Sciences, University Potsdam, Potsdam, Germany
- Practice of Integrative Medicine Bittmann, Potsdam, Germany
| | - Frank N. Bittmann
- Regulative Physiology and Prevention, Department of Sports and Health Sciences, University Potsdam, Potsdam, Germany
- Practice of Integrative Medicine Bittmann, Potsdam, Germany
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6
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Armenia I, Cuestas Ayllón C, Torres Herrero B, Bussolari F, Alfranca G, Grazú V, Martínez de la Fuente J. Photonic and magnetic materials for on-demand local drug delivery. Adv Drug Deliv Rev 2022; 191:114584. [PMID: 36273514 DOI: 10.1016/j.addr.2022.114584] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/26/2022] [Accepted: 10/16/2022] [Indexed: 02/06/2023]
Abstract
Nanomedicine has been considered a promising tool for biomedical research and clinical practice in the 21st century because of the great impact nanomaterials could have on human health. The generation of new smart nanomaterials, which enable time- and space-controlled drug delivery, improve the limitations of conventional treatments, such as non-specific targeting, poor biodistribution and permeability. These smart nanomaterials can respond to internal biological stimuli (pH, enzyme expression and redox potential) and/or external stimuli (such as temperature, ultrasound, magnetic field and light) to further the precision of therapies. To this end, photonic and magnetic nanoparticles, such as gold, silver and iron oxide, have been used to increase sensitivity and responsiveness to external stimuli. In this review, we aim to report the main and most recent systems that involve photonic or magnetic nanomaterials for external stimulus-responsive drug release. The uniqueness of this review lies in highlighting the versatility of integrating these materials within different carriers. This leads to enhanced performance in terms of in vitro and in vivo efficacy, stability and toxicity. We also point out the current regulatory challenges for the translation of these systems from the bench to the bedside, as well as the yet unresolved matter regarding the standardization of these materials.
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Affiliation(s)
- Ilaria Armenia
- BioNanoSurf Group, Instituto de Nanociencia y Materiales de Aragón (INMA,CSIC-UNIZAR), Edificio I +D, 50018 Zaragoza, Spain.
| | - Carlos Cuestas Ayllón
- BioNanoSurf Group, Instituto de Nanociencia y Materiales de Aragón (INMA,CSIC-UNIZAR), Edificio I +D, 50018 Zaragoza, Spain
| | - Beatriz Torres Herrero
- BioNanoSurf Group, Instituto de Nanociencia y Materiales de Aragón (INMA,CSIC-UNIZAR), Edificio I +D, 50018 Zaragoza, Spain
| | - Francesca Bussolari
- BioNanoSurf Group, Instituto de Nanociencia y Materiales de Aragón (INMA,CSIC-UNIZAR), Edificio I +D, 50018 Zaragoza, Spain
| | - Gabriel Alfranca
- BioNanoSurf Group, Instituto de Nanociencia y Materiales de Aragón (INMA,CSIC-UNIZAR), Edificio I +D, 50018 Zaragoza, Spain
| | - Valeria Grazú
- BioNanoSurf Group, Instituto de Nanociencia y Materiales de Aragón (INMA,CSIC-UNIZAR), Edificio I +D, 50018 Zaragoza, Spain; Centro de Investigación Biomédica em Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Avenida Monforte de Lemos, 3-5, 28029 Madrid, Spain.
| | - Jesús Martínez de la Fuente
- BioNanoSurf Group, Instituto de Nanociencia y Materiales de Aragón (INMA,CSIC-UNIZAR), Edificio I +D, 50018 Zaragoza, Spain; Centro de Investigación Biomédica em Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Avenida Monforte de Lemos, 3-5, 28029 Madrid, Spain.
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Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
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Kijak K, Cieślar G, Kowacka M, Skomro P, Gronwald H, Garstka A, Lietz-Kijak D. Cone Beam Computed Tomography in the Assessment of the Effectiveness of Physical Therapy with the Use of the Electromagnetic Field Combined with Light Radiation Emitted by LEDs in the Treatment of Inflammation of the Paranasal Sinuses-A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13570. [PMID: 36294150 PMCID: PMC9603137 DOI: 10.3390/ijerph192013570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Modern high-resolution volumetric tomography, commonly known as cone beam computed tomography (CBCT), is one of the most innovative imaging techniques which can provide views of anatomical structures not attainable by conventional techniques. Magnetic field LED therapy is a physical therapy method, combining the effects of the Extremely Low Frequency-Electromagnetic Field (ELF-EMF) and high-power light radiation emitted by Light Emitting Diodes (LEDs). The method has been widely applied in the treatment and rehabilitation of complications of many medical conditions, including in dentistry. The aim of this study was to use CBCT to assess the effectiveness of the simultaneous use of electromagnetic field and LED light in the physical therapy of paranasal sinusitis. Treatments employing the electromagnetic field combined with LED light were administered to a 39-year-old female outpatient of the physiotherapy ward for rehabilitation therapy of paranasal sinusitis. Normal sinus pneumatization was restored almost completely. Reduction in the swelling of the sinus mucosa was so significant that even the pneumatization of the ethmoid bulla was restored. Physical therapy with the simultaneous use of ELF-EMF and LED light was found to be effective in the rehabilitation of the patient with paranasal sinusitis. Positive effects of the treatment were confirmed by CBCT findings.
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Affiliation(s)
- Konrad Kijak
- Student Scientific Society, Department of Internal Medicine, Angiology and Physical Medicine, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology and Physical Medicine, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | | | - Piotr Skomro
- Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy, Faculty of Medicine and Dentistry, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Helena Gronwald
- Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy, Faculty of Medicine and Dentistry, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Adam Garstka
- Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy, Faculty of Medicine and Dentistry, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Danuta Lietz-Kijak
- Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy, Faculty of Medicine and Dentistry, Pomeranian Medical University, 70-204 Szczecin, Poland
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Multidisciplinary and Nonpharmacological Management of Pain in Temporomandibular Disorders (TMDs). Pain Res Manag 2022; 2022:3604386. [PMID: 36267665 PMCID: PMC9578907 DOI: 10.1155/2022/3604386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/06/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022]
Abstract
Temporomandibular joint dysfunction (TMD) is not a single diagnosis, but a term covering a group of conditions that involve pain and dysfunction of the masticatory muscles within the temporomandibular joint (TMJ) and associated structures. It is a set of disease entities comprising various ailments and clinical symptoms. One of the most distressing symptoms for TMD patients is pain. Pain is subjective and always unpleasant. The VAS (visual analogue scale) was used in this research. The aim of this study was to assess the influence of physical stimuli, namely extremely low frequency magnetic field (ELF-MF) and LED light, on the experience of pain caused by increased tension in the masticatory muscles in adults. Out of 150 people examined, 104 were enrolled in the study after meeting the eligibility criteria. The study group was divided into 4 subgroups. Each subgroup received physical therapy treatment using a different physical stimulus. The effects of four therapeutic modalities were compared. In terms of VAS scores, pain attenuation was observed in all subgroups. The study confirmed the analgesic effect of the selected physical therapy methods. The authors focused on the analysis of the results obtained for each subgroup, comparing the effects of individual modalities on pain intensity (according to VAS scores). After the treatment, pain relief was observed in each of the studied subgroups. Treatment using ELF-MF and ELF-MF in combination with LED light in the course of TMD brings about a significant improvement in the subjective pain experience expressed in VAS pain scores. The use of selected physical stimuli and their beneficial effect on pain symptoms during mandibular movements has important implications for patients' daily life and work. Incorporation of therapeutic methods can help enhance patient satisfaction and comfort during manual TMJ therapy and lengthy dental procedures.
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10
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Xiang XN, Zhu SY, Song KP, Wang XY, Liu HZ, Yang WJ, Wang H, Zhang C, Yang L, He C. Pulsed electromagnetic fields for the management of knee osteoarthritis: multicentre, randomised, controlled, non-inferiority trial protocol. BMJ Open 2022; 12:e060350. [PMID: 36514244 PMCID: PMC10441616 DOI: 10.1136/bmjopen-2021-060350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 08/18/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Pulsed electromagnetic field (PEMF) is an available treatment for knee osteoarthritis (KOA), which is the most common cause of pain and disability. Nonetheless, whether the clinical effects are like that of most used drugs is unclear. Thus, this study aims to determine the effect of PEMF on pain relief by comparing them with the positive drug (celecoxib). Furthermore, this clinical trial aims to evaluate the effect of PEMF on function and quality of life with a long-term follow-up. METHODS AND ANALYSIS This two-armed, non-inferiority, randomised, controlled trial will be conducted in the outpatient physiatry/physiotherapy clinic or inpatient ward of 17 hospitals in China. A total of 428 individuals will be included who are more than 40 years of age with diagnosed KOA. The participants will be randomly allocated to the PEMF group: receiving a 6-week PEMF (15 Hz, 30 mT) at a frequency of 40 min per day, 5 days per week plus sham drug (n=214), or drug group: receiving a 6-week celecoxib 200 mg combined with sham PEMF (n=214). Clinical outcomes will be measured at baseline (T0), mid-term of intervention (T1), post-intervention (T2), 10, 18 and 30 weeks (T3-5) of follow-up after randomisation. The primary outcome will be the Western Ontario and McMaster Universities (WOMAC) pain index. The secondary outcomes will be WOMAC function and stiffness, pain measured by numerical rating score, quality of life, 6-minute walk test, pain catastrophising scale and responder index. ETHICS AND DISSEMINATION The trial is performed following the Declaration of Helsinki. The study protocol and consent form have been approved by the Ethics Committee on Biomedical Research of West China Hospital of Sichuan University (#2021-220). All patients will give informed consent before participation and the trial is initiated after approval. Results of this trial will be disseminated through publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2100052131.
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Affiliation(s)
- Xiao-Na Xiang
- Department of Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, Sichuan University, Chengdu, Sichuan, China
- Rehabilitation Key Laboratory of Sichuan Province, Sichuan University, Chengdu, Sichuan, China
| | - Si-Yi Zhu
- Department of Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, Sichuan University, Chengdu, Sichuan, China
- Rehabilitation Key Laboratory of Sichuan Province, Sichuan University, Chengdu, Sichuan, China
| | - Kang-Ping Song
- Department of Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, Sichuan University, Chengdu, Sichuan, China
- Rehabilitation Key Laboratory of Sichuan Province, Sichuan University, Chengdu, Sichuan, China
| | - Xiao-Yi Wang
- Department of Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, Sichuan University, Chengdu, Sichuan, China
- Rehabilitation Key Laboratory of Sichuan Province, Sichuan University, Chengdu, Sichuan, China
| | - Hui-Zhen Liu
- Centre for Biostatistics, Design, Measurement and Evaluation (CBDME), Sichuan University, Chengdu, Sichuan, China
| | - Wen-Jie Yang
- Centre for Biostatistics, Design, Measurement and Evaluation (CBDME), Sichuan University, Chengdu, Sichuan, China
| | - Haiming Wang
- Department of Rehabilitation Medicine, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China
| | - Chi Zhang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Lin Yang
- Department of Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, Sichuan University, Chengdu, Sichuan, China
- Rehabilitation Key Laboratory of Sichuan Province, Sichuan University, Chengdu, Sichuan, China
| | - Chengqi He
- Department of Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, Sichuan University, Chengdu, Sichuan, China
- Rehabilitation Key Laboratory of Sichuan Province, Sichuan University, Chengdu, Sichuan, China
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11
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Mosley C, Edwards T, Romano L, Truchetti G, Dunbar L, Schiller T, Gibson T, Bruce C, Troncy E. Proposed Canadian Consensus Guidelines on Osteoarthritis Treatment Based on OA-COAST Stages 1–4. Front Vet Sci 2022; 9:830098. [PMID: 35558892 PMCID: PMC9088681 DOI: 10.3389/fvets.2022.830098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
The Canadian consensus guidelines on OA treatment were created from a diverse group of experts, with a strong clinical and/or academic background in treating OA in dogs. The document is a summary of the treatment recommendations made by the group, with treatments being divided into either a core or secondary recommendation. Each treatment or modality is then summarized in the context of available research based support and clinical experience, as the treatment of OA continues to be a multimodal and commonly a multidisciplinary as well as individualized approach. The guidelines aim to help clinicians by providing clear and clinically relevant information about treatment options based on COAST defined OA stages 1–4.
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Affiliation(s)
- Conny Mosley
- Elanco Animal Health, Mississauga, ON, Canada
- VCA Canada, 404 Veterinary Emergency and Referral Hospital, Newmarket, ON, Canada
- *Correspondence: Conny Mosley
| | - Tara Edwards
- VCA Canada, Central Victoria Veterinary Hospital, Victoria, BC, Canada
| | - Laura Romano
- VCA Canada, Centra Victoria Veterinary Hospital, Victoria, BC, Canada
| | | | | | - Teresa Schiller
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Tom Gibson
- Grand River Veterinary Surgical Services; Adjunct Faculty OVC, Mississauga, ON, Canada
| | - Charles Bruce
- Pulse Veterinary Specialists and Emergency, Sherwood Park, AB, Canada
| | - Eric Troncy
- Faculté de médecine vétérinaire, Université de Montréal, Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Montreal, QC, Canada
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12
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Effectiveness of pulsed electromagnetic field therapy in the management of complex regional pain syndrome type 1: A randomized-controlled trial. Turk J Phys Med Rehabil 2022; 68:107-116. [PMID: 35949961 PMCID: PMC9305649 DOI: 10.5606/tftrd.2022.9074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 12/08/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives: This study aims to investigate whether pulsed electromagnetic field (PEMF) therapy in addition to a conventional rehabilitation program is effective on pain and functioning in patients with type 1 complex regional pain syndrome (CRPS-1) of the hand.
Patients and methods: Between March 2013 and January 2015, a total of 32 patients (16 males, 16 females; mean age: 50.1±13.1 years; range, 25 to 75 years) were included. The patients were randomly allocated into two groups. The control group (n=16) received a conventional rehabilitation program consisting of physical modalities, exercises, and occupational therapy, whereas the PEMF group (n=16) received additional PEMF (8 Hz, 3.2 mT) to the affected hand. The primary outcome measure was pain intensity using the Numeric Rating Scale (NRS). Secondary outcome measures were grip and pinch strength, hand edema, hand dexterity, and hand activities. All patients received 20 therapy sessions (five sessions/week, four weeks in total) and were evaluated before and after the therapy and at the first-month follow-up.
Results: Both groups showed significant improvements in primary and secondary outcomes (p<0.05) after the therapy and at follow-up. When the groups were compared in terms of improvements in assessment parameters, no statistically significant difference was found between the two groups in any of the outcomes (p>0.05).
Conclusion: The PEMF in addition to conventional rehabilitation program did not provide additional benefit for pain and hand functions in CRPS-1. Future studies using different application parameters such as frequency, intensity, duration, and route may provide a better understanding of the role of PEMF in CRPS-1 treatment.
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Physiotherapeutic Reduction of Orofacial Pain Using Extremely Low-Frequency Electromagnetic Field and Light-Emitting Diode Therapy—A Pilot Study. Pain Res Manag 2022; 2022:3115154. [PMID: 35178136 PMCID: PMC8847020 DOI: 10.1155/2022/3115154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/12/2022] [Indexed: 11/17/2022]
Abstract
Introduction. Pain is a natural response of the body to injury and one of the symptoms defining an inflammatory reaction. It is almost always present after orthognathic surgeries (OGS), but its severity is subjective in each patient. Postoperative care of the patient is aimed at minimizing of postoperative pain relief orofacial region. Options of physiotherapy include extremely low-frequency electromagnetic field (ELF EMF) and high-energy light-emitting diode (LED). Aim of the Study. The aim of this study was to evaluate the effects of physiotherapy combining ELF EMF and LED to reduce pain of the orofacial region in patients after OGS. Material and Methods. The study was conducted in thirty-two patients who underwent OGS to treat morphological defects. The participants were randomly divided into two groups: Physiotherapy group (PT) and Control group (CG). In both groups, patients were prescribed Paracetamol and nonsteroidal analgesics (NSAID—ibuprofen). Patients from the PT group additionally received postoperative physiotherapy immediately after leaving the surgical clinic in the form of ELF EMF and LED therapy. Physiotherapeutic treatments were performed for 10 days, three applications a day, at no cost to the patient. Pain intensity was assessed using the visual analogue scale (VAS), which is a reliable instrument for the measurement of pain intensity self-reported by the patient. Results. Faster reduction of pain was the major observation made in patients who received physiotherapy treatments. In all subjects, after 5 days of therapy, the pain intensity was reduced by about 50% or resolved completely. Effects of therapy were measured with the relative changes in the pain intensity score, showing what fraction of the initial pain was eliminated at the first stage and throughout the whole therapy. The analysis of relative changes instead of absolute changes allowed us, among other things, to eliminate the bias of the higher initial pain intensity in the CG group compared to the PT group. Conclusions. The conducted research revealed that the combined use of ELF EMF and LED is beneficial in the reduction of pain of patients after OGS. The analgesic effects of physiotherapy in the treatment after OGS are necessary to continue research in this area and analyze the possibility of extending the indications for its use in other surgically treated maxillofacial diseases.
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Viganò M, Perucca Orfei C, Ragni E, Colombini A, de Girolamo L. Pain and Functional Scores in Patients Affected by Knee OA after Treatment with Pulsed Electromagnetic and Magnetic Fields: A Meta-Analysis. Cartilage 2021; 13:1749S-1760S. [PMID: 32508140 PMCID: PMC8808910 DOI: 10.1177/1947603520931168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review and meta-analysis was to evaluate the effect of electromagnetic field treatment on the symptoms of knee osteoarthritis (OA). In addition, the influence of the type of control group and other covariates have been investigated to identify the sources of heterogeneity in the results of the available clinical trials. METHODS Randomized controlled trials reporting pulsed electromagnetic field-based therapies for the treatment of knee OA have been included. Main outcomes were self-reported pain and activity scores collected by Visual Analogue Scale (VAS) and/or Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) at short term after treatment. RESULTS Thirteen studies comprising 914 unique patients were included in the analysis. Overall reduction in pain score was observed after treatment (standardized mean difference -0.4059, P = 0.0091), while improvement in the activity score was not significant (standardized mean difference -0.4452, P = 0.0859). Type of control (i.e., placebo or alternative therapies) and time of follow-up resulted as the two major elements influencing the outcomes. Indeed, the restriction of the analysis to placebo-controlled trials demonstrated higher standardized mean differences between treatment and control groups, with lower P value for pain, while statistical significance became evident also for the activity score. On the contrary, no differences were observed pooling only studies comparing pulsed electromagnetic or magnetic fields to alternative treatments. In addition, longer follow-up correlated with lower differences between treated and control patients. CONCLUSIONS Pulsed electromagnetic field therapy effectively relieves knee OA symptoms at short term, but it is not superior to other conservative therapies such as physiotherapy.
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Affiliation(s)
- Marco Viganò
- IRCCS Istituto Ortopedico Galeazzi,
Milano, Italy
| | - Carlotta Perucca Orfei
- IRCCS Istituto Ortopedico Galeazzi,
Milano, Italy,Carlotta Perucca Orfei, Laboratorio di
Biotecnologie Applicate all’Ortopedia, IRCCS Istituto Ortopedico Galeazzi, Via
R. Galeazzi 4, Milan 20161, Italy.
| | - Enrico Ragni
- IRCCS Istituto Ortopedico Galeazzi,
Milano, Italy
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15
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Moretti L, Bizzoca D, Giancaspro GA, Cassano GD, Moretti F, Setti S, Moretti B. Biophysical Stimulation in Athletes' Joint Degeneration: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111206. [PMID: 34833424 PMCID: PMC8619315 DOI: 10.3390/medicina57111206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/18/2022]
Abstract
Osteoarthritis (OA) is the most prevalent degenerative joint disease and the main cause of pain and disability in elderly people. OA currently represents a significant social health problem, since it affects 250 million individuals worldwide, mainly adults aged over 65. Although OA is a multifactorial disease, depending on both genetic and environmental factors, it is reported that joint degeneration has a higher prevalence in former athletes. Repetitive impact and loading, joint overuse and recurrent injuries followed by a rapid return to the sport might explain athletes' predisposition to joint articular degeneration. In recent years, however, big efforts have been made to improve the prevention and management of sports injuries and to speed up the athletes' return-to-sport. Biophysics is the study of biological processes and systems using physics-based methods or based on physical principles. Clinical biophysics has recently evolved as a medical branch that investigates the relationship between the human body and non-ionizing physical energy. A physical stimulus triggers a biological response by regulating specific intracellular pathways, thus acting as a drug. Preclinical and clinical trials have shown positive effects of biophysical stimulation on articular cartilage, subchondral bone and synovia. This review aims to assess the role of pulsed electromagnetic fields (PEMFs) and extracorporeal shockwave therapy (ESWT) in the prevention and treatment of joint degeneration in athletes.
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Affiliation(s)
- Lorenzo Moretti
- Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, 70124 Bari, Italy; (L.M.); (G.A.G.); (G.D.C.); (B.M.)
| | - Davide Bizzoca
- PhD. Course in Public Health, Clinical Medicine and Oncology, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Correspondence:
| | - Giovanni Angelo Giancaspro
- Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, 70124 Bari, Italy; (L.M.); (G.A.G.); (G.D.C.); (B.M.)
| | - Giuseppe Danilo Cassano
- Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, 70124 Bari, Italy; (L.M.); (G.A.G.); (G.D.C.); (B.M.)
| | - Francesco Moretti
- National Center for Chemicals, Cosmetic Products and Consumer Protection, National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Stefania Setti
- IGEA Spa-Clinical Biophysics, via Parmenide, 10/A, 41012 Carpi (Mo), Italy;
| | - Biagio Moretti
- Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, 70124 Bari, Italy; (L.M.); (G.A.G.); (G.D.C.); (B.M.)
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Wound Repair and Extremely Low Frequency-Electromagnetic Field: Insight from In Vitro Study and Potential Clinical Application. Int J Mol Sci 2021; 22:ijms22095037. [PMID: 34068809 PMCID: PMC8126245 DOI: 10.3390/ijms22095037] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 12/12/2022] Open
Abstract
Wound healing is a complex, staged process. It involves extensive communication between the different cellular constituents of various compartments of the skin and its extracellular matrix (ECM). Different signaling pathways are determined by a mutual influence on each other, resulting in a dynamic and complex crosstalk. It consists of various dynamic processes including a series of overlapping phases: hemostasis, inflammation response, new tissue formation, and tissue remodeling. Interruption or deregulation of one or more of these phases may lead to non-healing (chronic) wounds. The most important factor among local and systemic exogenous factors leading to a chronic wound is infection with a biofilm presence. In the last few years, an increasing number of reports have evaluated the effects of extremely low frequency (ELF) electromagnetic fields (EMFs) on tissue repair. Each experimental result comes from a single element of this complex process. An interaction between ELF-EMFs and healing has shown to effectively modulate inflammation, protease matrix rearrangement, neo-angiogenesis, senescence, stem-cell proliferation, and epithelialization. These effects are strictly related to the time of exposure, waveform, frequency, and amplitude. In this review, we focus on the effect of ELF-EMFs on different wound healing phases.
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17
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Alekseeva LI, Byalovsky YY, Zagorodny NV, Ivanova GE, Karateev DE, Konchugova TV, Rakitina IS, Strakhov MA. [Pathophysiological mechanisms of the therapeutic action of alternating electromagnetic fields in the treatment of osteoarticular pathology]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2021; 98:80-90. [PMID: 34223758 DOI: 10.17116/kurort20219803180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Treatment of osteoarticular pathology with an alternating electromagnetic field (AEMF) is used today as a promising, non-invasive and safe strategy of physiotherapy. It has been shown that the action of alternating electromagnetic fields on the musculoskeletal system triggers signaling cascades that effectively contribute to the restoration of bone and articular tissue. The pathophysiological mechanisms underlying the cellular and subcellular effects of stimulation by an alternating electromagnetic field during the restoration of bone and articular tissue are considered. It was pointed out the several key signaling pathways involved in the restoration of bone and articular tissue under the influence of electromagnetic fields with an analysis of the potential for therapeutic application of electromagnetic fields alone or in combination with other available therapies.
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Affiliation(s)
- L I Alekseeva
- V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia
| | | | - N V Zagorodny
- N.N. Priorov Central Research Institute of Traumatology and Orthopedics, Moscow, Russia
| | - G E Ivanova
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
| | - D E Karateev
- M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - T V Konchugova
- National Medical Research Center for Rehabilitation and Balneology, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - M A Strakhov
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
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18
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Khami A, Roostayi MM, Parhampour B, Heidari Z, Baharlouei H, Hoorfar H. Effect of Pulsed Electromagnetic Fields on Clinical Signs and Quality of Life in Patients with Hemophilic Arthropathy of the Knee Joint: A Randomized Controlled Trial. Adv Biomed Res 2020; 9:81. [PMID: 33912497 PMCID: PMC8059452 DOI: 10.4103/abr.abr_244_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/07/2019] [Accepted: 06/01/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hemophilic arthropathy (HA) causes severe joint damage and impairs the quality of life (QoL) of hemophiliacs. This study was undertaken to evaluate the effect of pulsed electromagnetic fields (PEMFs) on the clinical signs and QoL of patients with severe hemophilia A experiencing moderate HA in the knee joint. MATERIALS AND METHODS Thirty-six severe hemophiliacs with HA of the knee joint were randomly assigned into the PEMF (n = 20) or placebo (n = 16) groups. The PEMF group received 60 min of PEMF (2 Hz, 25 Gauss for 30 min and 70 Hz, 30 Gauss for 30 min) on the knee joint, three times per week for 6 weeks. The clinical signs, QoL, and pain intensity were measured by the Hemophilia Joint Health Score, A36 Hemofilia-QoL Questionnaire, and visual analog scale, respectively, before and after treatment. RESULTS In the PEMF group, a significant difference before and after intervention in terms of clinical signs, QoL, and pain intensity (P < 0.05) was founded. Between-group analysis showed a significant improvement in clinical signs (except for atrophy, strength, and swelling duration), QoL, and pain intensity in the PEMF versus control group (P < 0.05). CONCLUSIONS PEMF can improve the clinical signs, QoL, and pain intensity of severe hemophilia A patient with moderate knee hemophilic arthropathy.
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Affiliation(s)
- Azam Khami
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohsen Roostayi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behrouz Parhampour
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamzeh Baharlouei
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Hoorfar
- Hemophilia Treatment Center, Clinic Seiedshohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Biermann N, Sommerauer L, Diesch S, Koch C, Jung F, Kehrer A, Prantl L, Taeger CD. The influence of pulsed electromagnetic field therapy (PEMFT) on cutaneous blood flow in healthy volunteers1. Clin Hemorheol Microcirc 2020; 76:495-501. [PMID: 33216020 DOI: 10.3233/ch-209224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The biophysical interaction induced by low energy pulsed electromagnetic field therapy (PEMFT) on the capillary microcirculation is not well understood. Several studies indicate a significant effect of PEMFT in patients with chronic medical conditions. OBJECTIVE The aim of this study was to evaluate the influence of PEMFT on skin microcirculation in healthy volunteers. METHODS 15 healthy participants were included. Nine PEMF treatments were applied over three weeks in an 48-hour interval. The PEMFT system (BEMER) was placed beneath one of the participants' leg with the contralateral side serving as a control. A forty-minute application period was preceded by a 10-minute resting phase. Measuring was done using two Laser Doppler probes (LEA) placed on each anterior lateral thigh. RESULTS All outcome parameters including flow, mixed venous oxygen saturation and relative venous hemoglobin showed a significant increase during the experiment when compared to the baseline values of the resting phase in both groups (p < 0.01). Comparing both groups, the measurement values during the experiment did not differ (p > 0.05) except for higher flow values in the control group (P = 0.03). Over time, baseline values of both groups showed no significant difference (p > 0.05). CONCLUSION We found a significant increase of all measurement parameters during the study compared to the baseline values with no difference between the PEMF and control group.
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Affiliation(s)
- Niklas Biermann
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Laura Sommerauer
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Sophia Diesch
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Christoph Koch
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Friedrich Jung
- Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany
| | - Andreas Kehrer
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Christian D Taeger
- Department of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
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Comparative Analysis of the Influence of Selected Physical Factors on the Level of Pain in the Course of Temporomandibular Joint Disorders. Pain Res Manag 2020; 2020:1036306. [PMID: 33101559 PMCID: PMC7569428 DOI: 10.1155/2020/1036306] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/25/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022]
Abstract
Introduction Temporomandibular joints (TMJs) play a very significant function in the activity of the locomotor system of the masticatory system. But they are often a source of pain, myopathy, myoarthropathy, and malfunction of their surrounding or internal structures. The treatment of a patient's discomfort associated with masticatory system dysfunctions strongly depends on their cause. Aim of the Study. The objective of the study was to evaluate the impact of selected physical factors: LED light therapy with electromagnetic field and cryotherapy for the level of pain, in the treatment of patients suffering from temporomandibular disorders (TMDs). Materials and Methods The study included 60 patients of both genders with diagnosed TMD in a clinical trial. The participants were randomly divided into two groups. Each group consisted of 30 people and was subjected to separate therapies in which LED light therapy with electromagnetic field (MLT) and cryotherapy (CT) were applied. Results Having assessed the results of the author's own research in terms of analgesic activity, determined on the VAS scale during the daily routine activity of the mandible and its individual movements, in general, each of the studied groups demonstrated a considerable decrease in the level of the patients' perception of pain (<0.001). Having compared both the therapeutic methods used, a greater reduction in the level of perceived pain was achieved with MLT (p=0.002). The type of therapy used turned out to be the only significant factor for the magnitude of this reduction. Conclusions Conclusions based on the results of our own research indicate that the selected methods of treatment demonstrate an analgesic effect in terms of the overall discomfort in the course of TMD, and that they may be an alternative pain relief thereby reducing the patient's intake of painkillers.
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Hu H, Yang W, Zeng Q, Chen W, Zhu Y, Liu W, Wang S, Wang B, Shao Z, Zhang Y. Promising application of Pulsed Electromagnetic Fields (PEMFs) in musculoskeletal disorders. Biomed Pharmacother 2020; 131:110767. [PMID: 33152929 DOI: 10.1016/j.biopha.2020.110767] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/06/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
Increasing evidence suggests that an exogenous electromagnetic field might be involved in many biologic processes which are of great importance for therapeutic interventions. Pulsed electromagnetic fields (PEMFs) are known to be a noninvasive, safe and effective therapy agent without apparent side effects. Numerous studies have shown that PEMFs possess the potential to become a stand-alone or adjunctive treatment modality for treating musculoskeletal disorders. However, several issues remain unresolved. Prior to their widely clinical application, further researches from well-designed, high-quality studies are still required to standardize the treatment parameters and derive the optimal protocol for health-care decision making. In this review, we aim to provide current evidence on the mechanism of action, clinical applications, and controversies of PEMFs in musculoskeletal disorders.
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Affiliation(s)
- Hongzhi Hu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
| | - Wenbo Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Qianwen Zeng
- Department of Pediatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - YanBin Zhu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Weijian Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shangyu Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Baichuan Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Yingze Zhang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
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Yang X, He H, Ye W, Perry TA, He C. Effects of Pulsed Electromagnetic Field Therapy on Pain, Stiffness, Physical Function, and Quality of Life in Patients With Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Phys Ther 2020; 100:1118-1131. [PMID: 32251502 DOI: 10.1093/ptj/pzaa054] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 04/09/2019] [Accepted: 12/20/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Pulsed electromagnetic field (PEMF) therapy is a potentially useful treatment for osteoarthritis (OA), but its effectiveness is still controversial. This study aimed to examine the effects of PEMF therapy and PEMF parameters on symptoms and quality of life (QOL) in patients with OA. METHODS Cochrane Central Register of Controlled Trials, PubMed, CINAHL, EMBASE, PEDro, clinical trial registers, and reference lists were searched until April 2019. This study examined randomized, placebo-controlled trials, patients with OA, symptom and/or QOL related outcomes, and articles published in English. Two authors extracted data and completed quality assessment. RESULTS Sixteen studies were included in our systematic review, while 15 studies with complete data were included in the meta-analysis. Our primary outcome was the standardized mean difference, which was equal to the treatment effect in the PEMF group minus the treatment effect in the placebo group divided by the pooled standard deviation. For pain, the standardized mean difference was 1.06 (95% CI = 0.61 to 1.51), for stiffness 0.37 (95% CI = 0.07 to 0.67), for function 0.46 (95% CI = 0.14 to 0.78), and for QOL 1.49 (95% CI = -0.06 to 3.04). PEMF parameters did not influence symptoms. CONCLUSIONS Compared with placebo, there was a beneficial effect of PEMF therapy on pain, stiffness, and physical function in patients with OA. Duration of treatment may not be a critical factor in pain management. Further studies are required to confirm the effects of PEMF therapy on QOL. IMPACT Our study suggests that PEMF therapy has clinically significant effects on pain in patients with OA. The current evidence was limited to the short-term effects of PEMF therapy.
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Paolucci T, Pezzi L, Centra AM, Giannandrea N, Bellomo RG, Saggini R. Electromagnetic Field Therapy: A Rehabilitative Perspective in the Management of Musculoskeletal Pain - A Systematic Review. J Pain Res 2020; 13:1385-1400. [PMID: 32606905 PMCID: PMC7297361 DOI: 10.2147/jpr.s231778] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/07/2020] [Indexed: 12/22/2022] Open
Abstract
Electromagnetic fields (EMFs) provide a non-invasive, safe, and easy method to treat pain with respect to musculoskeletal diseases. The purpose of this systematic review was to describe the use of electromagnetic therapy in the rehabilitation field by investigating the efficacy in acute and chronic pain in the musculoskeletal disorders. A database search was conducted using the following resources: PubMed, Cochrane, PEDro, SCOPUS, and WoS. The following MESH terms were used: [Electromagnetic field AND/OR Rehabilitation], [Electromagnetic field AND/OR Pain], [Pulsed Magnetic field AND/OR Rehabilitation] and [Pulsed Magnetic field AND/OR Pain], [Pulsed Electromagnetic field AND/OR Rehabilitation] and [Pulsed Electromagnetic field AND/OR Pain], per the guidelines of the PRISMA statement. Articles published between January 1, 2009 and December 31, 2018 were included as assessment of musculoskeletal pain conditions, randomized clinical trial including crossover and prospective design studies, full English text available, population age > 18 years; instead were excluded neurological randomized clinical trials, transcranial magnetic stimulation application, neuropathic pain, animal/in vitro studies, and articles without English abstract or English full text. Three independent investigators (AMC, NG, and LP) retrieved all the information. Twenty-one RTC (N=21) were considered for the inclusion and exclusion criteria. The results showed as pulsed magnetic fields at low intensity and frequency (from 1 Hz up to 100 Hz) are commonly used with efficacy in resolving musculoskeletal pain. EMFs therapy is a well tolerated, effective with no negative side effects, which can be integrated with rehabilitation for the treatment of chronic and acute pain in musculoskeletal diseases, but further studies are needed to examine the use of more standardized protocols.
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Affiliation(s)
- Teresa Paolucci
- Department of Medical Oral Sciences and Biotechnology (DiSmob), Physical Medicine and Rehabilitation Unit, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Letizia Pezzi
- Department of Medical Oral Sciences and Biotechnology (DiSmob), Physical Medicine and Rehabilitation Unit, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Antonello Marco Centra
- Department of Medical Oral Sciences and Biotechnology (DiSmob), Physical Medicine and Rehabilitation Unit, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Niki Giannandrea
- Department of Medical Oral Sciences and Biotechnology (DiSmob), Physical Medicine and Rehabilitation Unit, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Rosa Grazia Bellomo
- Department of Biomolecular Sciences, University of Study of Urbino Carlo Bo, Urbino, Italy
| | - Raoul Saggini
- Department of Medical Oral Sciences and Biotechnology (DiSmob), Physical Medicine and Rehabilitation Unit, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
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Stewart GM, Wheatley-Guy CM, Johnson BD, Shen WK, Kim CH. Impact of pulsed electromagnetic field therapy on vascular function and blood pressure in hypertensive individuals. J Clin Hypertens (Greenwich) 2020; 22:1083-1089. [PMID: 32401418 DOI: 10.1111/jch.13877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/07/2020] [Accepted: 04/17/2020] [Indexed: 12/13/2022]
Abstract
The present study investigated the impact of 12 weeks of pulsed electromagnetic field (PEMF) therapy on peripheral vascular function, blood pressure (BP), and nitric oxide in hypertensive individuals. Thirty hypertensive individuals (SBP > 130 mm Hg and/or MAP > 100 mm Hg) were assigned to either PEMF group (n = 15) or control group (n = 15). During pre-assessment, participants underwent measures of flow-mediated dilation (FMD), BP, and blood draw for nitric oxide (NO). Subsequently, they received PEMF therapy 3x/day for 12 weeks and, at conclusion, returned to the laboratory for post-assessment. Fifteen participants from the PEMF group and 11 participants from the control group successfully completed the study protocol. After therapy, the PEMF group demonstrated significant improvements in FMD and FMDNOR (normalized to hyperemia), but the control group did not (P = .05 and P = .04, respectively). Moreover, SBP, DBP, and MAP were reduced, but the control group did not (P = .04, .04, and .03, respectively). There were no significant alterations in NO in both groups (P > .05). Twelve weeks of PEMF therapy may improve BP and vascular function in hypertensive individuals. Additional studies are needed to identify the mechanisms by which PEMF affects endothelial function.
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Affiliation(s)
- Glenn M Stewart
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | | | - Bruce D Johnson
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - Win K Shen
- Department of Cardiovascular Disease, Mayo Clinic, Phoenix, Arizona
| | - Chul-Ho Kim
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
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Karateev AE, Pogozheva EY, Sukhareva ML, Lila AM, Ivanov AV, Osnovina IP, Shchashkova OV, Borisova SV, Larinsky NЕ, Israelyan YA, Afoshin SА, Bondarenko TP, Repchanskaya EА, Chernyavskaya LA, Pupina SP, Darmova TV. Evaluation of the efficiency and safety of magnet therapy for osteoarthritis. Results of the multicenter blind placebo-controlled study COSMO (Clinical Evaluation of Current Magnet Therapy for Osteoarthritis). ACTA ACUST UNITED AC 2020. [DOI: 10.14412/1995-4484-2020-55-61] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - M. L. Sukhareva
- V.A. Nasonova Research Institute of RheumatologyAndrey Karateev
| | - A. M. Lila
- V.A. Nasonova Research Institute of RheumatologyAndrey Karateev; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
| | | | - I. P. Osnovina
- Ivanovo State Medical Academy, Ministry of Health of Russia
| | | | - S. V. Borisova
- Ivanovo Regional Clinical Center for Medical Rehabilitation
| | | | - Yu. A. Israelyan
- Volga Research Medical University, Ministry of Health of Russia; Clinical Hospital Three, Nizhny Novgorod Geriatric Center
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Hakimi F, Asheghan M, Hashemi SE. Isometric exercise, acupuncture, and magnet therapy for knee osteoarthritis: randomized clinical trial. REHABILITACJA MEDYCZNA 2019. [DOI: 10.5604/01.3001.0013.3766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Knee osteoarthritis is a common disease, particularly in the elderly population. Degenerative disorders of the cartilage cause pain and stiffness in the knee joint. As a result, patients frequently experience limitation in their daily activities.
Purpose: To compare the effects of exercise, acupuncture, and magnet therapy on symptoms and physical function among middle-aged and elderly people with knee osteoarthritis.
Materials and methods: We carried out a parallel three-arm randomized clinical trial in an outpatient clinic of the Department of Physical Medicine and Rehabilitation at a University Hospital. In total, 60 female patients of age ≥ 40 years with chronic knee osteoarthritis were randomly allocated to one of three groups of isometric exercise, acupuncture, and magnet therapy. The primary outcome measure was subjective pain rated according to the Visual Analog Scale. We also used the Western Ontario McMaster Universities Osteoarthritis Index for assessing and monitoring the symptoms of knee osteoarthritis in order to evaluate the efficacy of the interventions. An isometric exercise program was prescribed, consisting of three sessions per week for six weeks. Participants in the acupuncture group received three treatment sessions per week for six weeks, each lasting for 30 minutes. For pulsed electro-magnetic field therapy, a total of three 30-minute sessions per week for a period of 6 weeks were administered to each patient.
Results: There were no statistically significant differences between the study groups in terms of the outcome measures (all p values > 0.05). However, within-group analyses showed that there were significant differences regarding the clinical outcomes in each group (all p values < 0.05).
Conclusion: All three therapeutic modalities are effective and could be used as the first line of treatment for knee osteoarthritis. Moreover, it should be noted that the favorable outcomes remained at least two months after treatment concluded.
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Affiliation(s)
| | - Mahsa Asheghan
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Iran
| | - Seyed Ebrahim Hashemi
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Iran
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Kim CH, Wheatley-Guy CM, Stewart GM, Yeo D, Shen WK, Johnson BD. The impact of pulsed electromagnetic field therapy on blood pressure and circulating nitric oxide levels: a double blind, randomized study in subjects with metabolic syndrome. Blood Press 2019; 29:47-54. [PMID: 31394939 DOI: 10.1080/08037051.2019.1649591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Regulation of blood pressure (BP) is important in reducing the risk for cardiovascular disease. There is growing interest in non-pharmacological methods to treat BP including a novel approach using pulsed electromagnetic field therapy (PEMF). PEMF therapy has been proposed to impact physiological function at the cellular and tissue level and one possible mechanism is through an impact on endothelial function and nitric oxide (NO) related pathways. The focus of the present study was to evaluate the effect of PEMF on BP and NO in subjects with mild to moderate metabolic syndrome.Materials and methods: For 12 weeks, 23 subjects underwent PEMF therapy and 21 subjects underwent sham therapy. BP was measured at rest and near the end of submaximal exercise pre- and 12 week post-therapy. Additionally, plasma NO was measured at similar time points.Results: The PEMF demonstrated an increase in NO after therapy (p = .04) but SHAM did not (p = .37). For resting BP, there were no differences in systolic BP (SBP), diastolic BP (DBP) or mean arterial pressure (MAP) between groups (p > .05). During exercise, PEMF had a reduction in peak SBP (p = .04), but not SHAM (p = .57). PEMF demonstrated significant relationships between baseline SBP and change in SBP following therapy (r = -0.71, p < .01) and between MAP and change in MAP following therapy (r = -0.60, p < .01), but no such relationships were found in SHAM. Subjects with resting hypertension (SBP ≥140 mmHg) in PEMF (n = 11) had significant reductions in SBP, DBP and MAP when compared to SHAM with hypertension (n = 9) (p < .05). In this sub-group analysis, PEMF demonstrated lowered peak SBP (p = .04) at a given exercise load (p = .40) but SHAM did not (p > .05).Conclusion: PEMF may increase plasma NO availability and improve BP at rest and during exercise. However, this beneficial effect appears to be more pronounced in subjects with existing hypertension.
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Affiliation(s)
- Chul-Ho Kim
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | | | - Glenn M Stewart
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Dongwook Yeo
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Win-Kuang Shen
- Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ, USA
| | - Bruce D Johnson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
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Wang T, Xie W, Ye W, He C. Effects of electromagnetic fields on osteoarthritis. Biomed Pharmacother 2019; 118:109282. [PMID: 31387007 DOI: 10.1016/j.biopha.2019.109282] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/20/2019] [Accepted: 07/25/2019] [Indexed: 02/05/2023] Open
Abstract
Osteoarthritis (OA), characterized by joint malfunction and chronic disability, is the most common form of arthritis. The pathogenesis of OA is unclear, yet studies have shown that it is due to an imbalance between the synthesis and decomposition of chondrocytes, cell matrices and subchondral bone, which leads to the degeneration of articular cartilage. Currently, there are many therapies that can be used to treat OA, including the use of pulsed electromagnetic fields (PEMFs). PEMFs stimulate proliferation of chondrocytes and exert a protective effect on the catabolic environment. Furthermore, this technique is beneficial for subchondral trabecular bone microarchitecture and the prevention of subchondral bone loss, ultimately blocking the progression of OA. However, it is still unknown whether PEMFs could be used to treat OA in the clinic. Furthermore, the deeper signaling pathways underlying the mechanism by which PEMFs influence OA remain unclear.
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Affiliation(s)
- Tiantian Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Xie
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wenwen Ye
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
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Palmer JS, Monk AP, Hopewell S, Bayliss LE, Jackson W, Beard DJ, Price AJ. Surgical interventions for symptomatic mild to moderate knee osteoarthritis. Cochrane Database Syst Rev 2019; 7:CD012128. [PMID: 31322289 PMCID: PMC6639936 DOI: 10.1002/14651858.cd012128.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Osteoarthritis affecting the knee is common and represents a continuum of disease from early cartilage thinning to full-thickness cartilage loss, bony erosion, and deformity. Many studies do not stratify their results based on the severity of the disease at baseline or recruitment. OBJECTIVES To assess the benefits and harms of surgical intervention for the management of symptomatic mild to moderate knee osteoarthritis defined as knee pain and radiographic evidence of non-end stage osteoarthritis (Kellgren-Lawrence grade 1, 2, 3 or equivalent on MRI/arthroscopy). Outcomes of interest included pain, function, radiographic progression, quality of life, short-term serious adverse events, re-operation rates and withdrawals due to adverse events. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase up to May 2018. We also conducted searches of ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform for ongoing trials. Authors of trials were contacted if some but not all their participants appeared to fit our inclusion criteria. SELECTION CRITERIA We included randomised controlled trials that compared surgery to non-surgical interventions (including sham and placebo control groups, exercise or physiotherapy, and analgesic or other medication), injectable therapies, and trials that compared one type of surgical intervention to another surgical intervention in people with symptomatic mild to moderate knee osteoarthritis. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials and extracted data using standardised forms. We analysed the quality of evidence using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach. MAIN RESULTS A total of five studies involving 566 participants were identified as eligible for this review. Single studies compared arthroscopic partial meniscectomy to physical therapy (320 participants), arthroscopic surgery (debridement ± synovectomy ± chondroplasty) to closed needle joint lavage with saline (32 participants) and high tibial osteotomy surgery to knee joint distraction surgery (62 participants). Two studies (152 participants) compared arthroscopic surgery (washout ± debridement; debridement) to a hyaluronic acid injection. Only one study was at low risk of selection bias, and due to the difficulty of blinding participants to their treatment, all studies were at risk of performance and detection bias.Reporting of results in this summary has been restricted to the primary comparison: surgical intervention versus non-surgical intervention.A single study, included 320 participants with symptoms consistent with meniscal tear. All subjects had the meniscal tear confirmed on knee MRI and radiographic evidence of mild to moderate osteoarthritis (osteophytes, cartilage defect or joint space narrowing). Patients with severe osteoarthritis (KL grade 4) were excluded. The study compared arthroscopic partial meniscectomy and physical therapy to physical therapy alone (a six-week individualised progressive home exercise program). This study was at low risk of selection bias and outcome reporting biases, but was susceptible to performance and detection biases. A high rate of cross-over (30.2%) occurred from the physical therapy group to the arthroscopic group.Low-quality evidence suggests there may be little difference in pain and function at 12 months follow-up in people who have arthroscopic partial meniscectomy and those who have physical therapy. Evidence was downgraded to low quality due to risk of bias and imprecision.Mean pain was 19.3 points on a 0 to 100 point KOOS pain scale with physical therapy at 12 months follow-up and was 0.2 points better with surgery (95% confidence interval (CI) 4.05 better to 3.65 points worse with surgery, an absolute improvement of 0.2% (95% CI 4% better to 4% worse) and relative improvement 0.4% (95% CI 9% better to 8% worse) (low quality evidence). Mean function was 14.5 on a 0 to 100 point KOOS function scale with physical therapy at 12 months follow-up and 0.8 points better with surgery (95% CI 4.3 better to 2.7 worse); 0.8% absolute improvement (95% CI 4% better to 3% worse) and 2.1% relative improvement (95% CI 11% better to 7% worse) (low quality evidence).Radiographic structural osteoarthritis progression and quality of life outcomes were not reported.Due to very low quality evidence, we are uncertain if surgery is associated with an increased risk of serious adverse events, incidence of total knee replacement or withdrawal rates. Evidence was downgraded twice due to very low event rates, and once for risk of bias.At 12 months, the surgery group had a total of three serious adverse events including fatal pulmonary embolism, myocardial infarction and hypoxaemia. The physical therapy alone group had two serious adverse events including sudden death and stroke (Peto OR 1.58, 95% CI 0.27 to 9.21); 1% more events with surgery (95% CI 2% less to 3% more) and 58% relative change (95% CI 73% less to 821% more). One participant in each group withdrew due to adverse events.Two of 164 participants (1.2%) in the physical therapy group and three of 156 in the surgery group underwent conversion to total knee replacement within 12 months (Peto OR 1.76, 95% CI 0.43 to 7.13); 1% more events with surgery (95% CI 2% less to 5% more); 76% relative change (95% CI 57% less to 613% more). AUTHORS' CONCLUSIONS The review found no placebo-or sham-controlled trials of surgery in participants with symptomatic mild to moderate knee osteoarthritis. There was low quality evidence that there may be no evidence of a difference between arthroscopic partial meniscectomy surgery and a home exercise program for the treatment of this condition. Similarly, low-quality evidence from a few small trials indicates there may not be any benefit of arthroscopic surgery over other non-surgical treatments including saline irrigation and hyaluronic acid injection, or one type of surgery over another. We are uncertain of the risk of adverse events or of progressing to total knee replacement due to very small event rates. Thus, there is uncertainty around the current evidence to support or oppose the use of surgery in mild to moderate knee osteoarthritis. As no benefit has been demonstrated from the low quality trials included in this review, it is possible that future higher quality trials for these surgical interventions may not contradict these results.
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Affiliation(s)
- Jonathan S Palmer
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesWindmill Road, HeadingtonOxfordUKOX3 7LD
| | - A Paul Monk
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesWindmill Road, HeadingtonOxfordUKOX3 7LD
| | - Sally Hopewell
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Botnar Research Centre, Windmill RoadOxfordOxfordshireUKOX3 7LD
| | - Lee E Bayliss
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesWindmill Road, HeadingtonOxfordUKOX3 7LD
| | - William Jackson
- Oxford University Hospitals NHS TrustNuffield Orthopaedic CentreWindmill RoadOxfordUKOX3 7LD
| | - David J Beard
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesWindmill Road, HeadingtonOxfordUKOX3 7LD
| | - Andrew J Price
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesWindmill Road, HeadingtonOxfordUKOX3 7LD
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Ross CL, Ang DC, Almeida-Porada G. Targeting Mesenchymal Stromal Cells/Pericytes (MSCs) With Pulsed Electromagnetic Field (PEMF) Has the Potential to Treat Rheumatoid Arthritis. Front Immunol 2019; 10:266. [PMID: 30886614 PMCID: PMC6409305 DOI: 10.3389/fimmu.2019.00266] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/31/2019] [Indexed: 01/14/2023] Open
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation of synovium (synovitis), with inflammatory/immune cells and resident fibroblast-like synoviocytes (FLS) acting as major players in the pathogenesis of this disease. The resulting inflammatory response poses considerable risks as loss of bone and cartilage progresses, destroying the joint surface, causing joint damage, joint failure, articular dysfunction, and pre-mature death if left untreated. At the cellular level, early changes in RA synovium include inflammatory cell infiltration, synovial hyperplasia, and stimulation of angiogenesis to the site of injury. Different angiogenic factors promote this disease, making the role of anti-angiogenic therapy a focus of RA treatment. To control angiogenesis, mesenchymal stromal cells/pericytes (MSCs) in synovial tissue play a vital role in tissue repair. While recent evidence reports that MSCs found in joint tissues can differentiate to repair damaged tissue, this repair function can be repressed by the inflammatory milieu. Extremely-low frequency pulsed electromagnetic field (PEMF), a biophysical form of stimulation, has an anti-inflammatory effect by causing differentiation of MSCs. PEMF has also been reported to increase the functional activity of MSCs to improve differentiation to chondrocytes and osteocytes. Moreover, PEMF has been demonstrated to accelerate cell differentiation, increase deposition of collagen, and potentially return vascular dysfunction back to homeostasis. The aim of this report is to review the effects of PEMF on MSC modulation of cytokines, growth factors, and angiogenesis, and describe its effect on MSC regeneration of synovial tissue to further understand its potential role in the treatment of RA.
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Affiliation(s)
- Christina L Ross
- Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, United States.,Wake Forest Center for Integrative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Dennis C Ang
- Department of Rheumatology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Graça Almeida-Porada
- Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, United States
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Gomes Gobbi R, Pastore E Silva AL, Kawamura Demange M, Pécora JR, Espregueira-Mendes J, Camanho GL. Clinical results of pulsed signal therapy on patellofemoral syndrome with patellar chondropathy. Bioelectromagnetics 2019; 40:83-90. [PMID: 30763468 DOI: 10.1002/bem.22172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/15/2019] [Indexed: 12/31/2022]
Abstract
This study was designed to evaluate the effect of pulsed signal therapy (PST) on patellofemoral pain syndrome associated with patellar chondropathy. A prospective randomized double-blind placebo controlled trial included 25 patients (41 knees) between 20 and 50 years with pain due to isolated patellofemoral syndrome with chondropathy. PST group received nine 60-min daily sessions of PST treatment. Control group received the same protocol of blinded placebo treatment. The main outcome was change from baseline Kujala score at 3 months. After 3 months, patients in the control group received effective treatment (placebo post-treatment). All patients were then followed, for up to 12 months. Seventeen knees (5 males and 12 females, mean age 36.7 ± 7.9) received placebo and 24 knees (8 males and 16 females, mean age 35.5 ± 8.9) received PST. By the third month, PST group exhibited a mean change from baseline of 9.63 ± 7.5 Kujala points, compared to 0.53 ± 1.8 in the placebo group (P < 0.001). A significant progressive improvement was seen in the PST group between the 3rd and 6th and between the 6th and 12th month (P < 0.016). Patients initially allocated in the control group also improved at 3 months (P < 0.001) and 6 months (P = 0.005) post-effective treatment. In conclusion, PST in patellofemoral pain syndrome with chondropathy was effective compared to placebo at 3 months, showing an important improvement of Kujala score. The improvement was progressive and maintained up to 12 months. PST is safe and should be considered as a non-invasive option for management of this condition. Bioelectromagnetics. 40:83-90, 2019. © 2019 Bioelectromagnetics Society.
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Affiliation(s)
- Riccardo Gomes Gobbi
- Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Marco Kawamura Demange
- Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José Ricardo Pécora
- Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre-FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Orthopaedics Department of Minho University, Minho, Portugal.,3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco/Guimarães, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Gilberto Luis Camanho
- Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
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Wu Z, Ding X, Lei G, Zeng C, Wei J, Li J, Li H, Yang T, Cui Y, Xiong Y, Wang Y, Xie D. Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis. BMJ Open 2018; 8:e022879. [PMID: 30552258 PMCID: PMC6303578 DOI: 10.1136/bmjopen-2018-022879] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 07/21/2018] [Accepted: 10/19/2018] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate the efficacy and safety of the pulsed electromagnetic field (PEMF) therapy in treating osteoarthritis (OA). DESIGN Meta-analysis. DATA SOURCES PubMed, Embase, the Cochrane Library and Web of Science were searched through 13 October 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials compared the efficacy of PEMF therapy with sham control in patients with OA. DATA EXTRACTION AND SYNTHESIS Pain, function, adverse effects and characteristics of participants were extracted. RevMan V.5.2 was used to perform statistical analyses. RESULTS Twelve trials were included, among which ten trials involved knee OA, two involved cervical OA and one involved hand OA. The PEMF group showed more significant pain alleviation than the sham group in knee OA (standardised mean differences (SMD)=-0.54, 95% CI -1.04 to -0.04, p=0.03) and hand OA (SMD=-2.85, 95% CI -3.65 to -2.04, p<0.00001), but not in cervical OA. Similarly, comparing with the sham-control treatment, significant function improvement was observed in the PEMF group in both knee and hand OA patients (SMD=-0.34, 95% CI -0.53 to -0.14, p=0.0006, and SMD=-1.49, 95% CI -2.12 to -0.86, p<0.00001, respectively), but not in patients with cervical OA. Sensitivity analyses suggested that the exposure duration <=30 min per session exhibited better effects compared with the exposure duration >30 min per session. Three trials reported adverse events, and the combined results showed that there was no significant difference between PEMF and the sham group. CONCLUSIONS PEMF could alleviate pain and improve physical function for patients with knee and hand OA, but not for patients with cervical OA. Meanwhile, a short PEMF treatment duration (within 30 min) may achieve more favourable efficacy. However, given the limited number of study available in hand and cervical OA, the implication of this conclusion should be cautious for hand and cervical OA.
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Affiliation(s)
- Ziying Wu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xiang Ding
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jie Wei
- Department of Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Tuo Yang
- Department of Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yang Cui
- International Medical Department, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yilin Xiong
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yilun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Dongxing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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Hidisoglu E, Kantar-Gok D, Ozen S, Yargicoglu P. Short-term 2.1 GHz radiofrequency radiation treatment induces significant changes on the auditory evoked potentials in adult rats. Int J Radiat Biol 2018; 94:858-871. [DOI: 10.1080/09553002.2018.1492166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Enis Hidisoglu
- Faculty of Medicine, Department of Biophysics, Akdeniz University, Antalya, Turkey
| | - Deniz Kantar-Gok
- Faculty of Medicine, Department of Biophysics, Akdeniz University, Antalya, Turkey
| | - Sukru Ozen
- Engineering Faculty, Department of Electrical and Electronics Engineering, Akdeniz University, Antalya, Turkey
| | - Piraye Yargicoglu
- Faculty of Medicine, Department of Biophysics, Akdeniz University, Antalya, Turkey
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Zidan N, Fenn J, Griffith E, Early PJ, Mariani CL, Muñana KR, Guevar J, Olby NJ. The Effect of Electromagnetic Fields on Post-Operative Pain and Locomotor Recovery in Dogs with Acute, Severe Thoracolumbar Intervertebral Disc Extrusion: A Randomized Placebo-Controlled, Prospective Clinical Trial. J Neurotrauma 2018; 35:1726-1736. [DOI: 10.1089/neu.2017.5485] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Natalia Zidan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Joe Fenn
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Emily Griffith
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Peter J. Early
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Chris L. Mariani
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Karen R. Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Julien Guevar
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Natasha J. Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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Gaynor JS, Hagberg S, Gurfein BT. Veterinary applications of pulsed electromagnetic field therapy. Res Vet Sci 2018; 119:1-8. [DOI: 10.1016/j.rvsc.2018.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/01/2018] [Accepted: 05/06/2018] [Indexed: 11/26/2022]
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Ross CL, Pettenati MJ, Procita J, Cathey L, George SK, Almeida-Porada G. Evaluation of Cytotoxic and Genotoxic Effects of Extremely Low-frequency Electromagnetic Field on Mesenchymal Stromal Cells. Glob Adv Health Med 2018; 7:2164956118777472. [PMID: 29796339 PMCID: PMC5960853 DOI: 10.1177/2164956118777472] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 01/01/2023] Open
Abstract
Background Interest in the use of extremely low-frequency (ELF) electromagnetic field (EMF) for the treatment of pain and inflammation is increasing due to the ability of this promising therapy to compete with pharmaceuticals without the adverse effects caused by drugs. However, there continues to be concerns regarding cytotoxic and genotoxic effects that may occur as a result of exposure to EMF. Objective To investigate this concern, we tested the effect of our known therapeutic 5 Hz, 0.4 milliTesla (mT) EMF on a human mesenchymal stromal cell (hMSC) line to determine whether ELF-EMF exposure would cause cytotoxic or genotoxic effects. Methods Treated samples along with controls were exposed to 5 Hz, 0.4 mT ELF-EMF for 20 min/day, 3×/week for 2 weeks and then assayed for cell viability, proliferation rates, and chromosome breaks. Results Cytogenetic analysis of the viability and proliferation rates along with analysis of morphological genome stability showed no cytotoxicity, and no chromosome breaks per karyotype analysis—therefore no genotoxicity. Conclusion Exposure to an ELF-EMF of 5 Hz, 0.4 mT for 20 min/day, 3×/week for 2 weeks does not cause cytotoxic or genotoxic effects in hMSCs.
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Affiliation(s)
- Christina L Ross
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Wake Forest Center for Integrative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mark J Pettenati
- Department of Genetics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
| | - Joseph Procita
- Department of Genetics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
| | - Lisa Cathey
- Department of Genetics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
| | - Sunil K George
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Graca Almeida-Porada
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Effect of electromagnetic fields on human osteoarthritic and non-osteoarthritic chondrocytes. Altern Ther Health Med 2017; 17:402. [PMID: 28806939 PMCID: PMC5556359 DOI: 10.1186/s12906-017-1868-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 07/04/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Studies of the effects of electromagnetic fields (EMFs) on cartilaginous cells show a broad range of outcomes. However EMFs are not yet clinically applied as standard treatment of osteoarthritis, as EMF effects are showing varying outcomes in the literature. The aim of this study was to examine effects of EMFs (5 mT or 8 mT) on osteoarthritic (OA) and non-OA chondrocytes in order to investigate whether EMF effects are related to chondrocyte and EMF quality. METHODS Pellets of human OA and non-OA chondrocytes were exposed to a sinusoidal 15 Hz EMF produced by a solenoid. Control groups were cultivated without EMF under standard conditions for 7 days. Cultures were examined by staining, immunohistochemistry and quantitative real-time PCR for RNA corresponding to cartilage specific proteins (COL2A1, ACAN, SOX9). RESULTS OA chondrocytes increased the expression of COL2A1 and ACAN under 5 mT EMF compared to control. In contrast no changes in gene expression were observed in non-OA chondrocytes. OA and non-OA chondrocytes showed no significant changes in gene expression under 8 mT EMF. CONCLUSION A 5 mT EMF increased the expression of cartilage specific genes in OA chondrocytes whereas in non-OA chondrocytes no changes in gene expression were observed. An 8 mT EMF however showed no effect altogether. This suggests that EMF effects are related to EMF but also to chondrocyte quality. Further studies about the clinical relevance of this effect are necessary.
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Zhou J, Liao Y, Xie H, Liao Y, Liu H, Zeng Y, Li N. Pulsed electromagnetic field ameliorates cartilage degeneration by inhibiting mitogen-activated protein kinases in a rat model of osteoarthritis. Phys Ther Sport 2017; 24:32-38. [DOI: 10.1016/j.ptsp.2016.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 10/08/2016] [Accepted: 10/26/2016] [Indexed: 12/14/2022]
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Yu C, Peng RY. Biological effects and mechanisms of shortwave radiation: a review. Mil Med Res 2017; 4:24. [PMID: 28729909 PMCID: PMC5518414 DOI: 10.1186/s40779-017-0133-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 07/14/2017] [Indexed: 11/10/2022] Open
Abstract
With the increasing knowledge of shortwave radiation, it is widely used in wireless communications, radar observations, industrial manufacturing, and medical treatments. Despite of the benefits from shortwave, these wide applications expose humans to the risk of shortwave electromagnetic radiation, which is alleged to cause potential damage to biological systems. This review focused on the exposure to shortwave electromagnetic radiation, considering in vitro, in vivo and epidemiological results that have provided insight into the biological effects and mechanisms of shortwave. Additionally, some protective measures and suggestions are discussed here in the hope of obtaining more benefits from shortwave with fewer health risks.
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Affiliation(s)
- Chao Yu
- Beijing Institute of Radiation Medicine, Beijing, 100850 China
| | - Rui-Yun Peng
- Beijing Institute of Radiation Medicine, Beijing, 100850 China
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40
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Miller SL, Coughlin DG, Waldorff EI, Ryaby JT, Lotz JC. Pulsed electromagnetic field (PEMF) treatment reduces expression of genes associated with disc degeneration in human intervertebral disc cells. Spine J 2016; 16:770-6. [PMID: 26780754 DOI: 10.1016/j.spinee.2016.01.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 11/17/2015] [Accepted: 01/01/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Pulsed electromagnetic field (PEMF) therapies have been applied to stimulate bone healing and to reduce the symptoms of arthritis, but the effects of PEMF on intervertebral disc (IVD) biology is unknown. PURPOSE The purpose of this study was to determine how PEMF affects gene expression of IVD cells in normal and inflammatory environments. STUDY DESIGN/SETTING This was an in vitro human cell culture and microarray gene expression study. METHODS Human annulus fibrosus (AF) and nucleus pulposus (NP) cells were separately encapsulated in alginate beads and exposed to interleukin 1α (IL-1α) (10 ng/mL) to stimulate the inflammatory environment associated with IVD degeneration and/or stimulated by PEMF for 4 hours daily for up to 7 days. RNA was isolated from each treatment group and analyzed via microarray to assess IL-1α- and PEMF-induced changes in gene expression. RESULTS Although PEMF treatment did not completely inhibit the effects of IL-1α, PEMF treatment lessened the IL-1α-induced upregulation of genes expressed in degenerated IVDs. Consistent with our previous results, after 4 days, PEMF tended to reduce IL-1α-associated gene expression of IL-6 (25%, p=.07) in NP cells and MMP13 (26%, p=.10) in AF cells. Additionally, PEMF treatment significantly diminished IL-1α-induced gene expression of IL-17A (33%, p=.01) and MMP2 (24%, p=.006) in NP cells and NFκB (11%, p=.04) in AF cells. CONCLUSIONS These results demonstrate that IVD cells are responsive to PEMF and motivate future studies to determine whether PEMF may be helpful for patients with IVD degeneration.
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Affiliation(s)
- Stephanie L Miller
- Department of Orthopaedic Surgery, University of California, 513 Parnassus Ave, S-1161, Box 0514, San Francisco, CA, 94143, USA
| | - Dezba G Coughlin
- Department of Orthopaedic Surgery, University of California, 513 Parnassus Ave, S-1161, Box 0514, San Francisco, CA, 94143, USA
| | - Erik I Waldorff
- Orthofix, Inc., 3451 Plano Parkway, Lewisville, TX 75056, USA
| | - James T Ryaby
- Orthofix, Inc., 3451 Plano Parkway, Lewisville, TX 75056, USA
| | - Jeffrey C Lotz
- Department of Orthopaedic Surgery, University of California, 513 Parnassus Ave, S-1161, Box 0514, San Francisco, CA, 94143, USA.
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Palmer JS, Monk AP, Hopewell S, Bayliss LE, Jackson W, Beard DJ, Price AJ. Surgical interventions for early structural knee osteoarthritis. Hippokratia 2016. [DOI: 10.1002/14651858.cd012128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jonathan S Palmer
- University of Oxford; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences; Windmill Road, Headington Oxford UK OX3 7LD
| | - A Paul Monk
- University of Oxford; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences; Windmill Road, Headington Oxford UK OX3 7LD
| | - Sally Hopewell
- University of Oxford; Oxford Clinical Trials Research Unit; NDORMS Windmill Road Oxford Oxfordshire UK OX3 7LD
| | - Lee E Bayliss
- University of Oxford; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences; Windmill Road, Headington Oxford UK OX3 7LD
| | - William Jackson
- Oxford University Hospitals NHS Trust; Nuffield Orthopaedic Centre; Windmill Road Oxford UK OX3 7LD
| | - David J Beard
- University of Oxford; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences; Windmill Road, Headington Oxford UK OX3 7LD
| | - Andrew J Price
- University of Oxford; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences; Windmill Road, Headington Oxford UK OX3 7LD
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Kumaran B, Watson T. Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part II: chronic conditions. PHYSICAL THERAPY REVIEWS 2016. [DOI: 10.1080/10833196.2015.1133034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bagnato GL, Miceli G, Marino N, Sciortino D, Bagnato GF. Pulsed electromagnetic fields in knee osteoarthritis: a double blind, placebo-controlled, randomized clinical trial. Rheumatology (Oxford) 2015; 55:755-62. [PMID: 26705327 PMCID: PMC4795538 DOI: 10.1093/rheumatology/kev426] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This trial aimed to test the effectiveness of a wearable pulsed electromagnetic fields (PEMF) device in the management of pain in knee OA patients. METHODS In this randomized [with equal randomization (1:1)], double-blind, placebo-controlled clinical trial, patients with radiographic evidence of knee OA and persistent pain higher than 40 mm on the visual analog scale (VAS) were recruited. The trial consisted of 12 h daily treatment for 1 month in 60 knee OA patients. The primary outcome measure was the reduction in pain intensity, assessed through VAS and WOMAC scores. Secondary outcomes included quality of life assessment through the 36-item Medical Outcomes Study Short-Form version 2 (SF-36 v2), pressure pain threshold (PPT) and changes in intake of NSAIDs/analgesics. RESULTS Sixty-six patients were included, and 60 completed the study. After 1 month, PEMF induced a significant reduction in VAS pain and WOMAC scores compared with placebo. Additionally, pain tolerance, as expressed by PPT changes, and physical health improved in PEMF-treated patients. A mean treatment effect of -0.73 (95% CI - 1.24 to - 0.19) was seen in VAS score, while the effect size was -0.34 (95% CI - 0.85 to 0.17) for WOMAC score. Twenty-six per cent of patients in the PEMF group stopped NSAID/analgesic therapy. No adverse events were detected. CONCLUSION These results suggest that PEMF therapy is effective for pain management in knee OA patients and also affects pain threshold and physical functioning. Future larger studies, including head-to-head studies comparing PEMF therapy with standard pharmacological approaches in OA, are warranted. TRIAL REGISTRATION ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT01877278.
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Affiliation(s)
- Gian Luca Bagnato
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Giovanni Miceli
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Natale Marino
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Davide Sciortino
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Gian Filippo Bagnato
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Messina, Italy
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Effects of PEMF on patients with osteoarthritis: Results of a prospective, placebo-controlled, double-blind study. Bioelectromagnetics 2015; 36:576-85. [DOI: 10.1002/bem.21942] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/10/2015] [Indexed: 12/12/2022]
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Veronesi F, Fini M, Giavaresi G, Ongaro A, De Mattei M, Pellati A, Setti S, Tschon M. Experimentally induced cartilage degeneration treated by pulsed electromagnetic field stimulation; an in vitro study on bovine cartilage. BMC Musculoskelet Disord 2015; 16:308. [PMID: 26480822 PMCID: PMC4616002 DOI: 10.1186/s12891-015-0760-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 10/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is the final result of progressive alterations to articular cartilage structure, composition and cellularity, followed by an increase in the concentration of pro-inflammatory cytokines in joint synovial fluid. Even though the effect of pulsed electromagnetic field (PEMF) stimulation in counteracting OA progression and inflammation is of increasing interest, because of its anabolic and anti-inflammatory properties, the present study aimed to improve the knowledge on cartilage extracellular matrix (ECM) and chondrocyte changes related to the exposure of PEMF, from a histological and histomorphometric point of view. METHODS An in vitro OA model was realized, culturing bovine cartilage explants with a high dose of interleukin 1β (IL1β, 50 ng/ml) at different experimental times (24 h, and 7 and 21 days). The effects of PEMFs (75 Hz, 1.5 mT) were evaluated in cartilage explants treated with IL1β or not (control), in terms of cartilage structure, cellularity and proteoglycans, glycosaminoglycans, collagen II and transforming growth factor β1 synthesis by using histology, histomorphometry and immunohistochemistry. RESULTS Making a comparison with control cartilage, IL1β-treated explants showed a decrease in cartilage matrix, structure and cellularity parameters. PEMFs were able to counteract the progression of OA acting on both cartilage cellularity and ECM in cartilage previously treated with IL1β. Normal distribution (Kolmogroc-Smirnov test) and homoscedasticity (Levene test) of data were verified, then, the non-parametric Kruskal Wallis test followed by Mann-Whiteny U test for pairwise comparisons were performed. The p-value was adjusted according to the Dunn-Sidak correction. CONCLUSIONS These results, obtained by culturing and treating cartilage explants from two different joints, confirmed that PEMF stimulation can be used as adjuvant therapy to preserve cartilage from detrimental effects of high inflammatory cytokine levels during OA.
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Affiliation(s)
- Francesca Veronesi
- Department Rizzoli RIT, Rizzoli Orthopedic Institute, Laboratory of Biocompatibility, Innovative Technologies and Advanced Therapies, Bologna, 40136, Italy.
| | - Milena Fini
- Department Rizzoli RIT, Rizzoli Orthopedic Institute, Laboratory of Biocompatibility, Innovative Technologies and Advanced Therapies, Bologna, 40136, Italy. .,Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic Institute, Bologna, 40136, Italy.
| | - Gianluca Giavaresi
- Department Rizzoli RIT, Rizzoli Orthopedic Institute, Laboratory of Biocompatibility, Innovative Technologies and Advanced Therapies, Bologna, 40136, Italy. .,Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic Institute, Bologna, 40136, Italy.
| | - Alessia Ongaro
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, 44121, Italy.
| | - Monica De Mattei
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, 44121, Italy.
| | - Agnese Pellati
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, 44121, Italy.
| | - Stefania Setti
- IGEA - Clinical Biophysic, Carpi (Modena), 41012, Italy.
| | - Matilde Tschon
- Department Rizzoli RIT, Rizzoli Orthopedic Institute, Laboratory of Biocompatibility, Innovative Technologies and Advanced Therapies, Bologna, 40136, Italy. .,Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic Institute, Bologna, 40136, Italy.
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Olgar Y, Hidisoglu E, Celen MC, Yamasan BE, Yargicoglu P, Ozdemir S. 2.1 GHz electromagnetic field does not change contractility and intracellular Ca2+ transients but decreases β-adrenergic responsiveness through nitric oxide signaling in rat ventricular myocytes. Int J Radiat Biol 2015; 91:851-7. [PMID: 26136087 DOI: 10.3109/09553002.2015.1068462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Due to the increasing use of wireless technology in developing countries, particularly mobile phones, the influence of electromagnetic fields (EMF) on biologic systems has become the subject of an intense debate. Therefore, in this study we investigated the effect of 2.1 GHz EMF on contractility and beta-adrenergic (β-AR) responsiveness of ventricular myocytes. MATERIALS AND METHODS Rats were randomized to the following groups: Sham rats (SHAM) and rats exposed to 2.1 GHz EMF for 2 h/day for 10 weeks (EM-10). Sarcomere shortening and Ca(2+) transients were recorded in isolated myocytes loaded with Fura2-AM and electrically stimulated at 1 Hz, while L-type Ca(2+) currents (I(CaL)) were measured using whole-cell patch clamping at 36 ± 1°C. Cardiac nitric oxide (NO) levels were measured in tissue samples using a colorimetric assay kit. RESULTS Fractional shortening and amplitude of the matched Ca(2+) transients were not changed in EM-10 rats. Although the isoproterenol-induced (10(-6) M) I(CaL) response was reduced in rats exposed to EMF, basal I(CaL) density in myocytes was similar between the two groups (p < 0.01). Moreover, EMF exposure led to a significant increase in nitric oxide levels in rat heart (p < 0.02). CONCLUSIONS Long-term exposure to 2.1 GHz EMF decreases β-AR responsiveness of ventricular myocytes through NO signaling.
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Affiliation(s)
- Yusuf Olgar
- a Department of Biophysics , Faculty of Medicine, Akdeniz University , Antalya , Turkey
| | - Enis Hidisoglu
- a Department of Biophysics , Faculty of Medicine, Akdeniz University , Antalya , Turkey
| | - Murat Cenk Celen
- a Department of Biophysics , Faculty of Medicine, Akdeniz University , Antalya , Turkey
| | - Bilge Eren Yamasan
- a Department of Biophysics , Faculty of Medicine, Akdeniz University , Antalya , Turkey
| | - Piraye Yargicoglu
- a Department of Biophysics , Faculty of Medicine, Akdeniz University , Antalya , Turkey
| | - Semir Ozdemir
- a Department of Biophysics , Faculty of Medicine, Akdeniz University , Antalya , Turkey
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Liu HF, He HC, Yang L, Yang ZY, Yao K, Wu YC, Yang XB, He CQ. Pulsed electromagnetic fields for postmenopausal osteoporosis and concomitant lumbar osteoarthritis in southwest China using proximal femur bone mineral density as the primary endpoint: study protocol for a randomized controlled trial. Trials 2015; 16:265. [PMID: 26058489 PMCID: PMC4482283 DOI: 10.1186/s13063-015-0780-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 05/27/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Osteoporosis (OP) and osteoarthritis (OA) are prevalent skeletal disorders among postmenopausal women. Coexistence is common especially that of postmenopausal osteoporosis (PMO) and lumbar OA. An hypothesis has been raised that OP and OA might share the same pathogenic mechanism, and pulsed electromagnetic fields (PEMFs) were reported to have anti-osteoporosis and anti-osteoarthritis properties, but this suggestion was based primarily on biomarker data. Therefore, whether these two effects could take place simultaneously has not yet been investigated. This randomized controlled trial (RCT) is designed to explore the effect of PEMFs for PMO and concomitant lumbar OA. METHODS/DESIGN The study will include PMO patients (postmenopausal women; aged between 50 and 70 years; have been postmenopausal for at least 5 years and diagnosed with OP using proximal femur T-score) with concomitant lumbar OA (patients with confounding disorders like diabetes, hypertension, hyperlipidemia, and previous fracture history, etcetera, will be excluded) will be randomly assigned to two arms: PEMFs group and sham PEMFs group. There will be 25 participants in each arm (50 in total) and the outcome assessment, including the primary endpoint (proximal femur bone mineral density), will be performed at 5 weeks, 3 months and 6 months after enrollment. DISCUSSION PMO and lumbar OA are prominent public health problem, especially for postmenopausal women. We hope this RCT will provide scientific evidence to primary care of the postmenopausal women regarding the use of these nonpharmaceutical, noninvasive modalities, PEMFs, in managing PMO and lumbar OA. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR-TRC-14005156 (28 August 2014).
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Affiliation(s)
- Hui-Fang Liu
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, People's Republic of China.
| | - Hong-Chen He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, People's Republic of China. .,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Lin Yang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, People's Republic of China. .,Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Zhou-Yuan Yang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Ke Yao
- Department of Biostatistics, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China.
| | - Yuan-Chao Wu
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Xi-Biao Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Cheng-Qi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, People's Republic of China.
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Prato FS. Non-thermal extremely low frequency magnetic field effects on opioid related behaviors: Snails to humans, mechanisms to therapy. Bioelectromagnetics 2015; 36:333-48. [DOI: 10.1002/bem.21918] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/15/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Frank S. Prato
- Lawson Health Research Institute; London; Ontario Canada
- Department of Medical Biophysics; University of Western Ontario; London Ontario Canada
- Medical Imaging; University of Western Ontario; London Ontario Canada
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Bragin DE, Statom GL, Hagberg S, Nemoto EM. Increases in microvascular perfusion and tissue oxygenation via pulsed electromagnetic fields in the healthy rat brain. J Neurosurg 2014; 122:1239-47. [PMID: 25343187 DOI: 10.3171/2014.8.jns132083] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT High-frequency pulsed electromagnetic field stimulation is an emerging noninvasive therapy being used clinically to facilitate bone and cutaneous wound healing. Although the mechanisms of action of pulsed electromagnetic fields (PEMF) are unknown, some studies suggest that its effects are mediated by increased nitric oxide (NO), a well-known vasodilator. The authors hypothesized that in the brain, PEMF increase NO, which induces vasodilation, enhances microvascular perfusion and tissue oxygenation, and may be a useful adjunct therapy in stroke and traumatic brain injury. To test this hypothesis, they studied the effect of PEMF on a healthy rat brain with and without NO synthase (NOS) inhibition. METHODS In vivo two-photon laser scanning microscopy (2PLSM) was used on the parietal cortex of rat brains to measure microvascular tone and red blood cell (RBC) flow velocity in microvessels with diameters ranging from 3 to 50 μm, which includes capillaries, arterioles, and venules. Tissue oxygenation (reduced nicotinamide adenine dinucleotide [NADH] fluorescence) was also measured before and for 3 hours after PEMF treatment using the FDA-cleared SofPulse device (Ivivi Health Sciences, LLC). To test NO involvement, the NOS inhibitor N(G)-nitro-l-arginine methyl ester (L-NAME) was intravenously injected (10 mg/kg). In a time control group, PEMF were not used. Doppler flux (0.8-mm probe diameter), brain and rectal temperatures, arterial blood pressure, blood gases, hematocrit, and electrolytes were monitored. RESULTS Pulsed electromagnetic field stimulation significantly dilated cerebral arterioles from a baseline average diameter of 26.4 ± 0.84 μm to 29.1 ± 0.91 μm (11 rats, p < 0.01). Increased blood volume flow through dilated arterioles enhanced capillary flow with an average increase in RBC flow velocity by 5.5% ± 1.3% (p < 0.01). Enhanced microvascular flow increased tissue oxygenation as reflected by a decrease in NADH autofluorescence to 94.7% ± 1.6% of baseline (p < 0.05). Nitric oxide synthase inhibition by L-NAME prevented PEMF-induced changes in arteriolar diameter, microvascular perfusion, and tissue oxygenation (7 rats). No changes in measured parameters were observed throughout the study in the untreated time controls (5 rats). CONCLUSIONS This is the first demonstration of the acute effects of PEMF on cerebral cortical microvascular perfusion and metabolism. Thirty minutes of PEMF treatment induced cerebral arteriolar dilation leading to an increase in microvascular blood flow and tissue oxygenation that persisted for at least 3 hours. The effects of PEMF were mediated by NO, as we have shown in NOS inhibition experiments. These results suggest that PEMF may be an effective treatment for patients after traumatic or ischemic brain injury. Studies on the effect of PEMF on the injured brain are in progress.
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Gobbi A, Lad D, Petrera M, Karnatzikos G. Symptomatic Early Osteoarthritis of the Knee Treated With Pulsed Electromagnetic Fields: Two-Year Follow-up. Cartilage 2014; 5:78-85. [PMID: 26069687 PMCID: PMC4297082 DOI: 10.1177/1947603513515904] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE In vitro and in vivo studies have proven a pro-anabolic and anti-catabolic activity within cartilage with the use of pulsed electromagnetic fields (PEMFs). This has piqued interest of sports physicians for its use in the treatment of early osteoarthritis (OA). The aim was to determine if the use of PEMFs in patients with early OA of the knee would lead to an improved clinical outcome. STUDY DESIGN Prospective case series. METHODS Twenty-two patients aged between 30 and 60 years who underwent treatment with PEMFs (4-hour treatment per day, duration 45 days) were included. All patients presented with symptomatic early OA with grade 0-2 changes (Kellgren-Lawrence classification) at the pretreatment evaluation. Patients were evaluated before treatment, at 1- and 2-year follow-up using visual analogue scale for pain, International Knee Documentation Committee objective, Tegner, and Knee Injury and Osteoarthritis Outcome Scores. RESULTS A significant improvement in all scores was observed at 1-year follow-up (P = 0.008). At 2-year follow-up, results deteriorated but were still superior to pretreatment levels (P = 0.02). No adverse reactions or side effects were seen. CONCLUSIONS This study showed that the use of PEMFs in patients with symptomatic early OA of the knee led to significant improvement in symptoms, knee function, and activity at 1-year follow-up. There was a significant decline in all the scores at 2-year follow-up.
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