1
|
Flatscher J, Pavez Loriè E, Mittermayr R, Meznik P, Slezak P, Redl H, Slezak C. Pulsed Electromagnetic Fields (PEMF)-Physiological Response and Its Potential in Trauma Treatment. Int J Mol Sci 2023; 24:11239. [PMID: 37510998 PMCID: PMC10379303 DOI: 10.3390/ijms241411239] [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: 04/30/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Environmental biophysical interactions are recognized to play an essential part in the human biological processes associated with trauma recovery. Many studies over several decades have furthered our understanding of the effects that Pulsed Electromagnetic Fields (PEMF) have on the human body, as well as on cellular and biophysical systems. These investigations have been driven by the observed positive clinical effects of this non-invasive treatment on patients, mainly in orthopedics. Unfortunately, the diversity of the various study setups, with regard to physical parameters, molecular and cellular response, and clinical outcomes, has made it difficult to interpret and evaluate commonalities, which could, in turn, lead to finding an underlying mechanistic understanding of this treatment modality. In this review, we give a birds-eye view of the vast landscape of studies that have been published on PEMF, presenting the reader with a scaffolded summary of relevant literature starting from categorical literature reviews down to individual studies for future research studies and clinical use. We also highlight discrepancies within the many diverse study setups to find common reporting parameters that can lead to a better universal understanding of PEMF effects.
Collapse
Affiliation(s)
- Jonas Flatscher
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Elizabeth Pavez Loriè
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | | | - Paul Meznik
- AUVA Trauma Center Vienna-Meidling, 1120 Vienna, Austria
| | - Paul Slezak
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
| | - Cyrill Slezak
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria
- Department of Physics, Utah Valley University, Orem, UT 84058, USA
| |
Collapse
|
2
|
Xu Y, Wang Q, Wang XX, Xiang XN, Peng JL, He CQ, He HC. The Effect of Different Frequencies of Pulsed Electromagnetic Fields on Cartilage Repair of Adipose Mesenchymal Stem Cell-Derived Exosomes in Osteoarthritis. Cartilage 2022; 13:200-212. [PMID: 36377077 PMCID: PMC9924977 DOI: 10.1177/19476035221137726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The intra-articular injection of mesenchymal stem cell (MSC)-derived exosomes has already been proved to reverse osteoarthritic cartilage degeneration. Pulsed electromagnetic field (PEMF) has been found to regulate the biogenic function of MSCs. However, the effect of PEMF on MSC-derived exosomes has not yet been characterized. The aim of this study was to elucidate the regulatory role of different frequencies of PEMF in promoting the osteoarthritic cartilage regeneration of MSC-derived exosomes. METHODS The adipose tissue-derived MSCs (AMSCs) were extracted from the epididymal fat of healthy rats and further exposed to the PEMF at 1 mT amplitude and a frequency of 15, 45, and 75 Hz, respectively, in an incubator. The chondrocytes were treated with interlukin-1β (IL-1β) and the regenerative effect of co-culturing with PEMF-exposed AMSC-derived exosomes was assessed via Western blot, quantitative polymerase chain reaction, and ELISA assays. A rat model of osteoarthritis was established by anterior cruciate ligament transection (ACLT) surgery and received 4 times intra-articular injection of PEMF-exposed AMSC-derived exosomes once a week. After 8 weeks, the knee joint specimens of rats were collected for micro-computed tomography and histologic analyses. RESULTS PEMF-exposed AMSC-derived exosomes could be endocytosed with IL-1β-induced chondrocytes. Compared with the AMSC-derived exosomes alone, the PEMF-exposed AMSC-derived exosomes substantially suppressed the inflammation and extracellular matrix degeneration of IL-1β-induced chondrocytes as shown by higher expression of transcripts and proteins of COL2A1, SOX9, and ACAN and lower expression of MMP13 and caspase-1. Of these, the 75-Hz PEMF presented a more significant inhibitive effect than the 15-Hz and 45-Hz PEMFs. Furthermore, the intra-articular injection of 75-Hz PEMF-exposed exosomes could obviously increase the number of tibial epiphyseal trabeculae, lead to a remarkable decrease in Osteoarthritis Research Society International score, and upregulate the COL2A1 and ACAN protein level of the degenerated cartilage. CONCLUSION The present study demonstrated that PEMF stimulation could effectively promote the regeneration effects of AMSC-derived exosomes on osteoarthritic cartilage. Compared with other frequency parameters, the PEMF at a frequency of 75 Hz showed a superior positive effect on AMSC-derived exosomes in suppressing the IL-1β-induced chondrocyte inflammation and extracellular matrix catabolism, as well as the osteoarthritic cartilage degeneration.
Collapse
Affiliation(s)
- Yang Xu
- Rehabilitation Medicine Centre, West
China Hospital, Sichuan University, Chengdu, P.R. China,School of Rehabilitation Sciences, West
China School of Medicine, Sichuan University, Chengdu, P.R. China,Rehabilitation Medicine Key Laboratory
of Sichuan Province, Chengdu, P.R. China
| | - Qian Wang
- Rehabilitation Medicine Centre, West
China Hospital, Sichuan University, Chengdu, P.R. China,School of Rehabilitation Sciences, West
China School of Medicine, Sichuan University, Chengdu, P.R. China,Rehabilitation Medicine Key Laboratory
of Sichuan Province, Chengdu, P.R. China
| | - Xiang-Xiu Wang
- Rehabilitation Medicine Centre, West
China Hospital, Sichuan University, Chengdu, P.R. China,School of Rehabilitation Sciences, West
China School of Medicine, Sichuan University, Chengdu, P.R. China,Rehabilitation Medicine Key Laboratory
of Sichuan Province, Chengdu, P.R. China
| | - Xiao-Na Xiang
- Rehabilitation Medicine Centre, West
China Hospital, Sichuan University, Chengdu, P.R. China,School of Rehabilitation Sciences, West
China School of Medicine, Sichuan University, Chengdu, P.R. China,Rehabilitation Medicine Key Laboratory
of Sichuan Province, Chengdu, P.R. China
| | - Jia-Lei Peng
- Rehabilitation Medicine Centre, West
China Hospital, Sichuan University, Chengdu, P.R. China,School of Rehabilitation Sciences, West
China School of Medicine, Sichuan University, Chengdu, P.R. China,Rehabilitation Medicine Key Laboratory
of Sichuan Province, Chengdu, P.R. China
| | - Cheng-Qi He
- Rehabilitation Medicine Centre, West
China Hospital, Sichuan University, Chengdu, P.R. China,School of Rehabilitation Sciences, West
China School of Medicine, Sichuan University, Chengdu, P.R. China,Rehabilitation Medicine Key Laboratory
of Sichuan Province, Chengdu, P.R. China
| | - Hong-Chen He
- Rehabilitation Medicine Centre, West
China Hospital, Sichuan University, Chengdu, P.R. China,School of Rehabilitation Sciences, West
China School of Medicine, Sichuan University, Chengdu, P.R. China,Rehabilitation Medicine Key Laboratory
of Sichuan Province, Chengdu, P.R. China,Hong-Chen He, Rehabilitation Medicine
Centre, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P.R.
China.
| |
Collapse
|
3
|
Huang M, Li P, Chen F, Cai Z, Yang S, Zheng X, Li W. Is extremely low frequency pulsed electromagnetic fields applicable to gliomas? A literature review of the underlying mechanisms and application of extremely low frequency pulsed electromagnetic fields. Cancer Med 2022; 12:2187-2198. [PMID: 35929424 PMCID: PMC9939155 DOI: 10.1002/cam4.5112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 11/07/2022] Open
Abstract
Gliomas refer to a group of complicated human brain tumors with a low 5-year survival rate and limited therapeutic options. Extremely low-frequency pulsed electromagnetic field (ELF-PEMF) is a specific magnetic field featuring almost no side effects. However, the application of ELF-PEMF in the treatment of gliomas is rare. This review summarizes five significant underlying mechanisms including calcium ions, autophagy, apoptosis, angiogenesis, and reactive oxygen species, and applications of ELF-PEMF in glioma treatment from a clinical practice perspective. In addition, the prospects of ELF-PEMF in combination with conventional therapy for the treatment of gliomas are reviewed. This review benefits any specialists, especially oncologists, interested in this new therapy because it can help treat patients with gliomas properly.
Collapse
Affiliation(s)
- Mengqian Huang
- Cancer Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Parker Li
- Clinical MedicineShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Feng Chen
- Cancer Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zehao Cai
- Cancer Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Shoubo Yang
- Cancer Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xiaohong Zheng
- Cancer Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Wenbin Li
- Cancer Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| |
Collapse
|
4
|
Selva-Sarzo F, Fernández-Carnero S, Sillevis R, Hernández-Garcés H, Benitez-Martinez JC, Cuenca-Zaldívar JN. The Direct Effect of Magnetic Tape ® on Pain and Lower-Extremity Blood Flow in Subjects with Low-Back Pain: A Randomized Clinical Trial. SENSORS 2021; 21:s21196517. [PMID: 34640836 PMCID: PMC8512790 DOI: 10.3390/s21196517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
Low-back pain has a high impact on the world population, and solutions are in demand. The behavior of specific physiological processes has been modified using magnetic fields, whether for pain relief, bone consolidation, or improvement of vascularization. The use of tape with magnetic properties could help in these cases. A double-blind randomized clinical trial was designed to use Magnetic Tape® versus placebo Kinesio tape. Blood flow variables were evaluated using pulsed power Doppler ultrasound. Resistance index, pulsatility index, systolic velocity, and diastolic velocity were measured. The pressure pain threshold was measured using algometry in 22 subjects. The results reveal significant differences between the groups for the pulsation index variable (8.06 [5.16, 20.16] in Magnetic Tape® versus 5.50 [4.56, 6.64] in Kinesio tape) and lower (0.98 [0.92, 1.02] for Magnetic Tape® versus 0.99 [0.95, 1.01] for Kinesio tape) in the resistance index variable. The pressure pain threshold variable presented significant differences at multiple levels. The application of Magnetic Tape® causes immediate effects on blood flow and pain and could be a technique of choice for pain modulation. Further studies would be necessary.
Collapse
Affiliation(s)
- Francisco Selva-Sarzo
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (F.S.-S.); (J.-C.B.-M.)
| | - Samuel Fernández-Carnero
- Physiotherapy and Nursing Department, University of Alcala, 28801 Alcalá de Henares, Spain
- Correspondence:
| | - Rob Sillevis
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL 33965, USA;
| | | | | | - Juan-Nicolás Cuenca-Zaldívar
- Rehabilitation Service, Guadarrama Hospital, 28440 Madrid, Spain;
- Research Group in Nursing and Health Café, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Madrid, Spain
| |
Collapse
|
5
|
Zhang H, Li S, Liu Y, Yu Y, Lin S, Wang Q, Miao L, Wei H, Sun W. Fe 3O 4@GO magnetic nanocomposites protect mesenchymal stem cells and promote osteogenic differentiation of rat bone marrow mesenchymal stem cells. Biomater Sci 2020; 8:5984-5993. [PMID: 32985626 DOI: 10.1039/d0bm00906g] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Fe3O4 nanoparticles (Fe3O4 NPs) are typical magnetic materials for bone tissue regeneration. However, the accompanying oxidative stress during the reaction process of Fe3O4 NPs and H2O2 in bone remodeling and disease may hinder their application. In order to reduce this side effect, we selected graphene oxide (GO) to modify Fe3O4 NPs. We showed that Fe3O4@GO magnetic nanocomposites (Fe3O4@GO MNCs) eliminated 30% of H2O2 in 3 h, and reduced the amount of ˙OH, the intermediate product of the Fenton reaction. The cellular study demonstrated that Fe3O4@GO MNCs reduced the cell damage caused by reactive oxygen species (ROS) and improved the activity of mesenchymal stem cells (MSCs). Moreover, when the magnetic field and bone morphogenetic protein-2 (BMP2) delivered by Fe3O4@GO MNCs worked together, osteogenic differentiation of MSCs in vitro was well promoted.
Collapse
Affiliation(s)
- He Zhang
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210093, China
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Chen LR, Hou PH, Chen KH. Nutritional Support and Physical Modalities for People with Osteoporosis: Current Opinion. Nutrients 2019; 11:nu11122848. [PMID: 31757101 PMCID: PMC6950804 DOI: 10.3390/nu11122848] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/10/2019] [Accepted: 11/18/2019] [Indexed: 01/23/2023] Open
Abstract
Osteoporosis is a vital healthcare issue among elderly people. During the aging process, a gradual loss of bone mass results in osteopenia and osteoporosis. Heritable factors account for 60%-80% of optimal bone mineralization, whereas modifiable factors such as nutrition, weight-bearing exercise, body mass, and hormonal milieu affect the development of osteopenia and osteoporosis in adulthood. Osteoporosis substantially increases the risk of skeletal fractures and further morbidity and mortality. The effective prevention of fractures by reducing the loss of bone mass is the primary goal for physicians treating people with osteoporosis. Other than pharmacologic agents, lifestyle adjustment, nutritional support, fall prevention strategies, exercise, and physical modalities can be used to treat osteoporosis or prevent further osteoporotic fracture. Each of these factors, alone or in combination, can be of benefit to people with osteoporosis and should be implemented following a detailed discussion with patients. This review comprises a systematic survey of the current literature on osteoporosis and its nonpharmacologic and nonsurgical treatment. It provides clinicians and healthcare workers with evidence-based information on the assessment and management of osteoporosis. However, numerous issues regarding osteoporosis and its treatment remain unexplored and warrant future investigation.
Collapse
Affiliation(s)
- Li-Ru Chen
- Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Taipei 10449, Taiwan; (L.-R.C.); (P.-H.H.)
- Department of Mechanical Engineering, National Chiao-Tung University, Hsinchu 300, Taiwan
| | - Peng-Hsuan Hou
- Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Taipei 10449, Taiwan; (L.-R.C.); (P.-H.H.)
| | - Kuo-Hu Chen
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei 23142, Taiwan
- School of Medicine, Tzu-Chi University, Hualien 970, Taiwan
- Correspondence: ; Tel.: +886-2-66289779
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Ross CL. Energy Medicine: Current Status and Future Perspectives. Glob Adv Health Med 2019; 8:2164956119831221. [PMID: 30834177 PMCID: PMC6396053 DOI: 10.1177/2164956119831221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 12/21/2018] [Accepted: 01/02/2019] [Indexed: 12/18/2022] Open
Abstract
Current practices in allopathic medicine measure different types of energy in the human body by using quantum field dynamics involved in nuclear medicine, radiology, and imaging diagnostics. Once diagnosed, current treatments revert to biochemistry instead of using biophysics therapies to treat the disturbances in subtle energies detected and used for diagnostics. Quantum physics teaches us there is no difference between energy and matter. All systems in the human being, from the atomic to the molecular level, are constantly in motion-creating resonance. This resonance is important to understanding how subtle energy directs and maintains health and wellness in the human being. Energy medicine (EM), whether human touch or device-based, is the use of known subtle energy fields to therapeutically assess and treat energetic imbalances, bringing the body's systems back to homeostasis (balance). The future of EM depends on the ability of allopathic medicine to merge physics with biochemistry. Biophoton emissions as well as signal transduction and cell signaling communication systems are widely accepted in today's medicine. This technology needs to be expanded to include the existence of the human biofield (or human energy field) to better understand that disturbances in the coherence of energy patterns are indications of disease and aging. Future perspectives include understanding cellular voltage potentials and how they relate to health and wellness, understanding the overlap between the endocrine and chakra systems, and understanding how EM therapeutically enhances psychoneuroimmunology (mind-body) medicine.
Collapse
Affiliation(s)
- Christina L Ross
- Wake Forest Center for Integrative Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
| |
Collapse
|
9
|
Kulikov AG, Voronina DD, Morozov AE, Zajceva TN, Ustinova KI. New approach for evaluating the effectiveness of whole-body magnetic field therapy in the rehabilitation of patients with lumbar discectomy. J Back Musculoskelet Rehabil 2019; 31:1065-1073. [PMID: 29991122 DOI: 10.3233/bmr-171033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Magnetic field therapy involves the application of low-intensity magnetic fields (1-3.5 mT) to a patient's whole body. The purpose of this study was to assess the effectiveness of whole-body magnetic field (WBMF) therapy in the early rehabilitation of patients after lumbar discectomy. METHODS A convenience sample of 73 patients who underwent lumbar discectomy within 1 month previously participated in the study. All patients were randomly assigned to one of two groups and received either a course of conventional rehabilitation (control group) or conventional rehabilitation together with 10 sessions of WBMF therapy (WBMF group). Participants were evaluated before and after the rehabilitation course by using the Visual Analog Scale for Pain (VAS) and thermal infrared imaging. The latter was used to detect pathological changes in temperature (hyperthermia and thermal asymmetry) of the surface of the skin overlying the lumbar spine and lower extremities. RESULTS The VAS score of the WBMF group decreased from 6.2 ± 0.3 cm before to 3.2 ± 0.2 cm after rehabilitation (p< 0.01), compared to 6.1 ± 0.4 cm before to 4.3 ± 0.2 cm after rehabilitation for the control group (p< 0.05). Reduction of the area of lumbar hyperthermia was observed in 88% of WBMF and 35% of control group patients. CONCLUSIONS When combined with conventional rehabilitation, WBMF therapy was effective in reducing lumbar pain, temperature, and, possibly, inflammation. Results of this study will be used for designing a large-scale clinical trial.
Collapse
Affiliation(s)
- Alexander G Kulikov
- Federal State Budgetary Educational Institution of Further Professional Education, Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Darya D Voronina
- Federal State Budgetary Educational Institution of Further Professional Education, Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Aleksey E Morozov
- Baikov Institute of Metallurgy and Materials Science, Russian Academy of Sciences, Moscow, Russia
| | - Tatyana N Zajceva
- Federal State Budgetary Educational Institution of Further Professional Education, Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Ksenia I Ustinova
- Department of Physical Therapy, Central Michigan University, Mount Pleasant, MI, USA
| |
Collapse
|
10
|
Phang JK, Kwan YH, Goh H, Tan VIC, Thumboo J, Østbye T, Fong W. Complementary and alternative medicine for rheumatic diseases: A systematic review of randomized controlled trials. Complement Ther Med 2018; 37:143-157. [DOI: 10.1016/j.ctim.2018.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 02/27/2018] [Accepted: 03/04/2018] [Indexed: 12/11/2022] Open
|
11
|
Elgohary HM, Tantawy SA. Pulsed electromagnetic field with or without exercise therapy in the treatment of benign prostatic hyperplasia. J Phys Ther Sci 2017; 29:1305-1310. [PMID: 28878453 PMCID: PMC5574357 DOI: 10.1589/jpts.29.1305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/09/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the effect of pulsed electromagnetic field with or without
exercise therapy in the treatment of benign prostatic hyperplasia. [Subjects and Methods]
Sixty male patients aged 55–65 years with benign prostatic hyperplasia were invited to
participate in this study. Patients were randomly assigned to Group A (n=20; patients who
received pulsed electromagnetic field in addition to pelvic floor and aerobic exercises),
Group B (n=20; patients who received pulsed electromagnetic field), and Group C (n=20;
patients who received placebo electromagnetic field). The assessments included post-void
residual urine, urine flow rate, prostate specific antigen, white blood cells count, and
International Prostate Symptom Score were weighed, before and after a 4-week intervention.
[Results] There were significant differences in Group A and B in all parameters. Group C
showed non-significant differences in all measured variables except for International
Prostate Symptom Score. Among groups, all parameters showed highly significant differences
in favor of Group A. There were non-significant differences between Group A and B and
significant difference between Groups A and C and between Groups B and C. [Conclusion] The
present study demonstrated that electromagnetic field had a significant impact on the
treatment of benign prostatic hyperplasia. Accordingly, electromagnetic field can be
utilized alone or in combination with other physiotherapy modalities. Moreover, clinicians
should have the capacity to perceive the advantages accomplished using extra treatment
alternatives. Electromagnetic field is a safe, noninvasive method and can be used for the
treatment of benign prostatic hyperplasia.
Collapse
Affiliation(s)
- Hany M Elgohary
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Egypt
| | - Sayed A Tantawy
- Physiotherapy Department, Center of Radiation, Oncology and Nuclear Medicine, Cairo University, Egypt.,Department of Physiotherapy, College of Medical & Health Sciences, Ahlia University, Kingdom of Bahrain
| |
Collapse
|
12
|
Synergy of substrate conductivity and intermittent electrical stimulation towards osteogenic differentiation of human mesenchymal stem cells. Bioelectrochemistry 2017; 116:52-64. [DOI: 10.1016/j.bioelechem.2017.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/27/2017] [Accepted: 03/27/2017] [Indexed: 02/01/2023]
|
13
|
Al-Jabri T, Tan JYQ, Tong GY, Shenoy R, Kayani B, Parratt T, Khan T. The role of electrical stimulation in the management of avascular necrosis of the femoral head in adults: a systematic review. BMC Musculoskelet Disord 2017; 18:319. [PMID: 28754159 PMCID: PMC5534113 DOI: 10.1186/s12891-017-1663-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 07/09/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Avascular necrosis of the femoral head causes significant morbidity and occurs in up to 20,000 people per year. A variety of nonoperative and operative measures have been trialled however a definitive treatment algorithm is yet to be established. Young adults in many cases have undergone multiple surgical procedures in their lifetime with increasing risks of complications. Less invasive techniques may help reduce the number of operations required and positively influence the natural history of the disease process. Our aim was to navigate the literature and examine the results of electrical stimulation of the femoral head in avascular necrosis. METHODS The following defined search strategy was used to perform a systematic review using MEDLINE and Google Scholar databases: ((avascular necrosis) OR (osteonecrosis)) AND (femoral head) AND ((electrical stimulation) OR (capacitive coupling) OR (pulsed electromagnetic fields)). Articles were reviewed and data compiled into tables for analysis. RESULTS Fourty six articles were identified with a total of 10 articles meeting the inclusion criteria. 8 articles were prospective studies and 2 were retrospective. Early Ficat stages showed the best responses to treatment via pulsed electromagnetic fields with improvements in both clinical and radiographic parameters. Direct current and capacitative coupling have had a more ambiguous outcome. CONCLUSIONS Pulsed electromagnetic fields may have a role in the management of early avascular necrosis. The paucity of clinical studies into this technique indicates a need for further studies.
Collapse
Affiliation(s)
- Talal Al-Jabri
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
| | | | | | - Ravikiran Shenoy
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - Babar Kayani
- Great Ormond Street Hospital, Great Ormond St, London, WC1N 3JH, UK
| | - Timothy Parratt
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - Tahir Khan
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| |
Collapse
|
14
|
Kamel DM, Hamed NS, Abdel Raoof NA, Tantawy SA. Pulsed magnetic field versus ultrasound in the treatment of postnatal carpal tunnel syndrome: A randomized controlled trial in the women of an Egyptian population. J Adv Res 2017; 8:45-53. [PMID: 27980864 PMCID: PMC5144749 DOI: 10.1016/j.jare.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 11/04/2016] [Accepted: 11/14/2016] [Indexed: 01/16/2023] Open
Abstract
The aim of this study was to compare the effects of pulsed electromagnetic field versus pulsed ultrasound in treating patients with postnatal carpal tunnel syndrome. The study was a randomized, double-blinded trial. Forty postnatal female patients with idiopathic carpal tunnel syndrome were divided randomly into two equal groups. One group received pulsed electromagnetic field, with nerve and tendon gliding exercises for the wrist, three times per week for four weeks. The other group received pulsed ultrasound and the same wrist exercises. Pain level, sensory and motor distal latencies and conduction velocities of the median nerve, functional status scale and hand grip strength were assessed pre- and post-treatment. There was a significant decrease (P < 0.05) in pain level, sensory and motor distal latencies of the median nerve, and significant increase (P < 0.05) in sensory and motor conduction velocities of the median nerve and hand grip strength in both groups, with a significant difference between the two groups in favour of pulsed electromagnetic field treatment. However, the functional status scale showed intergroup no significant difference (P > 0.05). In conclusion, while the symptoms were alleviated in both groups, pulsed electromagnetic field was more effective than pulsed ultrasound in treating postnatal carpal tunnel syndrome.
Collapse
Key Words
- CTS, carpal tunnel syndrome
- CTSQ, carpal tunnel syndrome questionnaire
- Carpal tunnel syndrome
- EMG, electromyography
- Electromagnetic field
- MMCV, median motor conduction velocity
- MMDL, median motor distal latency
- MSCV, median sensory conduction velocity
- MSDL, median segmental sensory distal latency
- MSDL, median sensory distal latency
- NCSs, nerve conduction studies
- NCV, nerve conduction velocity
- Nerve conduction velocity
- PEMF, pulsed electromagnetic magnetic field
- Pain
- Postnatal
- Pregnancy
- Pulsed ultrasound
- US, ultrasound
- VAS, visual analogue scale
Collapse
Affiliation(s)
- Dalia M. Kamel
- Department of Physical Therapy for Obstetrics and Gynecology, Faculty of Physical Therapy, Cairo University, P.O. Box 12612, Giza, Egypt
- Department of Physical Therapy, Faculty of Medical and Health Sciences. Ahlia University, P.O. Box 10878, Manama, Bahrain
| | - Nashwa S. Hamed
- Department of Physical Therapy for Neuromuscular Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, P.O. Box 12612, Giza, Egypt
| | - Neveen A. Abdel Raoof
- Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, P.O. Box 12612, Giza, Egypt
| | - Sayed A. Tantawy
- Department of Physical Therapy, Faculty of Medical and Health Sciences. Ahlia University, P.O. Box 10878, Manama, Bahrain
- Center of Radiation, Oncology and Nuclear Medicine, Cairo University, Giza, Egypt
| |
Collapse
|
15
|
Weintraub MI, Cole SP. Pulsed Magnetic Field Therapy in Refractory Neuropathic Pain Secondary to Peripheral Neuropathy: Electrodiagnostic Parameters—Pilot Study. Neurorehabil Neural Repair 2016; 18:42-6. [PMID: 15035963 DOI: 10.1177/0888439003261024] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context. Neuropathic pain (NP) from peripheral neuropathy (PN) arises from ectopic firing of unmyelinated C-fibers with accumulation of sodium and calcium channels. Because pulsed electromagnetic fields (PEMF) safely induce extremely low frequency (ELF) quasirectangular currents that can depolarize, repolarize, and hyperpolarize neurons, it was hypothesized that directing this energy into the sole of one foot could potentially modulate neuropathic pain. Objective. To determine if 9 consecutive 1-h treatments in physician’s office (excluding weekends) of a pulsed signal therapy can reduce NP scores in refractory feet with PN. Design/setting/patients. 24 consecutive patients with refractory and symptomatic PN from diabetes, chronic inflammatory demyelinating polyneuropathy (CIDP), pernicious anemia, mercury poisoning, paraneoplastic syndrome, tarsal tunnel, and idiopathic sensory neuropathy were enrolled in this nonplacebo pilot study. The most symptomatic foot received therapy. Primary endpoints were comparison of VAS scores at the end of 9 days and the end of 30 days follow-up compared to baseline pain scores. Additionally, Patients’ Global Impression of Change (PGIC) questionnaire was tabulated describing response to treatment. Subgroup analysis of nerve conduction scores, quantified sensory testing (QST), and serial examination changes were also tabulated. Subgroup classification of pain (Serlin) was utilized to determine if there were disproportionate responses. Intervention. Noninvasive pulsed signal therapy generates a unidirectional quasirectangular waveform with strength about 20 gauss and a frequency about 30 Hz into the soles of the feet for 9 consecutive 1-h treatments (excluding weekends). The most symptomatic foot of each patient was treated. Results. All 24 feet completed 9 days of treatment. 15/24 completed follow-up (62%) with mean pain scores decreasing 21% from baseline to end of treatment (P = 0.19) but with 49% reduction of pain scores from baseline to end of follow-up (P < 0.01). Of this group, self-reported PGIC was improved 67% (n = 10) and no change was 33% (n = 5). An intent-to-treat analysis based on all 24 feet demonstrated a 19% reduction in pain scores from baseline to end of treatment (P = 0.10) and a 37% decrease from baseline to end of follow-up ( P < 0.01). Subgroup analysis revealed 5 patients with mild pain with nonsignificant reduction at end of follow-up. Of the 19 feet with moderate to severe pain, there was a 28% reduction from baseline to end of treatment (P < 0.05) and a 39% decrease from baseline to end of follow-up (P < 0.01). Benefit was better in those patients with axonal changes and advanced CPT baseline scores. The clinical examination did not change. There were no adverse events or safety issues. Conclusions. These pilot data demonstrate that directing PEMF to refractory feet can provide unexpected shortterm analgesic effects in more than 50% of individuals. The role of placebo is not known and was not tested. The precise mechanism is unclear yet suggests that severe and advanced cases are more magnetically sensitive. Future studies are needed with randomized placebo-controlled design and longer treatment periods.
Collapse
|
16
|
Wang R, Wu H, Yang Y, Song M. Effects of electromagnetic fields on osteoporosis: A systematic literature review. Electromagn Biol Med 2016; 35:384-90. [PMID: 27356174 DOI: 10.3109/15368378.2015.1107840] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Electromagnetic fields (EMFs) as a safe, effective and noninvasive treatment have been researched and used for many years in orthopedics, and the common use clinically is to promote fracture healing. The effects of EMFs on osteoporosis have not been well concerned. The balance between osteoblast and osteoclast activity as well as the balance between osteogenic differentiation and adipogenic differentiation of bone marrow mesenchymal stem cells plays an important role in the process of osteoporosis. A number of recent reports suggest that EMFs have a positive impact on the balances. In this review, we discuss the recent advances of EMFs in the treatment of osteoporosis from basic research to clinical study and introduce the possible mechanism. In addition, we presented future perspectives of application of EMFs for osteoporosis.
Collapse
Affiliation(s)
- Rong Wang
- a Department of Gastroenterology , General Hospital of the Yangtse River Shipping , Hubei , P. R. China
| | - Hua Wu
- b Department of Orthopedics , Tongji Hospital, Huazhong University of Science and Technology , Hubei , P. R. China
| | - Yong Yang
- b Department of Orthopedics , Tongji Hospital, Huazhong University of Science and Technology , Hubei , P. R. China
| | - Mingyu Song
- c Department of Obstetrics and Gynecology , Tongji Hospital, Huazhong University of Science and Technology , Hubei , P. R. China
| |
Collapse
|
17
|
Lee PB, Kim YC, Lim YJ, Lee CJ, Choi SS, Park SH, Lee JG, Lee SC. Efficacy of Pulsed Electromagnetic Therapy for Chronic Lower Back Pain: A Randomized, Double-blind, Placebo-controlled Study. J Int Med Res 2016; 34:160-7. [PMID: 16749411 DOI: 10.1177/147323000603400205] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This randomized, double-blind, placebo-controlled clinical trial studied the effectiveness of pulsed electromagnetic therapy (PEMT) in patients with chronic lower back pain. Active PEMT ( n = 17) or placebo treatment ( n = 19) was performed three times a week for 3 weeks. Patients were assessed using a numerical rating scale (NRS) and revised Oswestry disability scores for 4 weeks after therapy. PEMT produced significant pain reduction throughout the observation period compared with baseline values. The percentage change in the NRS score from baseline was significantly greater in the PEMT group than the placebo group at all three time-points measured. The mean revised Oswestry disability percentage after 4 weeks was significantly improved from the baseline value in the PEMT group, whereas there were no significant differences in the placebo group. In conclusion, PEMT reduced pain and disability and appears to be a potentially useful therapeutic tool for the conservative management of chronic lower back pain.
Collapse
Affiliation(s)
- P B Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Erkut A, Tumkaya L, Balik MS, Kalkan Y, Guvercin Y, Yilmaz A, Yuce S, Cure E, Sehitoglu I. The effect of prenatal exposure to 1800 MHz electromagnetic field on calcineurin and bone development in rats. Acta Cir Bras 2016; 31:74-83. [PMID: 26959616 DOI: 10.1590/s0102-865020160020000001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/19/2016] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To investigated the effects of exposure to an 1800 MHz electromagnetic field (EMF) on bone development during the prenatal period in rats. METHODS Pregnant rats in the experimental group were exposed to radiation for six, 12, and 24 hours daily for 20 days. No radiation was given to the pregnant rats in the control group. We distributed the newborn rats into four groups according to prenatal EMF exposure as follows: Group 1 was not exposed to EMF; groups 2, 3, and 4 were exposed to EMF for six, 12, and 24 hours a day, respectively. The rats were evaluated at the end of the 60th day following birth. RESULTS Increasing the duration of EMF exposure during the prenatal period resulted in a significant reduction of resting cartilage levels and a significant increase in the number of apoptotic chondrocytes and myocytes. There was also a reduction in calcineurin activities in both bone and muscle tissues. We observed that the development of the femur, tibia, and ulna were negatively affected, especially with a daily EMF exposure of 24 hours. CONCLUSION Bone and muscle tissue development was negatively affected due to prenatal exposure to 1800 MHz radiofrequency electromagnetic field.
Collapse
Affiliation(s)
- Adem Erkut
- School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Levent Tumkaya
- School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | | | - Yildiray Kalkan
- School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Yilmaz Guvercin
- School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Adnan Yilmaz
- School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Suleyman Yuce
- Department of Internal Medicine, Kumru State Hospital, Ordu, Turkey
| | - Erkan Cure
- School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | | |
Collapse
|
19
|
Controversies related to electromagnetic field exposure on peripheral nerves. J Chem Neuroanat 2016; 75:70-6. [PMID: 26718608 DOI: 10.1016/j.jchemneu.2015.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 11/23/2022]
Abstract
Electromagnetic field (EMF) is a pervasive environmental presence in modern society. In recent years, mobile phone usage has increased rapidly throughout the world. As mobile phones are generally held close to the head while talking, studies have mostly focused on the central and peripheral nervous system. There is a need for further research to ascertain the real effect of EMF exposure on the nervous system. Several studies have clearly demonstrated that EMF emitted by cell phones could affect the systems of the body as well as functions. However, the adverse effects of EMF emitted by mobile phones on the peripheral nerves are still controversial. Therefore, this review summarizes current knowledge on the possible positive or negative effects of electromagnetic field on peripheral nerves.
Collapse
|
20
|
Rosso F, Bonasia DE, Marmotti A, Cottino U, Rossi R. Mechanical Stimulation (Pulsed Electromagnetic Fields "PEMF" and Extracorporeal Shock Wave Therapy "ESWT") and Tendon Regeneration: A Possible Alternative. Front Aging Neurosci 2015; 7:211. [PMID: 26617513 PMCID: PMC4637423 DOI: 10.3389/fnagi.2015.00211] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/26/2015] [Indexed: 12/22/2022] Open
Abstract
The pathogenesis of tendon degeneration and tendinopathy is still partially unclear. However, an active role of metalloproteinases (MMP), growth factors, such as vascular endothelial growth factor (VEGF) and a crucial role of inflammatory elements and cytokines was demonstrated. Mechanical stimulation may play a role in regulation of inflammation. In vitro studies demonstrated that both pulsed electromagnetic fields (PEMF) and extracorporeal shock wave therapy (ESWT) increased the expression of pro-inflammatory cytokine such as interleukin (IL-6 and IL-10). Moreover, ESWT increases the expression of growth factors, such as transforming growth factor β(TGF-β), (VEGF), and insulin-like growth factor 1 (IGF1), as well as the synthesis of collagen I fibers. These pre-clinical results, in association with several clinical studies, suggest a potential effectiveness of ESWT for tendinopathy treatment. Recently PEMF gained popularity as adjuvant for fracture healing and bone regeneration. Similarly to ESWT, the mechanical stimulation obtained using PEMFs may play a role for treatment of tendinopathy and for tendon regeneration, increasing in vitro TGF-β production, as well as scleraxis and collagen I gene expression. In this manuscript the rational of mechanical stimulations and the clinical studies on the efficacy of extracorporeal shock wave (ESW) and PEMF will be discussed. However, no clear evidence of a clinical value of ESW and PEMF has been found in literature with regards to the treatment of tendinopathy in human, so further clinical trials are needed to confirm the promising hypotheses concerning the effectiveness of ESWT and PEMF mechanical stimulation.
Collapse
Affiliation(s)
- Federica Rosso
- Department of Orthopaedics and Traumatology, AO Mauriziano Umberto ITorino, Italy
| | | | | | | | | |
Collapse
|
21
|
Atalay Y, Gunes N, Guner MD, Akpolat V, Celik MS, Guner R. Pentoxifylline and electromagnetic field improved bone fracture healing in rats. Drug Des Devel Ther 2015; 9:5195-201. [PMID: 26388687 PMCID: PMC4571933 DOI: 10.2147/dddt.s89669] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study was to evaluate the effects of a phosphodiesterase inhibitor pentoxifylline (PTX), electromagnetic fields (EMFs), and a mixture of both materials on bone fracture healing in a rat model. Materials and methods Eighty male Wistar rats were randomly divided into four groups: Group A, femur fracture model with no treatment; Group B, femur fracture model treated with PTX 50 mg/kg/day intraperitoneal injection; Group C, femur fracture model treated with EMF 1.5±0.2 Mt/50 Hz/6 hours/day; and Group D, femur fracture model treated with PTX 50 mg/kg/day intraperitoneal injection and EMF 1.5±0.2 Mt/50 Hz/6 hours/day. Results Bone fracture healing was significantly better in Group B and Group C compared to Group A (P<0.05), but Group D did not show better bone fracture healing than Group A (P>0.05). Conclusion It can be concluded that both a specific EMF and PTX had a positive effect on bone fracture healing but when used in combination, may not be beneficial.
Collapse
Affiliation(s)
- Yusuf Atalay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Nedim Gunes
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | | | - Veysi Akpolat
- Department of Biophysics, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Mustafa Salih Celik
- Department of Biophysics, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Rezzan Guner
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| |
Collapse
|
22
|
Ross CL, Siriwardane M, Almeida-Porada G, Porada CD, Brink P, Christ GJ, Harrison BS. The effect of low-frequency electromagnetic field on human bone marrow stem/progenitor cell differentiation. Stem Cell Res 2015; 15:96-108. [PMID: 26042793 PMCID: PMC4516580 DOI: 10.1016/j.scr.2015.04.009] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 04/17/2015] [Accepted: 04/27/2015] [Indexed: 12/12/2022] Open
Abstract
Human bone marrow stromal cells (hBMSCs, also known as bone marrow-derived mesenchymal stem cells) are a population of progenitor cells that contain a subset of skeletal stem cells (hSSCs), able to recreate cartilage, bone, stroma that supports hematopoiesis and marrow adipocytes. As such, they have become an important resource in developing strategies for regenerative medicine and tissue engineering due to their self-renewal and differentiation capabilities. The differentiation of SSCs/BMSCs is dependent on exposure to biophysical and biochemical stimuli that favor early and rapid activation of the in vivo tissue repair process. Exposure to exogenous stimuli such as an electromagnetic field (EMF) can promote differentiation of SSCs/BMSCs via ion dynamics and small signaling molecules. The plasma membrane is often considered to be the main target for EMF signals and most results point to an effect on the rate of ion or ligand binding due to a receptor site acting as a modulator of signaling cascades. Ion fluxes are closely involved in differentiation control as stem cells move and grow in specific directions to form tissues and organs. EMF affects numerous biological functions such as gene expression, cell fate, and cell differentiation, but will only induce these effects within a certain range of low frequencies as well as low amplitudes. EMF has been reported to be effective in the enhancement of osteogenesis and chondrogenesis of hSSCs/BMSCs with no documented negative effects. Studies show specific EMF frequencies enhance hSSC/BMSC adherence, proliferation, differentiation, and viability, all of which play a key role in the use of hSSCs/BMSCs for tissue engineering. While many EMF studies report significant enhancement of the differentiation process, results differ depending on the experimental and environmental conditions. Here we review how specific EMF parameters (frequency, intensity, and time of exposure) significantly regulate hSSC/BMSC differentiation in vitro. We discuss optimal conditions and parameters for effective hSSC/BMSC differentiation using EMF treatment in an in vivo setting, and how these can be translated to clinical trials.
Collapse
Affiliation(s)
- Christina L Ross
- Wake Forest Institute for Regenerative Medicine, USA; Wake Forest Center for Integrative Medicine, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA.
| | | | | | | | - Peter Brink
- Department of Physiology and Biophysics, SUNY Stony Brook, Stony Brook, NY 11794, USA
| | | | | |
Collapse
|
23
|
Elsisi HFEM, Mousa GSM, ELdesoky MTM. Electromagnetic field versus circuit weight training on bone mineral density in elderly women. Clin Interv Aging 2015; 10:539-47. [PMID: 25834412 PMCID: PMC4358665 DOI: 10.2147/cia.s78485] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Osteoporosis is a common skeletal disorder with costly complications and a global health problem and one of the leading causes of morbidity and mortality worldwide. Magnetic field therapy and physical activity have been proven as beneficial interventions for prevention and treatment of osteoporosis. The purpose of this study was to compare the response of bone mineral content and bone mineral density (BMD) in elderly women to either low-frequency low-intensity pulsed magnetic field (LFLIPMF) or circuit weight training (CWT) on short-run basis (after 12 weeks). PATIENTS AND METHODS Thirty elderly women, aged 60-70 years, were randomly assigned into two groups (magnetic field and CWT) (n=15 each group). The session was performed three times per week for magnetic field and CWT groups, for 12 weeks. BMD and bone mineral content of lumbar spine (L2-L4) and femoral neck, trochanter, and Ward's triangle were evaluated before and after 12 weeks of treatment. RESULTS Both magnetic field and CWT for 12 weeks in elderly women seem to yield beneficial and statistically significant increasing effect on BMD and bone mineral content (P<0.05). But magnetic field seems to have more beneficially and statistically significant effect than does CWT. CONCLUSION It is possible to conclude that LFLIPMF and CWT programs are effective modalities in increasing BMD but LFLIPMF is more effective in elderly women.
Collapse
Affiliation(s)
- Hany Farid Eid Morsy Elsisi
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Cairo University, Cairo, Egypt
| | - Gihan Samir Mohamed Mousa
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Cairo University, Cairo, Egypt
| | | |
Collapse
|
24
|
Cook JJ, Summers NJ, Cook EA. Healing in the new millennium: bone stimulators: an overview of where we've been and where we may be heading. Clin Podiatr Med Surg 2015; 32:45-59. [PMID: 25440417 DOI: 10.1016/j.cpm.2014.09.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Electromagnetic fields and their uses in bone healing have been fairly well studied, with most results showing improvement in healing of both bone and cartilage. Most supportive data are found in relation to the spine, femur, and tibia, but there is increasing evidence for its use in the foot and ankle for treatment of nonunions and as an adjunctive device in arthrodeses, particularly in high-risk populations. There are varying data and a significant variety of quality in the current research and publications concerning the use of electrical bone stimulation in the treatment of the foot and ankle. Thus, there is a definite need for further investigation and high-quality study designs to determine the most effective treatment modalities and pathologies best used with bone stimulation. Bone stimulation should be viewed as an adjunctive procedure in which the surgeon optimizes the high-risk patient both medically or surgically whenever possible. But when used appropriately, bone stimulation has the potential to influence outcomes and aid in bone healing when complications arise and in high-risk populations.
Collapse
Affiliation(s)
- Jeremy J Cook
- Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Harvard Medical School, 330 Mount Auburn Street, Cambridge, MA 02138, USA
| | - N Jake Summers
- Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Harvard Medical School, 330 Mount Auburn Street, Cambridge, MA 02138, USA.
| | - Emily A Cook
- Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Harvard Medical School, 330 Mount Auburn Street, Cambridge, MA 02138, USA
| |
Collapse
|
25
|
Electromagnetic acupuncture to enhance the effects of manual acupuncture on recovery from muscle fatigue of the quadriceps. J Acupunct Meridian Stud 2014; 7:250-7. [PMID: 25441950 DOI: 10.1016/j.jams.2014.01.005] [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: 06/11/2013] [Revised: 12/27/2013] [Accepted: 01/07/2014] [Indexed: 10/24/2022] Open
Abstract
The aim of this study was to investigate a new method of manual acupuncture that used a magnetic field to stimulate only one acupoint vertically. We developed an eight-channel electromagnetic acupuncture (EMA) system that uses a solenoid-type electrode to insert the manual acupuncture needle into a hole in an electrode. We used a manual acupuncture needle for magnetic induction in order to penetrate vertically and deeply into tissues. In order to confirm the usefulness of EMA, we investigated the effects of treatment on muscle fatigue after strenuous knee extension/flexion exercises that had been performed by three groups: the nonstimulation, the manual acupuncture, and the EMA groups. Electromyograms showed that the median frequency (MF) in the EMA group had rapidly recovered after 4 minutes (p = 0.608), but that the peak torque had not recovered to the normal state (p < 0.05). Thus, we confirmed that compared with manual acupuncture, EMA resulted in better recovery from muscle fatigue.
Collapse
|
26
|
Liu Y, Wei X, Kuang Y, Zheng Y, Gu X, Zhan H, Shi Y. Ultrasound treatment for accelerating fracture healing of the distal radius. A control study. Acta Cir Bras 2014; 29:765-70. [DOI: 10.1590/s0102-86502014001800012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 09/22/2014] [Indexed: 11/22/2022] Open
|
27
|
Wang J, Tang N, Xiao Q, Zhang L, Li Y, Li J, Wang J, Zhao Z, Tan L. Pulsed electromagnetic field may accelerate in vitro endochondral ossification. Bioelectromagnetics 2014; 36:35-44. [PMID: 25358461 DOI: 10.1002/bem.21882] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 08/13/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Jue Wang
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Na Tang
- Stomatology Department of Sichuan Medical Science Academy; Sichuan Provincial People's Hospital; Chengdu China
| | - Qiang Xiao
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Li Zhang
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Yu Li
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Juan Li
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Jun Wang
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Lijun Tan
- State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| |
Collapse
|
28
|
The effects of static magnetic fields on bone. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2014; 114:146-52. [PMID: 24556024 DOI: 10.1016/j.pbiomolbio.2014.02.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/09/2014] [Indexed: 12/19/2022]
Abstract
All the living beings live and evolve under geomagnetic field (25-65 μT). Besides, opportunities for human exposed to different intensities of static magnetic fields (SMF) in the workplace have increased progressively, such SMF range from weak magnetic field (<1 mT), moderate SMF (1 mT-1 T) to high SMF (>1 T). Given this, numerous scientific studies focus on the health effects and have demonstrated that certain magnetic fields have positive influence on our skeleton systems. Therefore, SMF is considered as a potential physical therapy to improve bone healing and keep bones healthy nowadays. Here, we review the mechanisms of effects of SMF on bone tissue, ranging from physical interactions, animal studies to cellular studies.
Collapse
|
29
|
Abstract
BACKGROUND This is an update of a Cochrane review first published in 2002. Osteoarthritis is a disease that affects the synovial joints, causing degeneration and destruction of hyaline cartilage and subchondral bone. Electromagnetic field therapy is currently used by physiotherapists and may promote growth and repair of bone and cartilage. It is based on principles of physics which include Wolff's law, the piezoelectric effect and the concept of streaming potentials. OBJECTIVES To assess the benefits and harms of electromagnetic fields for the treatment of osteoarthritis as compared to placebo or sham. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 9), PreMEDLINE for trials published before 1966, MEDLINE from 1966 to October 2013, CINAHL and PEDro up to and including October 2013. Electronic searches were complemented by handsearches. SELECTION CRITERIA Randomised controlled trials of electromagnetic fields in osteoarthritis, with four or more weeks treatment duration. We included papers in any language. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion in the review and resolved differences by consensus with a third review author. We extracted data using pre-developed data extraction forms. The same review authors assessed the risk of bias of the trials independently using the Cochrane 'Risk of bias' tool. We extracted outcomes for osteoarthritis from the publications according to Outcome Measures in Rheumatology Clinical Trials (OMERACT) guidelines. We expressed results for continuous outcome measures as mean difference (MD) or standardised mean difference (SMD) with 95% confidence interval (CI). We pooled dichotomous outcome measures using risk ratio (RR) and calculated the number needed to treat (NNT). MAIN RESULTS Nine studies with a total of 636 participants with osteoarthritis were included, six of which were added in this update of the review. Selective outcome reporting was unclear in all nine included studies due to inadequate reporting of study design and conduct, and there was high risk of bias for incomplete outcome data in three studies. The overall risk of bias across the nine studies was low for the other domains.Participants who were randomised to electromagnetic field treatment rated their pain relief 15.10 points more on a scale of 0 to 100 (MD 15.10, 95% CI 9.08 to 21.13; absolute improvement 15%) after 4 to 26 weeks' treatment compared with placebo. Electromagnetic field treatment had no statistically significant effect on physical function (MD 4.55, 95% CI -2.23 to 11.32; absolute improvement 4.55%) based on the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scale from 0 to 100 after 12 to 26 weeks' treatment. We also found no statistically significant difference in quality of life on a scale from 0 to 100 (SMD 0.09, 95% CI -0.36 to 0.54; absolute improvement 0.09%) after four to six weeks' treatment, based on the SF-36. No data were available for analysis of radiographic changes. Safety was evaluated in four trials including up to 288 participants: there was no difference in the experience of any adverse event after 4 to 12 weeks of treatment compared with placebo (RR 1.17, 95% CI 0.72 to 1.92). There was no difference in participants who withdrew because of adverse events (measured in one trial) after four weeks of treatment (RR 0.90, 95% CI 0.06 to 13.92). No participants experienced any serious adverse events. AUTHORS' CONCLUSIONS Current evidence suggests that electromagnetic field treatment may provide moderate benefit for osteoarthritis sufferers in terms of pain relief. Further studies are required to confirm whether this treatment confers clinically important benefits in terms of physical function and quality of life. Our conclusions are unchanged from the previous review conducted in 2002.
Collapse
Affiliation(s)
- Shasha Li
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, No.37 Guo-xue-xiang Street, Chengdu, Sichuan Province, China, 610041
| | | | | | | | | | | |
Collapse
|
30
|
Negm A, Lorbergs A, Macintyre NJ. Efficacy of low frequency pulsed subsensory threshold electrical stimulation vs placebo on pain and physical function in people with knee osteoarthritis: systematic review with meta-analysis. Osteoarthritis Cartilage 2013; 21:1281-9. [PMID: 23973142 DOI: 10.1016/j.joca.2013.06.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 04/09/2013] [Accepted: 06/13/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if low frequency (≤100 Hz) pulsed subsensory threshold electrical stimulation produced either through pulsed electromagnetic field (PEMF) or pulsed electrical stimulation (PES) vs sham PEMF/PES intervention is effective in improving pain and physical function at treatment completion in adults with knee osteoarthritis (OA) blinded to treatment. METHOD The relevant studies were identified by searching eight electronic databases and hand search of the past systematic reviews on the same topic till April 5, 2012. We included randomized controlled trials (RCTs) of people with knee OA comparing the outcomes of interest for those receiving PEMF/PES with those receiving sham PEMF/PES. Two reviewers independently selected studies, extracted relevant data and assessed quality. Pooled analyses were conducted using inverse-variance random effects models and standardized mean difference (SMD) for the primary outcomes. RESULTS Seven small trials (459 participants/knees) were included. PEMF/PES improves physical function (SMD = 0.22, 95% confidence interval (CI) = 0.04, 0.41, P = 0.02, I(2) = 0%), and does not reduce pain (SMD = 0.08, 95% CI = -0.17, 0.32, P = 0.55, I(2) = 43%). The strength of the body of evidence was low for physical function and very low for pain. CONCLUSION Current evidence of low and very low quality suggests that low frequency (≤100 Hz) pulsed subsensory threshold electrical stimulation produced either through PEMF/PES vs sham PEMF/PES is effective in improving physical function but not pain intensity at treatment completion in adults with knee OA blinded to treatment. Methodologically rigorous and adequately powered RCTs are needed to confirm the findings of this review.
Collapse
Affiliation(s)
- A Negm
- School of Rehabilitation Sciences, McMaster University, 1400 Main St. W., Hamilton, Ontario L8S 1C7, Canada.
| | | | | |
Collapse
|
31
|
Sadoghi P, Leithner A, Dorotka R, Vavken P. Effect of pulsed electromagnetic fields on the bioactivity of human osteoarthritic chondrocytes. Orthopedics 2013; 36:e360-5. [PMID: 23464958 DOI: 10.3928/01477447-20130222-27] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Low-frequency pulsed electromagnetic fields (PEMFs) are used for the treatment of human osteoarthritic cells in vivo without knowledge of underling principles. The authors evaluated the effect of PEMFs on human chondrocytes of the osteoarthritic knee in vitro. Biopsies of the cut femoral condyles after total knee arthroplasty were kept in a standard cell culture medium consisting of Dulbecco's modified Eagle's medium: nutrient mixture F-12, 10% fetal calf serum, PenStrept (Mediatech, Inc, Manassas, Virginia), and ascorbic acid for 4 days and randomly split into an exposed group (PEMF for 4 hours daily for 4 days at 75 Hz and 1.6 mT) and a control group. Both groups were retained for biochemical and polymerase chain reaction analysis (glycosaminoglycan and DNA levels). A P value less than .05 was considered significant.DNA analysis revealed no differences between groups and no increase in content after exposure (P=.88 and .66, respectively). The increase of glycosaminoglycans was 0.4±1.6 ng (95% confidence interval [CI], 1.4 to 0.5) and -0.5±1.8 ng (95% CI, 0.6 to -1.5) in the exposed and control groups, respectively, with no significant difference (P=.24). A smaller decrease of glycosaminoglycan and DNA levels was observed over 4 days in the exposed group compared with the control group, with no statistical significance. The authors concluded that low-frequency PEMFs do not significantly influence the biosynthetic activity of explantcultures of human osteoarthritic cells in vitro. Nevertheless, they may be suitable as an adjuvant to a larger treatment regimen.
Collapse
Affiliation(s)
- Patrick Sadoghi
- Department of Orthopedic Surgery, Medical University of Graz, Graz, Austria
| | | | | | | |
Collapse
|
32
|
Kim SB, Kim JY, Park SW, Lee NR, Lee SW, Kim YH, Lee YH. Comparison of 2 methods of non-invasive treatment between transcutaneous electrical stimulation and pulsed electromagnetic field stimulation as replacement of invasive manual acupuncture. ACUPUNCTURE ELECTRO 2013; 37:247-61. [PMID: 23409610 DOI: 10.3727/036012912x13831831256294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The aim of this study was to find the non-invasive optimal alternative method for Manual Acupuncture. Existing researches had reported that Transcutaneous Electrical Acupoint Stimulation (TEAS) was an effective treatment method instead of manual acupuncture. In place of the TEAS, we suggested the Pulsed Electromagnetic Fields (PEMFs). Thus, we designed the PEMFs system which can stimulate only an acupoint. There have been no researches which reported therapeutic effect when stimulating at an identical acupoint by TEAS and PEMFs. Hence, this study investigated the therapeutic effect on the muscle fatigue after the strenuous knee extension/flexion exercise by two stimulations. We selected the stimulation method of both TEAS and PEMFs by using 2Hz biphasic rectangular wave pulse and pulse width 0.2ms. The magnetic flux was the 30.92mT (309.2gauss) at 2 Hz. The electromyogram (EMG) and the maximal voluntary contraction (MVC) at rectus femoris were measured. The Median Frequency (MF) at TEAS group was significantly effective at 6 minutes (p=0.499). The PEMFs group was recovered to the MF rapidly after 4 minutes (p=0.166). The results of the peak torque indicated that both non-stimulation group and TEAS group did not recover to the peak torque at pre-exercise during the recovery period (p<0.05). In contrast, the significant treatment effect of PEMFs group was found after 14 minutes (p=0.135). The results of this study demonstrated that PEMFs were better than TEAS as a non-invasive method to replace the manual acupuncture.
Collapse
Affiliation(s)
- Soo-Byeong Kim
- Eastern & Western Biomedical System Laboratory, Dept. of Biomedical Engineering, Yonsei University, Wonju, South Korea
| | | | | | | | | | | | | |
Collapse
|
33
|
Kang KS, Hong JM, Kang JA, Rhie JW, Jeong YH, Cho DW. Regulation of osteogenic differentiation of human adipose-derived stem cells by controlling electromagnetic field conditions. Exp Mol Med 2013; 45:e6. [PMID: 23306704 PMCID: PMC3584658 DOI: 10.1038/emm.2013.11] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Many studies have reported that an electromagnetic field can promote osteogenic differentiation of mesenchymal stem cells. However, experimental results have differed depending on the experimental and environmental conditions. Optimization of electromagnetic field conditions in a single, identified system can compensate for these differences. Here we demonstrated that specific electromagnetic field conditions (that is, frequency and magnetic flux density) significantly regulate osteogenic differentiation of adipose-derived stem cells (ASCs) in vitro. Before inducing osteogenic differentiation, we determined ASC stemness and confirmed that the electromagnetic field was uniform at the solenoid coil center. Then, we selected positive (30/45 Hz, 1 mT) and negative (7.5 Hz, 1 mT) osteogenic differentiation conditions by quantifying alkaline phosphate (ALP) mRNA expression. Osteogenic marker (for example, runt-related transcription factor 2) expression was higher in the 30/45 Hz condition and lower in the 7.5 Hz condition as compared with the nonstimulated group. Both positive and negative regulation of ALP activity and mineralized nodule formation supported these responses. Our data indicate that the effects of the electromagnetic fields on osteogenic differentiation differ depending on the electromagnetic field conditions. This study provides a framework for future work on controlling stem cell differentiation.
Collapse
Affiliation(s)
- Kyung Shin Kang
- Department of Mechanical Engineering, POSTECH, Pohang, Korea
| | | | | | | | | | | |
Collapse
|
34
|
Effect of Static Magnetic Fields on the Osseointegration of Immediately Placed Implants. IMPLANT DENT 2012; 21:491-5. [DOI: 10.1097/id.0b013e31826dcc2f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
35
|
Lee YB, Eun YS, Lee JH, Cheon MS, Cho BK, Park HJ. Effects of multi-polar radiofrequency and pulsed electromagnetic field treatment in Koreans: case series and survey study. J DERMATOL TREAT 2012; 25:310-3. [PMID: 22812649 DOI: 10.3109/09546634.2012.714454] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Recently, a novel combined multi-polar radiofrequency and pulsed electromagnetic field device was developed for non-ablative skin tightening. However, little is known about the clinical effects of this device. OBJECTIVES The present study evaluated the clinical efficacy and safety of the multi-polar radiofrequency and pulsed electromagnetic field device. MATERIALS AND METHODS Ten Korean patients underwent eight treatment sessions over 6 weeks. Clinical photographs of the skin were taken before and after the treatment at each week of treatment. Satisfaction score (0; dissatisfied, 5; neutral, 10; very satisfied) and pain score (0; no pain, 10; too painful) was determined using weekly questionnaires. A dermatologist evaluated the improvement of facial skin aging, including laxity, nasolabial fold, facial contour, skin texture, and skin color tone. RESULTS The mean satisfaction score was high (>8) and the mean pain score was low (1.5). Improved skin laxity, nasolabial fold, and facial contour were observed in four, one, and three patients, respectively. Skin texture and skin color tone improved in 90% and 70% of the patients, respectively. CONCLUSION The novel combined multi-polar radiofrequency and pulsed electromagnetic field device is safe and effective for rejuvenating aged skin in Korean subjects.
Collapse
Affiliation(s)
- Young Bok Lee
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul , Korea
| | | | | | | | | | | |
Collapse
|
36
|
Barnaba S, Papalia R, Ruzzini L, Sgambato A, Maffulli N, Denaro V. Effect of Pulsed Electromagnetic Fields on Human Osteoblast Cultures. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2012; 18:109-14. [DOI: 10.1002/pri.1536] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 04/29/2012] [Accepted: 08/23/2012] [Indexed: 11/05/2022]
Affiliation(s)
- Simona Barnaba
- Department of Orthopaedic and Trauma Surgery; Campus Biomedico University of Rome; Via Alvaro del Portillo 200 Rome Italy
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery; Campus Biomedico University of Rome; Via Alvaro del Portillo 200 Rome Italy
| | - Laura Ruzzini
- Department of Orthopaedic and Trauma Surgery; Campus Biomedico University of Rome; Via Alvaro del Portillo 200 Rome Italy
| | - Alessandro Sgambato
- Giovanni XXIII Cancer Research Center-Institute of General Pathology; Catholic University, School of Medicine; Largo Agostino Gemelli, 8 Rome Italy
| | - Nicola Maffulli
- The Centre for Sports and Exercise Medicine Barts and The London School of Medicine and Dentistry; Mile End Hospital; London UK
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery; Campus Biomedico University of Rome; Via Alvaro del Portillo 200 Rome Italy
| |
Collapse
|
37
|
Corallo C, Rigato M, Battisti E, Albanese A, Gonnelli S, Giordano N. Therapeutic Application of Musically Modulated Electromagnetic Fields in the Treatment of Musculoskeletal Disorders. EUR J INFLAMM 2012. [DOI: 10.1177/1721727x1201000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Different studies have demonstrated the efficacy of extremely low frequency electromagnetic fields (ELF EMFs) in the treatment of pain. In particular, the positive effects of ELF EMFs seems to depend on their respective codes, such as frequency, intensity and waveform, even if the exact mechanism of interaction is still debated. The most commonly used for extremely low frequency magnetotherapy is a 100Hz sinusoidal field (ELF) with a mean of induction of few Gauss. This article reviews the therapeutic application of a musically modulated electromagnetic field (TAMMEF), a new-generation of electromagnetic field used for extremely low frequency magnetotherapy characterized by variable frequencies, intensities and waveforms. Both clinical and experimental studies, performed by authors of the present review, have demonstrated the efficacy of ELF and the new TAMMEF systems in several musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, carpal tunnel syndrome, shoulder periarthritis and cervical spondylosis. Moreover, it has been demonstrated that ELF and TAMMEF systems are not only effective, but also safe, from clinical and experimental point of view. In fact, clinical trials did not reported any undesired side effect, while in vitro studies showed that ELF EMFs did not induce uncontrolled cell proliferation, did not affect cell viability and did not induce apoptosis. With their efficacy and safety, ELF and even more the new TAMMEF systems represent a valid complementary or alternative treatment to standard pharmacological therapies in reducing both pain and inflammation of patients affected by musculoskeletal disorders.
Collapse
Affiliation(s)
- C. Corallo
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Siena, Italy
- TAMMEF Centre, Department of Medical Physics, University of Siena, Siena, Italy
| | - M. Rigato
- TAMMEF Centre, Department of Medical Physics, University of Siena, Siena, Italy
| | - E. Battisti
- TAMMEF Centre, Department of Medical Physics, University of Siena, Siena, Italy
| | - A. Albanese
- TAMMEF Centre, Department of Medical Physics, University of Siena, Siena, Italy
| | - S. Gonnelli
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Siena, Italy
| | - N. Giordano
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Siena, Italy
- TAMMEF Centre, Department of Medical Physics, University of Siena, Siena, Italy
| |
Collapse
|
38
|
Short-term low intensity PMF does not improve functional or histological outcomes in a rat model of transient focal cerebral ischemia. Brain Res 2012; 1458:76-85. [DOI: 10.1016/j.brainres.2012.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 03/10/2012] [Accepted: 04/05/2012] [Indexed: 11/18/2022]
|
39
|
Effects of low-intensity pulsed ultrasound therapy on fracture healing: a systematic review and meta-analysis. Am J Phys Med Rehabil 2012; 91:349-67. [PMID: 21904188 DOI: 10.1097/phm.0b013e31822419ba] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis was performed to identify the clinical trials relevant to the effects of low-intensity pulsed ultrasound (LIPUS) on bone regeneration. DESIGN We searched five international electronic databases including MEDLINE (1966-June 2010), and PubMed, EMBase, Cumulative Index to Nursing and Allied Health, and Cochrane (1980-June 2010) to identify the relevant studies on the effects of LIPUS on bone healing. The inclusion criteria were human clinical trial, all types of bones, fractures, and outcome measurements, LIPUS application, and English language. Overall, 260 potentially eligible abstracts were identified, and 65 articles were retrieved in full text. Of the 65 studies, 23 met the inclusion criteria and were critically appraised by two raters independently using the PEDro quality measurement method. The results of all eligible studies were categorized in three groups: fresh fractures, delayed or nonunions, and distraction osteogenesis. Seven trials among fresh fracture trials were identified eligible for meta-analysis because of the varieties of outcome measurements and clinical situations. The time of the third cortical bridging (increase in density or size of initial periosteal reaction) in radiographic healing was our common criteria for the meta-analysis. RESULTS The time of third cortical bridging was statistically earlier following LIPUS therapy in fresh fractures (mean random effect, 2.263; 95% CI, 0.183-4.343, P = 0.033). CONCLUSIONS LIPUS can stimulate radiographic bone healing in fresh fractures. Although there is weak evidence that LIPUS also supports radiographic healing in delayed unions and nonunions, it was not possible to pool the data because of a paucity of sufficient studies with similar outcome measures.
Collapse
|
40
|
Zhang JX, Woo J, Lau WCS, Lee P, Chiu P, Lam D. Effects of Use of Alternative Therapies on Quality of Life and Healthcare Spending. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2012; 35:183-93. [PMID: 17436359 DOI: 10.1142/s0192415x07004722] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Osteoarthritis (OA) is a costly disease that causes much morbidity and mortality in the world, and it was the sixth leading cause of disability in developed countries. We aim to study the utilization pattern of alternative therapies and their effects on quality of life and personal health spending in Chinese OA patients in Hong Kong. Five-hundred forty-seven patients with OA from four regional hospitals in Hong Kong were recruited, and we measured various types of alternative therapies, SF-36 scales, an overall Health Utility Index derived from a pre-scored multi-attribute classification system based upon SF-36 health surveys, health spending per person and out-of-pocket payments and side-effects. The study shows that out of the 547 OA patients, the patients have used a wide spectrum of alternative therapies and often used a multiplicity of them. Payment for alternative therapies constitutes 5% of the overall personal healthcare spending, and 29% of the out-of-pocket payments. The use of alternative therapies was significantly associated with higher personal healthcare spending ( p = 0.01), after adjusting for socioeconomic variables, years of OA and severity of OA. The use of alternative therapies was not significantly associated with an improvement in the quality of life in the regression analysis ( p = 0.64). The use of alternative therapies was statistically significant associated with the side effects, including gastric discomfort and gastric ulcer/bleeding ( p = 0.04, 0.02, respectively). Alternative therapies were used extensively by OA patients in Hong Kong. Clinicians, health policy makers, and insurance carriers should be aware of the potential health and economic effects in practice and policy formulation.
Collapse
Affiliation(s)
- James X Zhang
- Department of Medicine, Section of General Internal Medicine, The University of Chicago,Chcago, IL 60637, USA.
| | | | | | | | | | | |
Collapse
|
41
|
Kazerooni AF, Rabbani M, Yazdchi M, Kasiri S, Rad HS. Effects of electric and magnetic loadings on bone surface remodeling: a model modification and simulation. BIOMED ENG-BIOMED TE 2011; 56:167-73. [PMID: 21657990 DOI: 10.1515/bmt.2011.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper presents a new modification to the previous model of bone surface remodeling under electric and magnetic loadings. For this study, the thermo-electro-magneto-elastic model of bone surface remodeling is used. This model is modified by considering an important phenomenon occurring in living bone through its adaptation to external loadings called desensitization. In fact, bone cells lose their responsiveness and sensitivity to long-term external loadings, i.e., they become desensitized. Therefore, bone cells need a recovery period, during which they become resensitized. In this work, this phenomenon is considered in the original model. The effects of various electric and magnetic loading conditions, including various frequencies, waveforms and pulse duty cycles, are explored on the modified model and compared to the original model. The modified model is also searched for the optimal frequency and duty cycle, to obtain the best bone growth response under electromagnetic fields. The results of this paper show that the modified model is consistent with experimental observations. In addition, it is indicated that this modified model in contrast to the original model, is sensitive to frequency. It is shown that the optimal frequency of loading for the modified model is 1 Hertz (Hz), and the pulse duty cycles up to 50% are sufficient for bone remodeling to reach its maximum value.
Collapse
Affiliation(s)
- Anahita Fathi Kazerooni
- Department of Biomedical Systems and Biophysics, Tehran University of Medical Sciences, Iran
| | | | | | | | | |
Collapse
|
42
|
Jing D, Shen G, Cai J, Li F, Huang J, Wang Y, Xu Q, Tang C, Luo E. Effects of 180 mT static magnetic fields on diabetic wound healing in rats. Bioelectromagnetics 2011; 31:640-8. [PMID: 20607739 DOI: 10.1002/bem.20592] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Diabetic wound (DW) problems are becoming a formidable clinical challenge due to the sharp increase in the diabetic population and the high incidence of DW. Static magnetic field (SMF) therapy, an inexpensive and accessible noninvasive method, has been proven to be effective on various tissue repairs. However, the issue of the therapeutic effect of SMF on DW healing has never been investigated. The objective of this study was to systematically evaluate the effect of a 180 mT moderate-intensity gradient SMF on DW healing in streptozotocin-induced diabetic rats. Forty-eight 3-month-old male Sprague-Dawley rats (32 diabetic and 16 non-diabetic rats) were assigned to three equal groups: normal wound, DW, and DW + SMF groups. An open circular wound with 1.5 cm diameter was created in the dorsum. The wound was covered with a dressing and the magnet was fixed on top of the dressing. On days 5, 12, and 19, four rats of each group were euthanized and gross wound area, histology and tensile strength were evaluated. The wound area determination suggested that SMF significantly increased the healing rate and reduced the gross healing time. This result was further confirmed by histological observations. The wound tensile strength, reflecting the amount and quality of collagen deposition, increased to a larger extent in the DW + SMF group on days 12 and 19 compared with the DW group. The results indicated that 180 mT SMF presented a beneficial effect on DW healing, and implied the clinical potential of SMF therapy in accelerating DW repair and releasing the psychological and physical burdens of diabetic patients.
Collapse
Affiliation(s)
- Da Jing
- Faculty of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Özgüçlü E, Çetin A, Çetin M, Calp E. Additional effect of pulsed electromagnetic field therapy on knee osteoarthritis treatment: a randomized, placebo-controlled study. Clin Rheumatol 2010; 29:927-31. [DOI: 10.1007/s10067-010-1453-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Revised: 03/07/2010] [Accepted: 03/24/2010] [Indexed: 11/24/2022]
|
44
|
Low-frequency pulsed electromagnetic field therapy in fibromyalgia: a randomized, double-blind, sham-controlled clinical study. Clin J Pain 2010; 25:722-8. [PMID: 19920724 DOI: 10.1097/ajp.0b013e3181a68a6c] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the clinical effectiveness of low-frequency pulsed electromagnetic field (PEMF) therapy for women with fibromyalgia (FM). METHODS Fifty-six women with FM, aged 18 to 60 years, were randomly assigned to either PEMF or sham therapy. Both the PEMF group (n=28) and the sham group (n=28) participated in therapy, 30 minutes per session, twice a day for 3 weeks. Treatment outcomes were assessed by the fibromyalgia Impact questionnaire (FIQ), visual analog scale (VAS), patient global assessment of response to therapy, Beck Depression Inventory (BDI), and Short-Form 36 health survey (SF-36), after treatment (at 4 wk) and follow-up (at 12 wk). RESULTS The PEMF group showed significant improvements in FIQ, VAS pain, BDI score, and SF-36 scale in all domains at the end of therapy. These improvements in FIQ, VAS pain, and SF-36 pain score during follow-up. The sham group also showed improvement were maintained on all outcome measures except total FIQ scores after treatment. At 12 weeks follow-up, only improvements in the BDI and SF-36 scores were present in the sham group. CONCLUSION Low-frequency PEMF therapy might improve function, pain, fatigue, and global status in FM patients.
Collapse
|
45
|
Ay S, Evcik D. The effects of pulsed electromagnetic fields in the treatment of knee osteoarthritis: a randomized, placebo-controlled trial. Rheumatol Int 2008; 29:663-6. [PMID: 19015858 DOI: 10.1007/s00296-008-0754-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Accepted: 10/19/2008] [Indexed: 10/21/2022]
Abstract
In this study, we planned to investigate the effects of pulse electromagnetic field (PEMF) on pain relief and functional capacity of patients with knee osteoarthritis (OA). Fifty-five patients with knee OA were included in a randomized, placebo-controlled study. At the end of the therapy, there was statistically significant improvement in pain scores in both groups (P < 0.05). However, no significant difference was observed within the groups (P > 0.05). We observed statistically significant improvement in some of the subgroups of Lequesne index. These are morning stiffness and activities of daily living activities compared to placebo group. However, we could not observe statistically significant differences in total of the scale between two groups (P > 0.05). Applying between-group analysis, we were unable to demonstrate a beneficial symptomatic effect of PEMF in the treatment of knee OA in all patients. Further studies using different types of magnetic devices, treatment protocols and patient populations are warranted to confirm the general efficacy of PEMF therapy in OA and other conditions.
Collapse
Affiliation(s)
- Saime Ay
- Department of Physical Medicine and Rehabilitation, Ufuk University School of Medicine Doctor Ridvan Ege Hospital, Balgat, 06520, Ankara,
| | | |
Collapse
|
46
|
Richmond SJ. Magnet therapy for the relief of pain and inflammation in rheumatoid arthritis (CAMBRA): a randomised placebo-controlled crossover trial. Trials 2008; 9:53. [PMID: 18789135 PMCID: PMC2556642 DOI: 10.1186/1745-6215-9-53] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Accepted: 09/12/2008] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis is a common inflammatory autoimmune disease. Although disease activity may be managed effectively with prescription drugs, unproven treatments such as magnet therapy are sometimes used as an adjunct for pain control. Therapeutic devices incorporating permanent magnets are widely available and easy to use. Magnets may also be perceived as a more natural and less harmful alternative to analgesic compounds. Of interest to health service researchers is the possibility that magnet therapy might help to reduce the economic burden of managing chronic musculoskeletal disorders. Magnets are extremely cheap to manufacture and prolonged treatment involves a single cost. Despite this, good quality scientific evidence concerning the safety, effectiveness and cost-effectiveness of magnet therapy is scarce. The primary aim of the CAMBRA trial is to investigate the effectiveness of magnet therapy for relieving pain and inflammation in rheumatoid arthritis. METHODS/DESIGN The CAMBRA trial employs a randomised double-blind placebo-controlled crossover design. Participant will each wear four devices: a commercially available magnetic wrist strap; an attenuated wrist strap; a demagnetised wrist strap; and a copper bracelet. Device will be allocated in a randomised sequence and each worn for five weeks. The four treatment phases will be separated by wash out periods lasting one week. Both participants and researchers will be blind, as far as feasible, to the allocation of experimental and control devices. In total 69 participants will be recruited from general practices within the UK. Eligible patients will have a verified diagnosis of rheumatoid arthritis that is being managed using drugs, and will be experiencing chronic pain. Outcomes measured will include pain, inflammation, disease activity, physical function, medication use, affect, and health related costs. Data will be collected using questionnaires, diaries, manual pill counts and blood tests. DISCUSSION Magnetism is an inherent property of experimental devices which is hard to conceal. The use of multiple control devices, including a copper bracelet, represents a concerted attempt to overcome methodological limitations associated with trials in this field. The trial began in July 2007. At the time of submission (August 2008) recruitment has finished, with 70 trial participants, and data collection is almost complete. TRIAL REGISTRATION Current Controlled Trials ISRCTN51459023.
Collapse
|
47
|
Abstract
Unfortunately, many physicians and patients only seek pharmacologic treatments to aid in pain relief; however, many nonpharmacologic interventions exist with excellent potential for pain treatment. This article reviews several of these strategies with an emphasis on clinical indications and expected outcomes. The topics of chronic pain psychology and prescription writing also are reviewed. As a medical provider, it is important to remain open minded to alternative approaches to pain control.
Collapse
|
48
|
Novicoff WM, Manaswi A, Hogan MV, Brubaker SM, Mihalko WM, Saleh KJ. Critical analysis of the evidence for current technologies in bone-healing and repair. J Bone Joint Surg Am 2008; 90 Suppl 1:85-91. [PMID: 18292362 DOI: 10.2106/jbjs.g.01521] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Substances that enhance fracture-healing and bone regeneration have valuable clinical application and merit future research. Advances in these technologies will enhance our ability to heal fractures in a more effective and expedient manner. This review provides a brief description of the different techniques and technologies and their respective clinical utility. This paper also reviews the available literature on gene therapy, tissue engineering, growth factors, osteoconductive agents, and physical forces and assesses the evidence regarding the current status of these techniques of healing and regenerating bone. Only twenty-seven articles met our guidelines for studies containing Level-I evidence. We were able to determine that atrophic nonunions and pseudarthrosis led to poorer outcomes, and the results were uniformly poor irrespective of the technique used. Although the literature contains a large number of studies on the effects of different agents and modalities on bone repair and healing, it still is not clear how these agents work or in what circumstances they should be used. Many of the treatment modalities of interest are still at an experimental stage, so good evidence to support clinical practice is lacking. Additional multicenter, prospective randomized studies are needed to define the indications, specifications, dosage, limitations, and contraindications in the treatment of nonunions. Studies are also needed to address the full clinical feasibility of the role of each modality in fracture-healing and repair.
Collapse
|
49
|
Fibromyalgia: an update for oral health care providers. ACTA ACUST UNITED AC 2007; 104:589-602. [DOI: 10.1016/j.tripleo.2007.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Revised: 05/05/2007] [Accepted: 05/11/2007] [Indexed: 11/22/2022]
|
50
|
Pittler MH, Brown EM, Ernst E. Static magnets for reducing pain: systematic review and meta-analysis of randomized trials. CMAJ 2007; 177:736-42. [PMID: 17893349 PMCID: PMC1976658 DOI: 10.1503/cmaj.061344] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Static magnets are marketed with claims of effectiveness for reducing pain, although evidence of scientific principles or biological mechanisms to support such claims is limited. We performed a systematic review and meta-analysis to assess the clinical evidence from randomized trials of static magnets for treating pain. METHODS Systematic literature searches were conducted from inception to March 2007 for the following data sources: MEDLINE, EMBASE, AMED (Allied and Complementary Medicine Database), CINAHL, Scopus, the Cochrane Library and the UK National Research Register. All randomized clinical trials of static magnets for treating pain from any cause were considered. Trials were included only if they involved a placebo control or a weak magnet as the control, with pain as an outcome measure. The mean change in pain, as measured on a 100-mm visual analogue scale, was defined as the primary outcome and was used to assess the difference between static magnets and placebo. RESULTS Twenty-nine potentially relevant trials were identified. Nine randomized placebo-controlled trials assessing pain with a visual analogue scale were included in the main meta-analysis; analysis of these trials suggested no significant difference in pain reduction (weighted mean difference [on a 100-mm visual analogue scale] 2.1 mm, 95% confidence interval -1.8 to 5.9 mm, p = 0.29). This result was corroborated by sensitivity analyses excluding trials of acute effects and conditions other than musculoskeletal conditions. Analysis of trials that assessed pain with different scales suggested significant heterogeneity among the trials, which means that pooling these data is unreliable. INTERPRETATION The evidence does not support the use of static magnets for pain relief, and therefore magnets cannot be recommended as an effective treatment. For osteoarthritis, the evidence is insufficient to exclude a clinically important benefit, which creates an opportunity for further investigation.
Collapse
Affiliation(s)
- Max H Pittler
- Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK.
| | | | | |
Collapse
|