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Albornoz-Cabello M, Ibáñez-Vera AJ, Barrios-Quinta CJ, Espejo-Antúnez L, Lara-Palomo IC, de los Ángeles Cardero-Durán M. Non-Invasive Radiofrequency Diathermy Neuromodulation Added to Supervised Therapeutic Exercise in Patellofemoral Pain Syndrome: A Single Blind Randomized Controlled Trial with Six Months of Follow-Up. Biomedicines 2024; 12:850. [PMID: 38672204 PMCID: PMC11048228 DOI: 10.3390/biomedicines12040850] [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: 03/02/2024] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The evidence-based treatment of patellofemoral pain (PFP) suggests that therapeutic exercise (TE) focused on improving muscle strength and motor control be the main conservative treatment. Recent research determined that the success of the TE approach gets improved in the short term by the addition of neuromodulation via radiofrequency diathermy (RFD). As there is no follow up data, the objective of this research is to assess the long-term effects of adding RFD to TE for the pain, function and quality of life of PFP patients. To this aim, a single-blind randomized controlled trial was conducted on 86 participants diagnosed of PFP. Participants who met the selection criteria were randomized and allocated into either a TE group or an RFD + TE group. TE consisted of a 20 min daily supervised exercise protocol for knee and hip muscle strengthening, while RFD consisted of the application of neuromodulation using a radiofrequency on the knee across 10 sessions. Sociodemographic data, knee pain and lower limb function outcomes were collected. The RFD + TE group obtained greater improvements in knee pain (p < 0.001) than the TE group. Knee function showed statistically significant improvements in Kujala (p < 0.05) and LEFS (p < 0.001) in the RFD + TE group in the short and long term. In conclusion, the addition of RFD to TE increases the beneficial effects of TE alone on PFP, effects that remain six months after treatment.
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Affiliation(s)
| | | | | | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapy, Universidad de Extremadura, 06006 Badajoz, Spain; (L.E.-A.)
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González-Gutiérrez MD, López-Garrido Á, Cortés-Pérez I, Obrero-Gaitán E, León-Morillas F, Ibáñez-Vera AJ. Effects of Non-Invasive Radiofrequency Diathermy in Pelvic Floor Disorders: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58030437. [PMID: 35334613 PMCID: PMC8951766 DOI: 10.3390/medicina58030437] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: In recent years, the use of radiofrequency diathermy in pelvic floor disorders has grown proportionally to the interest in this specialty. Despite the common use of this therapy among pelvic floor physiotherapists, little is known about its effects and effectiveness in pelvic floor disorders. For this reason, the aim of the present review is to assess the effects of non-invasive 300 kHz–1 MHz radiofrequency diathermy in the treatment of pelvic floor disorders. Materials and Methods: A literature search was performed in PubMed, Scopus and Web of Science, searching for any type of study that included pelvic floor disorder participants and an experimental group treated with non-invasive nor ablative radiofrequency diathermy. Results: There were a total of 578 studies after removing duplicates. The inclusion and exclusion criteria were applied, resulting in a total of 15 studies, which were methodologically assessed with PEDro and the Newcastle and Ottawa scale. Conclusions: Despite the low quality of most of them, the studies showed improvements in urinary incontinence, pelvic pain conditions, pelvic floor muscles strength and sexual function. These findings must be considered with caution until more randomized clinical trials are performed to solve the biases detected.
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Affiliation(s)
| | | | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaén, Spain; (I.C.-P.); (A.J.I.-V.)
- Poniente de Almería Northeast Health District, Andalusian Health Service, 04740 Roquetas de Mar, Spain
| | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaén, Spain; (I.C.-P.); (A.J.I.-V.)
- Correspondence: ; Tel.: +34-953-212-918
| | - Felipe León-Morillas
- Department of Physiotherapy, Catholic University of Murcia UCAM, Avenida de los Jerónimos, 30107 Murcia, Spain;
| | - Alfonso Javier Ibáñez-Vera
- Department of Health Sciences, University of Jaen, Campus las Lagunillas, 23071 Jaén, Spain; (I.C.-P.); (A.J.I.-V.)
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Albornoz-Cabello M, Barrios-Quinta CJ, Escobio-Prieto I, Sobrino-Sánchez R, Ibáñez-Vera AJ, Espejo-Antúnez L. Treatment of Patellofemoral Pain Syndrome with Dielectric Radiofrequency Diathermy: A Preliminary Single-Group Study with Six-Month Follow-Up. ACTA ACUST UNITED AC 2021; 57:medicina57050429. [PMID: 33925211 PMCID: PMC8145052 DOI: 10.3390/medicina57050429] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Notwithstanding patellofemoral pain syndrome (PFPS) being one of the most common causes of pain in the front of the knee in outpatients, few studies have shown the effects of radiofrequency on knee pain and function in this population. The aim of the present study was to determine whether outpatients diagnosed with PFPS obtained improvement in pain and function after treatment by dynamic application of monopolar dielectric diathermy by emission of radiofrequency (MDR). Materials and Methods: An experimental study was conducted with 27 subjects with PFPS. Subjects were treated with 10 sessions of MDR in dynamic application. The visual analogue scale (VAS), the Kujala scale, the DN4 questionnaire, the lower extremity function scale (LEFS), the range of movement (ROM) in knee flexion and extension and the daily drug intake were measured pre- and post-intervention and at the time of the follow-up (six months). Results: Statistically significant differences were found in pain perception (VAS: F1,26 = 92.43, p < 0.000, ŋ2 = 0.78 and DN4: F1.26 = 124.15, p < 0.000, ŋ2 = 0.82), as well as improvements in functionality (LEFS: F1.26 = 72.42, p < 0.000, ŋ2 = 0.74 and Kujala: F1.26 = 40.37, p < 0.000, ŋ2 = 0.61]) and in ROM (Flexion: F1.26 = 63.15, p < 0.000, ŋ2 = 0.71). No statistically significant changes in drug intake were found. Conclusions: The present study shows that the dynamic application of MDR seems effective in reducing pain and increasing functionality and knee flexion in patients with PFPS, after a follow-up of six months.
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Affiliation(s)
- Manuel Albornoz-Cabello
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain;
| | | | - Isabel Escobio-Prieto
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41009 Sevilla, Spain;
- Correspondence:
| | | | | | - Luis Espejo-Antúnez
- Department of Medical-Surgical Therapy, Medicine Faculty, University of Extremadura, 06071 Badajoz, Spain;
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Efficacy of Non-Invasive Radiofrequency-Based Diathermy in the Postoperative Phase of Knee Arthroplasty: A Double-Blind Randomized Clinical Trial. J Clin Med 2021; 10:jcm10081611. [PMID: 33920165 PMCID: PMC8070555 DOI: 10.3390/jcm10081611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/31/2022] Open
Abstract
Total knee replacement (TKR) surgery ameliorates knee function and the quality of life of patients, although 20% still experience dissatisfaction due to pain limiting their function. Radiofrequency Diathermy (MDR) has shown improvements in knee osteoarthritis and patellofemoral pain syndrome. As such, this study aims to assess the effects of MDR in the postoperative treatment of TKR patients. Forty-two participants were allocated to an experimental, placebo, or control group. For two weeks, subjects performed daily knee exercises and MDR, knee exercises and placebo MDR, or only knee exercises. Data from the Visual Analogue Scale (VAS), Timed Up-and-Go (TUG) test, Five Times Sit-to-Stand Test (FSST), Western Ontario and McMaster Universities Arthritis Index (WOMAC), physical component summary (PCS), and the mental component summary (MCS) of the SF-12 questionnaire were collected. Group-by-time interaction was significant, with favorable results in the MDR group for VAS (p = 0.009) and WOMAC (p = 0.021). No significant differences were found for TUG, FSST, PCS, or MCS (p > 0.05). In conclusion, the addition of MDR to therapeutic knee exercises obtained better results for knee pain than exercise alone in patients who had recently undergone TKR surgery.
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Albornoz-Cabello M, Ibáñez-Vera AJ, Aguilar-Ferrándiz ME, Espejo-Antúnez L. Monopolar dielectric diathermy by emission of radiofrequency in Patellofemoral pain. A single-blind-randomized clinical trial. Electromagn Biol Med 2020; 39:282-289. [PMID: 32683992 DOI: 10.1080/15368378.2020.1793169] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Despite the high incidence of patellofemoral pain syndrome (PFPS), few studies show the effects of radiofrequency on pain and functionality in these patients. For this reason, the aim of this study was to determine the efficacy of monopolar dielectric diathermy by emission of radiofrequency (MDR) in dynamic applications aimed at treating pain and improving function in patients with PFPS. For this purpose, a single-blind randomized clinical trial was conducted. Eighty-four participants with PFPS were evenly divided into an experimental group (EG) and a control group (CG). All subjects receive 10 min of daily home exercises along 3 weeks, and in addition, the subjects of the EG received 10 sessions based on the dynamic application of MDR. Variables measured included Visual Analogue Scale (VAS), DN4 questionnaire, Lower Extremity Functionality Scale (LEFS), Kujala scale, Range of Movement (ROM) in knee flexion and extension and drug intake. The EG showed a statistically significant reduction in pain (VAS = 4.8 [5.5-4.1] [p < .001]; DN4 = 3.8 [4.4-3.2] [p < .001]), and an increase in functionality (LEFS = 16 [19-13] [p < .001]; Kujala = 19 [23-14] [p < .001]) and in ROM (flexion 18º [21º-16º] [p < .001]). No statistically significant changes in drug intake were found. Based on this data, the dynamic application of MDR seems effective in reducing pain and increasing functionality and flexion in patients with PFPS. Diathermy by emission of radiofrequency could be recommended as complement or main therapy in the treatment of PFPS.
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Affiliation(s)
| | - A J Ibáñez-Vera
- Health Sciences Department, University of Jaen , Jaen, Spain
| | | | - L Espejo-Antúnez
- Department of Medical-Surgical Therapy, University of Extremadura , Badajoz, Spain
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Effects of Monopolar Dielectric Radiofrequency Signals on the Symptoms of Fibromyalgia: A Single-Blind Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072465. [PMID: 32260313 PMCID: PMC7177294 DOI: 10.3390/ijerph17072465] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 12/22/2022]
Abstract
Monopolar dielectric radiofrequency (MDR) is a non-invasive treatment for pain based on the local application of electromagnetic signals. The study’s goal was to analyze the effects of MDR on the symptoms of fibromyalgia. For this aim, a randomized controlled trial was conducted on 66 female participants (aged 47 ± 17.7) diagnosed with fibromyalgia. Participants were randomly allocated to either an experimental group (n = 23), which received eight 20-minute sessions of MDR; a sham group, which received the same number of sessions of a sham MDR therapy (n = 22); or a control group (n = 21), which received usual care. The outcome variables included pain measured by the visual analogue scale (VAS), score on the hospital anxiety and depression scale (HADS) and quality of life measured by the combined index of fibromyalgia severity (ICAF). A large effect size was observed for the local pain (R2 = 0.46), total ICAF (R2 = 0.42) and ICAF physical factor scores (R2 = 0.38). Significant mean differences were found for the local pain (p = 0.025) and ICAF physical factor (p = 0.031) scores of the experimental group in comparison with the sham group. No statistically significant differences between groups were found in HADS. In conclusion, MDR is more effective than either sham treatment or usual care in the short-term improvement of pain and the physical wellbeing of participants with fibromyalgia.
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Hochsprung A, Escudero-Uribe S, Ibáñez-Vera AJ, Izquierdo-Ayuso G. Effectiveness of monopolar dielectric transmission of pulsed electromagnetic fields for multiple sclerosis-related pain: a pilot study. NEUROLOGÍA (ENGLISH EDITION) 2020; 36:433-439. [PMID: 34238526 DOI: 10.1016/j.nrleng.2018.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 03/01/2018] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Pain is highly prevalent in patients with multiple sclerosis (MS); it is chronic in 50% of cases and is classified as nociceptive, neuropathic, or mixed-type. Pain affects quality of life, sleep, and the activities of daily living. Electrotherapy is an interesting alternative or complementary treatment in the management of pain in MS, with new innovations constantly appearing. MATERIAL AND METHODS This study evaluates the effectiveness of treatment with monopolar dielectric transmission of pulsed electromagnetic fields (PEMF) for pain associated with MS. We performed a randomised, placebo-controlled clinical trial including 24 patients, who were assessed with the Brief Pain Inventory, the Multiple Sclerosis International Quality of Life questionnaire, the Beck Depression Inventory, and the Modified Fatigue Impact Scale. RESULTS Statistically significant improvements were observed in maximum and mean pain scores, as well as in the impact of pain on work, personal relationships, and sleep and rest. Not significant differences were found between the treatment and placebo groups. CONCLUSIONS Treatment with PEMF may be effective in reducing pain in patients with MS, although further research is necessary to confirm its effectiveness over placebo and to differentiate which type of pain may be more susceptible to this treatment.
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Affiliation(s)
- A Hochsprung
- Fisioterapeuta. Sala de Neurofisioterapia. Unidad de EM del Hospital Virgen de la Macarena. Sevilla, Spain
| | - S Escudero-Uribe
- Fisioterapeuta. Sala de Neurofisioterapia. Unidad de EM del Hospital Virgen de la Macarena. Sevilla, Spain
| | - A J Ibáñez-Vera
- Fisioterapeuta. Universidad de Jaén. Departamento de Ciencias de la Salud, Área de Fisioterapia. Jaén, Spain.
| | - G Izquierdo-Ayuso
- Neurólogo. Unidad de EM del Hospital Virgen de la Macarena. Edificio Policlínico, Planta 1ª, Puerta nº106, 3 Avenida de Doctor Fedriani, 41009, Sevilla, Spain
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Hochsprung A, Escudero-Uribe S, Ibáñez-Vera AJ, Izquierdo-Ayuso G. Effectiveness of monopolar dielectric transmission of pulsed electromagnetic fields for multiple sclerosis-related pain: A pilot study. Neurologia 2018. [PMID: 29752033 DOI: 10.1016/j.nrl.2018.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Pain is highly prevalent in patients with multiple sclerosis (MS); it is chronic in 50% of cases and is classified as nociceptive, neuropathic, or mixed-type. Pain affects quality of life, sleep, and the activities of daily living. Electrotherapy is an interesting alternative or complementary treatment in the management of pain in MS, with new innovations constantly appearing. MATERIAL AND METHODS This study evaluates the effectiveness of treatment with monopolar dielectric transmission of pulsed electromagnetic fields (PEMF) for pain associated with MS. We performed a randomised, placebo-controlled clinical trial including 24 patients, who were assessed with the Brief Pain Inventory, the Multiple Sclerosis International Quality of Life questionnaire, the Beck Depression Inventory, and the Modified Fatigue Impact Scale. RESULTS Statistically significant improvements were observed in maximum and mean pain scores, as well as in the impact of pain on work, personal relationships, and sleep and rest. Not significant differences were found between the treatment and placebo groups. CONCLUSIONS Treatment with PEMF may be effective in reducing pain in patients with MS, although further research is necessary to confirm its effectiveness over placebo and to differentiate which type of pain may be more susceptible to this treatment.
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Affiliation(s)
- A Hochsprung
- Servicio de Neurofisioterapia, Unidad de EM, Hospital Virgen de la Macarena, Sevilla, España
| | - S Escudero-Uribe
- Servicio de Neurofisioterapia, Unidad de EM, Hospital Virgen de la Macarena, Sevilla, España
| | - A J Ibáñez-Vera
- Universidad de Jaén, Departamento de Ciencias de la Salud, Área de Fisioterapia, Jaén, España.
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