Case Studies supporting PEMF benefits for Muscle
Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis
We aimed to investigate the efficacy of pulsed electromagnetic field (PEMF) in lateral epicondylitis comparing the modality with sham PEMF and local steroid injection. Sixty patients with lateral epicondylitis were randomly and equally distributed into three groups as follows: Group I received PEMF, Group II sham PEMF, and Group III a corticosteroid + anesthetic agent injection. Pain levels during rest, activity, nighttime, resisted wrist dorsiflexion, and forearm supination were investigated with visual analog scale (VAS). Pain threshold on elbow was determined with algometer. All patients were evaluated before treatment at the third week and the third month. VAS values during activity and pain levels during resisted wrist dorsiflexion were significantly lower in Group III than Group I at the third week. Group I patients had lower pain during rest, activity and nighttime than Group III at third month. PEMF seems to reduce lateral epicondylitis pain better than sham PEMF. Corticosteroid and anesthetic agent injections can be used in patients for rapid return to activities.
Electrically stimulating nerve and muscle to enhance regeneration and reinnervation following peripheral nerve injury
Recovery following peripheral nerve injuries is often incomplete. The gold standard treatment is surgical nerve repair performed immediately or shortly after injury. To date, there are no additional treatments that are used to enhance functional recovery. In this paper we outline two emerging applications of electrical stimulation to enhance nerve regeneration and functional recovery. The first is brief electrical nerve stimulation performed at the time of nerve repair that is used to accelerate nerve outgrowth across the injury site. The second is daily electrical muscle stimulation that reduces muscle atrophy and also accelerates muscle reinnervation.
Effect of Pulsed Electromagnetic Field Treatment on Alleviation of Lumbar Myalgia; A Single Center, Randomized, Double-blind, Sham-controlled Pilot Trial Study
The aim of this study is to investigate the efficacy of pulsed electromagnetic field (PEMF) on the alleviation of lumbar myalgia. This is a randomized, real-sham, double blind pilot study. 38 patients were divided into the PEMF group and the Sham group, each of which was composed of 19 patients (1 patient dropped out in the Sham group) of randomized allocation. The PEMF group was treated by using the PEMF device and the Sham group by using a sham device on the lumbar muscle and acupuncture points, three times a week for a total of two weeks. Evaluations of Visual Analogue Scale for bothersomeness (VASB), Visual Analogue Scale for pain intensity (VASP), Oswestry Disability Index (ODI), 36-Item Short Form Health Survey Instrument (SF-36), EuroQol-5Dimension (EQ-5D), Beck's Depression Inventory (BDI) and Roland-Morris Disability Questionnaire (RMDQ), etc. before and 1 week after treatment were carried out. The primary outcome measure was the VASB, measured 1 week after the end of the pulsed electromagnetic therapy. VASB scores for the PEMF group changed by −2.06 ± 2.12 from the baseline, and that for the Sham group changed by −0.52 ± 0.82 (p < 0.05). VASP scores for the PEMF group were reduced by −2.10 ± 2.12 from the base line, and that for the Sham group was reduced by −0.53 ± 1.50 (p < 0.05). PEMF group showed significant improvements in all VASB, VASP, ODI, SF-36, EQ-5D, BDI and RMDQ scores, while the Sham group showed significant improvements in all scores, except the VASP score. However, the VASB, VASP and RMDQ scores of the PEMF group were much lower than those of the Sham group. The two groups showed no significant difference in ODI, SF-36, EQ-5D and BDI. This study demonstrates the effectiveness of PEMF treatment for alleviating lumbar myalgia.
PULSED ELECTROMAGNETIC FIELD THERAPY MAY REDUCE THIGH MUSCLE SORENESS IN MARATHON RUNNERS. A RANDOMIZED CONTROLLED PILOT STUDY.
Introduction: Delayed onset muscle soreness (DOMS) in the quadriceps is frequent in runners finishing a marathon race, and may result in several days of discomfort and pain. There is an increasing clinical evidence that noninvasive, pulsed electromagnetic field therapy (PEMF) can have physiological effect on inflammation and tissue repair. The purpose of this pilot study was to investigate the effect of PEMF on quadriceps muscle soreness in marathon runners and to use the data to calculate an appropriate sample size for a subsequent study.
Material and methods: The design was a randomized doubleblind prospective study covering a 5 day period after completion of a beach marathon. After the marathon all 74 runners that completed the 42.195 km were asked to participate in the study. Forty-six agreed to enter the study and were block randomized into an intervention group or a control group. The intervention group received an active pulsed electromagnetic field device, and the control group received a sham device. The sham devices were used in exactly the same manner but produced no electromagnetic field. The active PEMF device does not produce heat or cause any sensation in the tissue allowing participants to be blinded to treatment. The pulsed electromagnetic field signals of a 2msec burst of 27.12MHz sinusoidal waves were repeated at two bursts per second. Peak magnetic field was 0.05 G, which induced an average electric field of 10 mV/cm in the tissue with an effect of 7.3 mW/cm3. All subjects were instructed to place the device on the most painful area of the quadriceps for 20 minutes four times a day. Pain intensity was measured three times a day with the Visual Analogue Scale (VAS) during a 90o squat with a selfadministered questionnaire. Data were nonparametric and compared with a two sample Wilcoxon ranksum test.
Results: 39 of the 46 runners returned the questionnaire. There was no difference in characteristiscs between the groups. There was a clear trend towards a smaller amount of pain in the intervention group compared to the control group at day one and two. Subjects in the intervention group reported on average 20mm (40 %) less pain on day one and approximately 10mm (40 %) less pain on day two (p=0.17−0.27). At day three, four and five, there were no clear differences in pain intensity reported in the two groups. Using the data from the current pilot study a sample size of 41 subjects in each group are needed to show a statistically significant difference between groups ((power 0.90, alpha 0.05 onesided test)).
Conclusion: This pilot study indicates that PEMF can reduce quadriceps DOMS following a marathon race. However a study with a larger sample size is needed before any firm conclusions on the pain reducing effect of PEMF can be drawn.
Pulsed Electromagnetic Field and Exercises in Patients With Shoulder Impingement Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Objective: To evaluate the effects of pulsed electromagnetic field (PEMF) and exercises in reducing pain and improving function and muscle strength in patients with shoulder impingement syndrome (SIS).
Design: Double-blind, randomized controlled trial with a 3-month posttreatment follow-up.
Setting: Outpatient rehabilitation of a public hospital.
Participants: Patients (NZ56) between 40 and 60 years of age, with a diagnosis of SIS, were randomly assigned to receive active PEMF (nZ26; mean age, 50.1y) or placebo PEMF (nZ30; mean age, 50.8y).
Interventions: After 3 weeks of active or placebo PEMF, both groups performed the same program of exercises that focused on shoulder strengthening.
Main Outcome Measures: A visual analog scale, the University of California/Los Angeles shoulder rating scale, the Constant-Murley shoulder score, and handheld dynamometry for muscle strength were used as outcome measures at baseline (pretreatment), at 3 weeks (after active or placebo PEMF), at 9 weeks (postexercise), and at 3 months posttreatment.
Results: Patients in the active PEMF group had a higher level of function and less pain at all follow-up time frames compared with baseline (P<.05). However, the placebo PEMF group had increased function and reduced pain only at the 9-week and 3-month follow-ups (P<.05) that is, after performing the associated exercises. For the shoulder dynamometry, the active PEMF group had increased strength for lateral rotation at 9 weeks (P<.05), and increased strength for medial rotation at 9 weeks and 3 months (both P<.05) when compared with baseline. There was no significant difference for shoulder strength in the placebo PEMF group (P>.05), as well as no significant differences (P>.05) for all outcome measures.
Conclusions: The combination of PEMF and shoulder exercises is effective in improving function and muscle strength and decreasing pain in patients with SIS. However, these results should be carefully interpreted because of the lack of differences between groups.
Trigger points and systemic effect for EMF therapy
The use of magnetic fields (MFs), in general, and electromagnetic fields (EMFs), in specific, as therapeutic modalities is becoming very common. In the USA, EMFs are mostly used in orthopedics, followed by pain relief and the wound-healing arena. Even though a substantial literature exists worldwide, we are still lacking the accepted comprehensive mechanism(s) of action. In general, it is thought that the best therapeutic effects are achieved when the stimulation is applied directly to the target area. Since the beginning of this century, however, more and more evidence has been collected indicating that effects of the MF stimulation may also be observed at site(s) different from the site of application of the signal. A primary purpose of this paper is to propose a link between the systemic and direct effects. The functional units known as trigger points are discussed as possible "doors" allowing the stimulation to be delivered to the target tissue/organ. A second purpose is to suggest some possible modes of action.
Case Study Reference Source:
1. Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis
(Authors: Kaan Uzunca, Murat Birtane, Nurettin Taştekin)
2. Electrically stimulating nerve and muscle to enhance regeneration and reinnervation following peripheral nerve injury
(Authors: Michael P. Willand, Gregory H Borschel, and Tessa Gordon)
3. Effect of Pulsed Electromagnetic Field Treatment on Alleviation of Lumbar Myalgia; A Single Center, Randomized, Double-blind, Sham-controlled Pilot Trial Study
(Authors: Won-hyung Park, Seung-ho Sun, Sun-gu Lee, Byoung-kab Kang, Jong-soo Lee, Do-guwn Hwang, and Yun-yeop Cha)
4. PULSED ELECTROMAGNETIC FIELD THERAPY MAY REDUCE THIGH MUSCLE SORENESS IN MARATHON RUNNERS. A RANDOMIZED CONTROLLED PILOT STUDY.
(Authors: Sten Rasmussen, Camilla Knudsen, Soeren Skou, Martin Gronbech, Jens Olesen, Michael Rathleff)
5. Pulsed Electromagnetic Field and Exercises in Patients With Shoulder Impingement Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
(Authors: "Diego Galace de Freitas, PT, PhD", "Freddy Beretta Marcondes, PT", "Renan Lima Monteiro, PT", "Sabrina Gonc¸alves Rosa, PT", "Patrı´cia Maria de Moraes Barros Fucs, MD, PhD", "Thiago Yukio Fukuda, PT, PhD")
6. Trigger points and systemic effect for EMF therapy
(Authors: C. F. Hazlewood, Marko Markov)