Is there a role of pulsed electromagnetic fields in management of patellofemoral pain syndrome? Randomized controlled study at one year follow‐up

Abstract

Patellofemoral pain syndrome (PFPS) is a common cause of recurrent or chronic knee pain in young adults, generally located in the retropatellar region. Etiology is controversial and includes several factors, such as anatomical defects, muscular imbalance, or joint overuse. Good results have been reported with exercise therapy, including home exercise program (HEP). Joint inflammation with increase of pro-inflammatory cytokines levels in the synovial fluid might be seen especially when chondromalacia becomes evident. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has shown anti-inflammatory effects and anabolic chondrocyte activity. The purpose of this randomized controlled study was to evaluate if the combination of HEP with PEMFs was more effective than HEP alone in PFPS treatment. Thirty-one PFPS patients were enrolled in this study. All patients were instructed to train with HEP. Patients in the PEMFs group associated HEP with PEMFs. Function and pain were assessed with Victorian Institute of Sport Assessment score (VISA), Visual Analog Scale (VAS), and Feller's Patella Score at baseline at 2, 6, and 12 months of follow-up. Drug assumption was also recorded. Increase in VISA score was significantly higher in PEMFs group compared to controls at 6 and 12 months, as well as the increase in the Feller's Patella Score at 12 months. VAS score became significantly lower in the PEMFs group with respect to control group since 6 month follow-up. Pain reduction obtained with PEMFs enhanced practicing therapeutic exercises leading to a better recovery process; this is extremely important in addressing the expectations of young patients, who wish to return to sporting activities.

Effectiveness of conservative treatment for patellofemoral pain syndrome: A systematic review and meta-analysis

“…In a 12-month follow-up, the study by Servodio et al conducted on 14 young cases and 17 controls demonstrated a superiority of pulsed electromagnetic fields when combined with a home exercise programme over home exercise alone, showing an effect size of -33.0 (95% CI -45.2 to -20.8) points (31).…”

“…Two trials compared open kinetic chain exercises with closed ones (25,26). Five studies assessed the effectiveness of different electrical methods (27)(28)(29)(30)(31). Seven trials evaluated the effectiveness of bracing and insoles (19,20,(32)(33)(34)(35)(36).…”

“…Of the studies with clinically significant effect sizes, 4 were considered to have a low risk of bias (31,39,46,50). Another 3 studies were considered to have a high risk of systematic bias (20,45,54).…”

“…Except for the single study by Moyano et al (50), all the others trials that have reported clinically significant results were conducted on cohorts of a population of people with PFP: amongst men (46) or women (39,45,54) exclusively, or amongst very young adults with a predomination of women (31). Thus, the possibility of a particular treatment being effective for specific subgroups of patients with PFP should be taken into account.…”

Clinical results of pulsed signal therapy on patellofemoral syndrome with patellar chondropathy

“…A study comparing PEMF associated with a home exercise program to the program alone for patellofemoral pain syndrome showed that in the PEMF group, both function and pain were significantly better at 6 and 12 months [Servodio Iammarrone et al, ]. This was the only other study with electromagnetic fields for patellofemoral pain syndrome found in the literature.…”