Pulsed electromagnetic field therapy for management of osteoarthritis-related pain, stiffness and physical function: clinical experience in the elderly

Abstract

BackgroundPulsed electromagnetic field (PEMF) therapy has shown promising therapeutic effectiveness on bone- and cartilage-related pathologies, being also safe for management of knee osteoarthritis.AimThe aim of this study was to investigate the clinical efficacy of a PEMF device for management of knee osteoarthritis in elderly patients.Materials and methodsA total of 33 patients were screened, and 28 patients, aged between 60 and 83 and affected by bilateral knee osteoarthritis, were enrolled in this study. They received PEMF therapy on the right leg for a total of three 30-minute sessions per week for a period of 6 weeks, while the left leg did not receive any treatment and served as control. An intravenous drip containing ketoprofen, sodium clodronate, glucosamine sulfate, calcitonin, and ascorbic acid, for a total volume of 500 mL, was administered during PEMF therapy. At baseline and 3 months post-PEMF therapy, Visual Analog Scale (VAS) was used to assess knee pain and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) was used to measure knee pain, stiffness and physical function.ResultsChanges in VAS and WOMAC scores were calculated for both knees as baseline minus post-treatment. A two sample Student’s t-test, comparing change in knee-related VAS pain for PEMF-treated leg (49.8 ± 2.03) vs control leg (11 ± 1.1), showed a significant difference in favor of PEMF therapy (P < 0.001). A two sample Student’s t-test comparing change in knee-related WOMAC pain, stiffness, and physical function for PEMF-treated leg (8.5 ± 0.4, 3.5 ± 0.2, 38.5 ± 2.08, respectively) vs control leg (2.6 ± 0.2; 1.6 ± 0.1; 4.5 ± 0.5 respectively), also showed a significant difference in favor of PEMF therapy (P < 0.001). No adverse reactions to therapy were observed.ConclusionThe present study shows that PEMF therapy improves pain, stiffness and physical function in elderly patients affected by knee osteoarthritis.

Chondrogenic Priming at Reduced Cell Density Enhances Cartilage Adhesion of Equine Allogeneic MSCs - a Loading Sensitive Phenomenon in an Organ Culture Study with 180 Explants

“…Alternative approaches to improve regeneration capacity in explants treated with PEMFs may include: 1) increasing exposure amplitude; 2) increasing exposure duration; 3) increasing number of exposures to a value greater than 1; 4) exposing MSC-seeded explants directly to PEMFs or; 5) a combination of the above. In fact, Esposito et al have previously reported induction of chondrogenic differentiation upon PEMF treatment [14] and several in vivo studies have demonstrated beneficial effects of this therapy on clinical symptoms of animals and humans with osteoarthritis [11,12]. It has to be mentioned though that these studies applied 6 weeks of daily treatment of the injured joint, whereas our study employed single 10 minute prestimulation of chondrogenically induced MSCs and unstimulated ex vivo cartilage explants.…”

“…In 28 elderly humans with bilateral knee osteoarthritis, PEMF stimulation at 3 times per week over 6 weeks significantly improved pain, stiffness, and physical function in comparison to the untreated contralateral joint [12]. Trock et al found that treating human patients with knee osteoarthritis (n=86) with PEMFs for a total of 18 times caused significant differences in pain, pain on motion, and tenderness in comparison to placebo treatments [13].…”

Effects of pulsed electromagnetic field therapy at different frequencies and durations on rotator cuff tendon-to-bone healing in a rat model

“…PEMF has been utilized in clinical studies to treat osteoarthritis, epicondylitis, and rotator cuff tears. 9,18,19,26 At three months post-op, patients with small or medium rotator cuff tears showed improved range of motion after receiving PEMF therapy when compared to those receiving placebo. In order to investigate the structural and functional effects of PEMF on tendon-to-bone healing, we have previously utilized PEMF in a rat rotator cuff injury and transosseous repair model.…”

Harnessing magnetic-mechano actuation in regenerative medicine and tissue engineering

“…Owing to recent progress in nanomedicine and molecular biology, we can begin to understand the signalling pathways involved in mechanotransduction and exploit them with magnetic actuation for a myriad of applications: stem cell differentiation and homing to injury sites, as well as tissue engineering strategies [19][20][21][22][23][24][25]. In tissue engineering, magnetic actuation can allow for better seeding in 3D scaffolds [26][27][28], and can be used in scaffold-free approaches to build tissues bottom-up from mesenchymal stem cells (MSCs) or induced pluripotent stem cells (iPSCs) [29][30][31].…”