Effects Of Pulsed Electromagnetic Fields Research Articles

Effects of Pulsed Electromagnetic Field Therapy at Different Frequencies on Bone Mass and Microarchitecture in Osteoporotic Mice.

A pulsed electromagnetic field (PEMF) can promote osteogenesis. However, studies have shown variation in the signal characteristics in terms of waveform type, intensity, frequency, and treatment duration. Among the factors that affect electromagnetic fields, frequency plays a major role. However, few studies have investigated the effects of PEMF at different frequencies in osteoporotic mice. Therefore, our objective was to determine the effect of PEMF frequency in osteoporotic mice. Forty 3-month-old female mice were randomly divided into the following five groups: sham, OVX, and OVX followed by 1.6-mT PEMF exposure groups (8 Hz, 50 Hz, and 75 Hz, 1.6 mT). The PEMF was applied for 1 h/day, 7 days/week, for 4 weeks. After 4 weeks, the micro-computed tomography showed that PEMF with (50and 75 Hz) ameliorated the deterioration of bone microarchitecture. Improvements in the bone histological analysis were identified for PEMF with 50and 75 Hz groups compared with the ovariectomy (OVX) controls. Osteoclast numbers were decreased in PEMF with (50 and75 Hz). Moreover, the real-time PCR demonstrated PEMF with (50 and75 Hz) significantly promoted the expression of the osteoblast-related genes (ALP, OCN, Runx2), and increased the serum PINP. PEMF with (50 and75 Hz) exerted significant inhibitory effects on the osteoclast-related mRNA expression (CTSK, NFATc1, TRAP) and bone resorption markers CTX-I and IL-1β. Taken together, our results showed that PEMF at 50and 75 Hz with 1.6 mT significantly ameliorate the deterioration of bone microarchitecture in OVX mice. The inhibitory effect of PEMF may be associated with IL-1β inhibition. © 2021 Bioelectromagnetics Society.

POS1447 LOW-INTENSITY PULSED ELECTROMAGNETIC FIELDS IMPROVE PHYSICAL PERFORMANCE IN A DOSE-DEPENDENT MANNER: AN OBSERVATIONAL STUDY IN OLDER ADULTS WITH RHEUMATIC DISEASES

Background:Low-intensity pulsed electromagnetic fields (PEMF) have been shown to improve gait parameters in frail older adults.1 Furthermore, the continuous exposure to PEMF (up to 1 year) have been demonstrated to produce progressive improvements in self-selected gait speed in older adults at risk of falling.2Objectives:To investigate the effects of two different treatment regimens of PEMF on physical performances in older adults presenting with rheumatoid arthritis (RA), osteoarthritis (OA) or severe osteoporosis (OP).Methods:Older adults presenting with RA, OA or OP, at increased risk of falls, evaluated in our Falls Prevention Clinic, were considered for a prospective observational study investigating the effects of PEMF on physical performances. PEMF were supplied by the THS 280 E device (THS-Therapeutic Solutions Srl, Milan, Italy). It provides a new therapeutic approach, named TEPS (Triple Energy Postural Stabilization), that represents an evolution of physical therapy.1,2 On the basis of the physician judgment, PEMF were administered following an intensive protocol, every 45 days (PEMF-45), or a standard validated protocol1,2, every 60 days (PEMF-60). All subjects were assessed at baseline and every 3 months with the following tests: 4 meters gait speed test [4MGS, seconds (sec)], timed up and go test (TUG, sec), chair stand test (CST, sec), short physical performance battery (SPPB, score), and hand grip strength (HGS) by hand dynamometer (Kg). Demographic, anthropometric and clinical characteristics, including pharmacological treatments and functional status were evaluated at baseline. Clinical and adverse events were assessed every 45 or 60 days after PEMF administration.Results:Overall, 94 patients were enrolled between January and December 2020. Of these, 43 subjects (N=33 PEMF-45, N=11 PEMF-60) with a valid 6-month follow-up assessment were considered for the current analysis. The two groups were comparable regarding the main baseline characteristics, and similar % of patients presented with RA, OA or OP. Mean age (±SE) was 78±7 in PEMF-45 and 77±7 in PEMF-60. As expected, all physical performance tests improved significantly from baseline to 6 months in both groups. Mean (±SE) 4MGS increased significantly more in PEMF-45 (from 3.24±0.12 sec to 2.83±0.18 sec) compared to PEMF-60 (from 3.22±0.21 sec to 3.02±0.30 sec, p=.018). Likewise, mean (±SE) CST improved more in PEMF-45 (from 12.4±0.9 sec to 8.7±0.4 sec) compared to PEMF-60 (from 11.1±1.5 sec to 9.8±0.7 sec, p=.002). No significant difference between groups was found for the other tests, although a trend toward better results in PEMF-45 was manifest: SPPB improved by 6.4% in PEMF-45 and by 3.0% in PEMF-60, and TUG decreased by 7.8% in PEMF-45 and by 6.1% in PEMF-60. During the 6 months observation period no adverse event was observed.Conclusion:Preliminary results of our ongoing prospective observational study suggest that a more frequent administration of PEMF produces greater improvements in some but not all physical performance parameters compared to a standard validated regimen1,2.

Efficacy of Pulsed Electromagnetic Fields on Experimental Osteopenia in Rodents: A Systematic Review.

Osteoporosis leads to increased bone fragility and risk of fractures. Different strategies have been employed to reduce bone loss, including the use of a pulsed electromagnetic field (PEMF). Although many experimental studies have demonstrated the effect of PEMF on reduction of bone loss, the outcomes studied are varied and insufficient, and the quality of evidence is unknown. Therefore, the aim of this review was to assess the preclinical evidence on the effect of PEMF on bone loss. The existing challenges were also evaluated, and suggestions were provided to strengthen the quality of evidence in future studies. All original articles concerning the effect of PEMF on osteoporosis in animal models were included. Twenty-four studies met the inclusion criteria, 23 of which suggested that PEMF was effective in reducing bone loss, while one study failed to demonstrate any benefit. Risk of bias analysis suggested that information on key measures to reduce bias was frequently not reported. Animal models for osteoporosis, PEMF intervention regimens, outcomes, and specific bone detection sites seemed to influence the efficacy of PEMF in osteoporosis. Our results indicate the potential benefits of PEMF selection in animal models of osteoporosis. However, due to the heterogeneity of the parameters and the quality of the included literature, comprehensive studies using standardized protocols are warranted to confirm the results. © 2021 Bioelectromagnetics Society.

Effects of focused continuous pulsed electromagnetic field therapy on early tendon-to-bone healing.

AimsRotator cuff (RC) tears are common musculoskeletal injuries which often require surgical intervention. Noninvasive pulsed electromagnetic field (PEMF) devices have been approved for treatment of long-bone fracture nonunions and as an adjunct to lumbar and cervical spine fusion surgery. This study aimed to assess the effect of continuous PEMF on postoperative RC healing in a rat RC repair model.MethodsA total of 30 Wistar rats underwent acute bilateral supraspinatus tear and repair. A miniaturized electromagnetic device (MED) was implanted at the right shoulder and generated focused PEMF therapy. The animals’ left shoulders served as controls. Biomechanical, histological, and bone properties were assessed at three and six weeks.ResultsExtension of the tendon from preload to the maximum load to failure was significantly better in the PEMF-treated shoulders at three weeks compared to controls (p = 0.038). The percentage strain was significantly higher in the PEMF group at both timepoints (p = 0.037). Collagen organization was significantly better (p = 0.034) as was tissue mineral density in the PEMF-treated group at three weeks (p = 0.028). Tendon immunohistochemistry revealed a prominent increase in type I collagen at the repair site at three weeks following continuous PEMF treatment compared with controls. None of the other tested parameters differed between the groups.ConclusionMED-generated PEMF may enhance early postoperative tendon-to-bone healing in an acute rat supraspinatus detachment and repair model. Superior biomechanical elasticity parameters together with better collagen organization suggest improved RC healing.Cite this article: Bone Joint Res 2021;10(5):298–306.

Effect of PEMF on Muscle Oxygenation during Cycling: A Single-Blind Controlled Pilot Study

Pulsed electromagnetic fields (PEMFs) are used as non-invasive tools to enhance microcirculation and tissue oxygenation, with a modulatory influence on the microvasculature. This study aimed to measure the acute effect of PEMF on muscle oxygenation and its influence on pulmonary oxygen kinetics during exercise. Eighteen male cyclists performed, on different days, a constant-load exercise in both active (ON) and inactive (OFF) PEMF stimulations while deoxyhemoglobin and pulmonary oxygen kinetics, total oxygenation index, and blood lactate were collected. PEMF enhanced muscle oxygenation, with higher values of deoxyhemoglobin both at the primary component and at the steady-state level. Moreover, PEMF accelerated deoxyhemoglobin on-transition kinetic, with a shorter time delay, time constant, and mean response time than the OFF condition. Lactate concentration was higher during stimulation. No differences were found for total oxygenation index and pulmonary oxygen kinetics. Local application of a precise PEMF stimulation can increase the rate of the muscle O2 extraction and utilization. These changes were not accompanied by faster oxygen kinetics, reduced oxygen slow component, or reduced blood lactate level. It seems that oxygen consumption is more influenced by exercise involving large muscle mass like cycling, whereas PEMF might only act at the local level.

The effects of pulsed electromagnetic field on experimentally induced sciatic nerve injury in rats

ABSTRACT Some experimental research indicates that low-frequency pulsed electromagnetic field (PEMF) stimulation may accelerate regeneration in sciatic nerve injury. However, little research has examined the electrophysiological and functional properties of regenerating peripheral nerves under PEMF. The main aim of the present study is to investigate the effects of PEMF on sciatic nerve regeneration in short- and long-term processes with electrophysiologically and functionally after crushing damage. Crush lesions were performed using jewelery forceps for 30 s. After crush injury of the sciatic nerves, 24 female Wistar-Albino rats were divided into 3 groups with 8 rats in each group: SH(Sham), SNI (Sciatic Nerve Injury), SNI+PEMF(Sciatic Nerve Injury+Pulsed Electromagnetic Field). SNI+PEMF group was exposed to PEMF (4 h/day, intensity; 0.3mT, low-frequency; 2 Hz) for 40-days. Electrophysiological records (at the beginning and 1st, 2nd, 4th and 6th weeks post-crush) and functional footprints (at 1st, 2nd, 3rd, 4th, 5th and 6th weeks post crush) were measured from all groups during the experiment. The results were compared to SNI and SNI+PEMF groups, it was found that amplitude and area parameters in the first-week were significantly higher and latency was lower in the SNI+PEMF group than in the SNI group (p < 0,05). However, the effect of PEMF was not significant in the 2nd, 4th, 6th weeks. In addition, in the 1st and 2nd weeks, the SSI parameters were significantly higher in SNI+PMF group than SNI group (p < .05). These results indicate that low-frequency PEMF is not effective for long-periods of application time while PEMF may be useful during the short-term recovery period.

Effect of pulsed electromagnetic field therapy in patients with supraspinatus tendon tear.

The aim of this study was to compare the effect of transcutaneous electrical nerve stimulation (TENS), ultrasound (US), and pulsed electromagnetic field (PEMF) combination with TENS and US therapy alone in patients with supraspinatus tear. Forty patients were included in this study. The patients were randomly divided into two groups as follows: PEMF (n=20) and Sham (n=20) groups. PEMF was applied to the first group at a frequency of 50 Hz, 25 G intensity, and 20 min/session. The device was turned off while PEMF was applied to the second group. Diathermy (US) and electrotherapy (TENS) were applied to both groups for 10 sessions. Numerical Rating Scale (NRS), University of California-Los Angeles (UCLA) Shoulder Scale, and Shoulder Pain and Disability Index (SPADI) were used as outcome measures. In both groups, there was a significant improvement in the NRS, UCLA Shoulder Scale, and SPADI scores after treatment compared with pretreatment (p<0.05). In the comparison of the difference between the pretreatment and posttreatment measurement values between the groups, no significant difference was found between PEMF and Sham groups according to the NRS (p=0.165), UCLA Shoulder Scale (p=0.141), and SPADI (p=0.839) scores. In our study, a combination of PEMF therapy with conventional physical therapy modalities was not found to be superior to the conventional therapy alone, and adding it to the routine treatment of symptomatic supraspinatus tear would not provide any additional benefit.

Focused-pulsed electromagnetic field treatment reverses lipopolysaccharide-induced alterations in gene expression profile in human gastrointestinal epithelial cells

BACKGROUND: Although the therapeutic effects of pulsed electromagnetic field (PEMF) treatment are well documented, underlying mechanisms of PEMF in treating pathological conditions are incompletely understood. METHODS: We utilized a human gastrointestinal epithelial cell system to investigate the influence of a low-frequency electromagnetic field generated from a focused PEMF (f-PEMF) device on the expression of human genes. We simulated an inflammatory condition by stimulating the cells with lipopolysaccharide (LPS). A set of LPS-activated cells were then subjected to 100-Hz f-PEMF for 30 seconds to observe the therapeutic effect of f-PEMF. We determined the therapeutic effect by analyzing the reversal of LPS-induced alterations in gene expression using RNA-seq analysis. The results were compared to the changes between untreated controls versus LPS treated cells, defining the homeostatic alteration of changes in gene expression profile caused by LPS stimulation alone. We further compared LPS treated versus LPS + f-PEMF treated cells to examine the effect of f-PEMF in the reversal of the LPS-induced alterations in gene expression patterns. RESULTS: A total of 38,162 genes (of 60,448 tested) were constitutively expressed in the untreated control cells. Stimulation with LPS altered the expression profile through de novo-induction of >1950 genes that were originally unexpressed and silencing 2486 constitutively expressed genes. LPS treatment also altered expression levels in a large panel of genes. Exposing LPS-treated cells to 100 Hz of f-PEMF for 30 seconds (s) showed reversals of LPS treatment-induced altered gene expression. In this paper, we emphasize the f-PEMF regulation of genes associated with inflammatory processes. CONCLUSION: Our data indicates for possibility of developing new nonchemical alternative therapeutic approaches for treatment of inflammation and pain.

HEK293 cell response to static magnetic fields via the radical pair mechanism may explain therapeutic effects of pulsed electromagnetic fields.

PEMF (Pulsed Electromagnetic Field) stimulation has been used for therapeutic purposes for over 50 years including in the treatment of memory loss, depression, alleviation of pain, bone and wound healing, and treatment of certain cancers. However, the underlying cellular mechanisms mediating these effects have remained poorly understood. In particular, because magnetic field pulses will induce electric currents in the stimulated tissue, it is unclear whether the observed effects are due to the magnetic or electric component of the stimulation. Recently, it has been shown that PEMFs stimulate the formation of ROS (reactive oxygen species) in human cell cultures by a mechanism that requires cryptochrome, a putative magnetosensor. Here we show by qPCR analysis of ROS-regulated gene expression that simply removing cell cultures from the Earth’s geomagnetic field by placing them in a Low-Level Field condition induces similar effects on ROS signaling as does exposure of cells to PEMF. This effect can be explained by the so-called Radical Pair mechanism, which provides a quantum physical means by which the rates and product yields (e.g. ROS) of biochemical redox reactions may be modulated by magnetic fields. Since transient cancelling of the Earth’s magnetic field can in principle be achieved by PEMF exposure, we propose that the therapeutic effects of PEMFs may be explained by the ensuing modulation of ROS synthesis. Our results could lead to significant improvements in the design and therapeutic applications of PEMF devices.

Effect of Pulsed Electromagnetic Field Versus Aerobic Exercise on Primary Dysmenorrhea

Abstract Background: Dysmenorrhea is the most common gyneco-logic complaint among adolescent and young adult females, so the purpose of this study was to investigate the effect of pulsed electromagnetic field versus aerobic exercise on primary dysmenorrhea. Aim of Study: This study was conducted to compare between the effect of pulsed electromagnetic field and aerobic exercise on primary dysmenorrhea. Subjects and Methods: Forty girls diagnosed with primary dysmenorrhea participated in this study. They were selected randomly from Kasre El-Ainy University Hospital in Cairo. They had regular menstrual cycle. Their ages were ranged from 16-25 years. Their Body Mass Index (BMI) was ranged from 20-25Kg/m2. All of them were virgins. Girls with irregular or infrequent menstrual cycles, pacemaker, hyperthyroidism, pelvic pathology and BMI 20Kg/m2 are ex-cluded from the study. Design: Design of this study was two group pre-test and post-test experimental design. Methods: They were divided into two equal groups: Group A consisted of twenty girls and treated by pulsed electromag-netic field on the pelvic region, 3 times per week for four weeks. Group B consisted of twenty girls and treated by aerobic exercise, 3 times per week for four weeks. Evaluation: Pain was evaluated by VAS, quality of life was assessed by short form survey (SF-12) and progesterone hormone was evaluated for both groups (A and B) before and after treatment. Results: Results found that; pre-treatment, there was no significant difference between both groups (A and B) in progesterone hormone, VAS and quality of life. While post-treatment, there was significant difference between both groups (A and B) in progesterone hormone (more increase in group A), VAS (more decrease in group A) and quality of life (more increase in group A).Conclusion: It can be concluded that pulsed electromag-netic field is more effective than aerobic exercise in treating primary dysmenorrhea.

Effect of Pulsed Magnetic Field Therapy Versus Aerobic Training on Peripheral Arteries in Type 2 Diabetes

Abstract Background: Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose levels over a prolonged period of time, requiring continuous medical care and ongoing patient. Self-management education and support, to prevent acute complications and to reduce the risk of long-term complications. Aim of Study: The main purpose of this study was to investigate and compare between the effect of pulsed electro-magnetic field and aerobic exercises in treatment of athero-sclerosis in type 2 diabetic patients. Subjects and Methods: Forty atherosclerotic diabetic patients, with ages ranged from 45 to 55 years old, were recruited from Out Clinic of Faculty of Physical Therapy, Cairo University. They were assigned randomly to two equal groups; group A, which included 20 diabetic atherosclerotic patientswho received PEMF for with 15Hz frequency and 20 gauss intensity for 20min., while group B included 20 diabetic atherosclerotic patients who received aerobic exercise with 65-80% pf predicted max. heart rate. For both groups treatment conducted for 8 weeks, 3 sessions/week. Measurement of arterial blood flow and intimal thickness by Doppler ultra-sonography were reported before and after 8 weeks of the treatment. Results: Within group comparison showed significant increase of arterial blood flow and significant reduction of intimal thickness in both groups in both groups (p < 0.05). Comparison between post-treatment values between both groups showed non-significant difference. Conclusion: It could be concluded that, PEMF and aerobic exercises are effective methods in treatment of arterial problems in type 2 diabetic patients.

Therapeutic effect of pulsed electromagnetic field on bone wound healing in rats

ABSTRACT This study aimed to investigate the therapeutic effect of pulsed electromagnetic field (PEMF) on bone wound in rats as a potential therapy for bone fracture-related conditions. Male rats, aged 3 months, were used to construct model of bone wounding. Wound models were randomly selected to receive PEMF therapy at 1 to 10 mT intensity. Models that did not receive PEMF therapy were used as control. The serum concentrations of calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) were determined. Bone density and biomechanical properties of callus were measured using a tensile tester. Compared with control, rats subjected to PEMF therapy had similar weight gain, but significantly higher levels of serum Ca and ALP (P < .05) at 5 and 10 mT, while the serum level of P remained unchanged after PEMF therapy. The bone mineral density of callus increased after the therapy, particularly, after 5 and 10 mT therapy (P < .05). Biomechanical measurements showed that 21 days after the therapy, the maximum load, fracture load, elastic load and bending energy were significantly greater in rats receiving 5 and 10 mT PEMF therapy as compared with control (P < .05). Our experiments demonstrate that PEMF at 5 and 10 mT can significantly accelerate wound healing and enhance the repairing ability of bone tissue.

A novel pulsed electromagnetic field promotes distraction osteogenesis via enhancing osteogenesis and angiogenesis in a rat model

Summary Background Distraction Osteogenesis (DO) is a widely used surgical procedure for limb lengthening, deformity correction, and management of segmental bone defects. However, delayed bone consolidation during DO remains an unsolved clinical problem, which significantly and negatively affects the quality of healing outcome. Pulsed electromagnetic field (PEMF) therapy has been shown to promote osteogenesis and exhibit beneficial effects on the management of delayed union and nonunion fractures. Thus, we hypothesize that PEMF could have beneficial effects on DO. Methods In this study, specialized PEMF devices employing a novel high slew rate signal were used to firstly investigate effects of PEMF on osteogenesis of MSCs in vitro. MSCs cultured in osteogenic inductive medium treated with or without PEMF (3hrs/day) were subject to qPCR test, Alizarin Red S and ALP staining on day 7. Secondly, an in vivo study was undertaken using a DO model with fifty-six SD-rats randomly divided into two groups. The PEMF group received daily PEMF treatment, 3hr/day, and the control group received no treatment. Histology and IHC staining, radiographic exams, μCT, and biomechanical tests were used to evaluate the quality of bone healing. Immunofluorescence staining and vessel perfusion following by μCT were used to evaluate the effect of PEMF on angiogenesis. Results Significantly more bone volume and mineral density were observed in the PEMF group compared with the control group, along with better biomechanical properties. Histological results showed that better quality callus formation with less cartilage in callus in PEMF group than control group. Immunofluorescence staining and vessel perfusion results showed that more blood vessels at both early and late stage of DO in PEMF group compared with control group. Conclusion Our study showed that new high slew rate PEMF signal could promote osteogenesis and angiogenesis in a rat model of DO, which provides insight into the development of new noninvasive mean to accelerate bone formation in the DO process. The translation potential of this article This study provides supporting evidence for the use of high slew rate PEMF signal to promote bone formation in DO.

Pulsed Electromagnetic Fields Ameliorate Skeletal Deterioration in Bone Mass, Microarchitecture, and Strength by Enhancing Canonical Wnt Signaling-Mediated Bone Formation in Rats with Spinal Cord Injury.

Spinal cord injury (SCI) leads to extensive bone loss and high incidence of low-energy fractures. Pulsed electromagnetic fields (PEMF) treatment, as a non-invasive biophysical technique, has proven to be efficient in promoting osteogenesis. The potential osteoprotective effect and mechanism of PEMF on SCI-related bone deterioration, however, remain unknown. The spinal cord of rats was transected at vertebral level T12 to induce SCI. Thirty rats were assigned to the control, SCI, and SCI+PEMF groups (n = 10). One week after surgery, the SCI+PEMF rats were subjected to PEMF (2.0 mT, 15 Hz, 2 h/day) for eight weeks. Micro-computed tomography results showed that PEMF significantly ameliorated trabecular and cortical bone microarchitecture deterioration induced by SCI. Three-point bending and nanoindentation assays revealed that PEMF significantly improved bone mechanical properties in SCI rats. Serum biomarker and bone histomorphometric analyses demonstrated that PEMF enhanced bone formation, as evidenced by significant increase in serum osteocalcin and P1NP, mineral apposition rate, and osteoblast number on bone surface. The PEMF had no impact, however, on serum bone-resorbing cytokines (TRACP 5b and CTX-1) or osteoclast number on bone surface. The PEMF also attenuated SCI-induced negative changes in osteocyte morphology and osteocyte survival. Moreover, PEMF significantly increased skeletal expression of canonical Wnt ligands (Wnt1 and Wnt10b) and stimulated their downstream p-GSK3β and β-catenin expression in SCI rats. This study demonstrates that PEMF can mitigate the detrimental consequence of SCI on bone quantity/quality, which might be associated with canonical Wnt signaling-mediated bone formation, and reveals that PEMF may be a promising biophysical approach for resisting osteopenia/osteoporosis after SCI in clinics.

Pulsed Electromagnetic Fields Accelerate Sensorimotor Recovery Following Experimental Disc Herniation.

An experimental animal study. The aim of this study was to investigate the effect of pulsed electromagnetic fields (PEMF) on recovery of sensorimotor function in a rodent model of disc herniation (DH). Radiculopathy associated with DH is mediated by proinflammatory cytokines. Although we have demonstrated the anti-inflammatory effects of PEMF on various tissues, we have not investigated the potential therapeutic effect of PEMF on radiculopathy resulting from DH. Nineteen rats were divided into three groups: positive control (PC; left L4 nerve ligation) (n = 6), DH alone (DH; exposure of left L4 dorsal root ganglion [DRG] to harvested nucleus pulposus and DRG displacement) (n = 6), and DH + PEMF (n = 7). Rodents from the DH + PEMF group were exposed to PEMF immediately postoperatively and for 3 hours/day until the end of the study. Sensory function was assessed via paw withdrawal thresholds to non-noxious stimuli preoperatively and 1 and 3 days postoperatively, and every 7 days thereafter until 7 weeks after surgery. Motor function was assessed via DigiGait treadmill analysis preoperatively and weekly starting 7 days following surgery until 7 weeks following surgery. All groups demonstrated marked increases in the left hindlimb response threshold postoperatively. However, 1 week following surgery, there was a significant effect of condition on left hindlimb withdrawal thresholds (one-way analysis of variance: F = 3.82, df = 2, P = 0.044) where a more rapid recovery to baseline threshold was evident for DH + PEMF compared to PC and DH alone. All groups demonstrated gait disturbance postoperatively. However, DH + PEMF rodents were able to regain baseline gait speeds before DH and PC rodents. When comparing gait parameters, DH + PEMF showed consistently less impairment postoperatively suggesting that PEMF treatment was associated with less severe gait disturbance. These data demonstrate that PEMF accelerates sensorimotor recovery in a rodent model of DH, suggesting that PEMF may be reasonable to evaluate for the clinical management of patients with herniation-associated radiculopathy.Level of Evidence: N/A.

Analgesic effect of pulsed electromagnetic fields for mammaplasty: A meta-analysis of randomized controlled studies.

Background:Pulsed electromagnetic fields shows some potential in alleviating pain after mammaplasty. This systematic review and meta-analysis is conducted to investigate the analgesic efficacy of pulsed electromagnetic fields for pain control after mammaplasty.Methods:The databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases are systematically searched for collecting the randomized controlled trials regarding the impact of pulsed electromagnetic fields on pain intensity after mammaplasty.Results:This meta-analysis has included 4 randomized controlled trials. Compared with control group after mammaplasty, pulsed electromagnetic fields results in remarkably reduced pain scores on 1 day (MD = −1.34; 95% confidence interval [CI] = −2.23 to −0.45; P = .003) and 3 days (MD = −1.86; 95% CI = −3.23 to −0.49; P = .008), as well as analgesic consumption (Std. MD = −5.64; 95% CI = −7.26 to −4.02; P < .00001).Conclusions:Pulsed electromagnetic fields is associated with substantially reduced pain intensity after mammaplasty.

In Vitro Production of Calcified Bone Matrix onto Wool Keratin Scaffolds via Osteogenic Factors and Electromagnetic Stimulus.

Pulsed electromagnetic field (PEMF) has drawn attention as a potential tool to improve the ability of bone biomaterials to integrate into the surrounding tissue. We investigated the effects of PEMF (frequency, 75 Hz; magnetic induction amplitude, 2 mT; pulse duration, 1.3 ms) on human osteoblast-like cells (SAOS-2) seeded onto wool keratin scaffolds in terms of proliferation, differentiation, and production of the calcified bone extracellular matrix. The wool keratin scaffold offered a 3D porous architecture for cell guesting and nutrient diffusion, suggesting its possible use as a filler to repair bone defects. Here, the combined approach of applying a daily PEMF exposure with additional osteogenic factors stimulated the cells to increase both the deposition of bone-related proteins and calcified matrix onto the wool keratin scaffolds. Also, the presence of SAOS-2 cells, or PEMF, or osteogenic factors did not influence the compression behavior or the resilience of keratin scaffolds in wet conditions. Besides, ageing tests revealed that wool keratin scaffolds were very stable and showed a lower degradation rate compared to commercial collagen sponges. It is for these reasons that this tissue engineering strategy, which improves the osteointegration properties of the wool keratin scaffold, may have a promising application for long term support of bone formation in vivo.

Role of pulsed electromagnetic fields after joint replacements.

Although the rate of patients reporting satisfaction is generally high after joint replacement surgery, up to 23% after total hip replacement and 34% after total knee arthroplasty of treated subjects report discomfort or pain 1 year after surgery. Moreover, chronic or subacute inflammation is reported in some cases even a long time after surgery. Another open and debated issue in prosthetic surgery is implant survivorship, especially when related to good prosthesis bone ingrowth. Pulsed Electro Magnetic Fields (PEMFs) treatment, although initially recommended after total joint replacement to promote bone ingrowth and to reduce inflammation and pain, is not currently part of usual clinical practice. The purpose of this review was to analyze existing literature on PEMFs effects in joint replacement surgery and to report results of clinical studies and current indications. We selected all currently available prospective studies or RCT on the use of PEMFs in total joint replacement with the purpose of investigating effects of PEMFs on recovery, pain relief and patients' satisfaction following hip, knee or shoulder arthroplasty. All the studies analyzed reported no adverse effects, and good patient compliance to the treatment. The available literature shows that early control of joint inflammation process in the first days after surgery through the use of PEMFs should be considered an effective completion of the surgical procedure to improve the patient's functional recovery.

Effectiveness of Pulsed Electromagnetic Fields on Bone Healing: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The effect of pulsed electromagnetic field (PEMF) on bone healing is still uncertain and it has not been established as a standardized treatment. The aim of this systematic review and meta-analysis is to evaluate the effect of PEMF on bone healing in patients with fracture. We searched CNKI, Wan Fang, VIP, EMbase, PubMed, CENTRAL, Web of Science, Physiotherapy Evidence Database, and Open Grey websites for randomized controlled trials (published before July 2019 in English or Chinese) comparing any form of PEMF to sham. Reference lists were also searched. Related data were extracted by two investigators independently. The bias risk of the articles and the evidence strength of the outcomes were evaluated. Twenty-two studies were eligible and included in our analysis (n = 1,468 participants). The pooled results of 14 studies (n = 1,131 participants) demonstrated that healing rate in PEMF group was 79.7% (443/556), and that in the control group was 64.3% (370/575). PEMF increased healing rate (RR = 1.22; 95% confidence interval [CI] = 1.10-1.35; I2 = 48%) by the Mantel-Haenszel analysis, relieved pain (standardized mean difference (SMD) = -0.49; 95% CI = -0.88 to -0.10; I2 = 60%) by the inverse variance analysis, and accelerated healing time (SMD = -1.01; 95% CI = -2.01 to -0.00; I2 = 90%) by the inverse variance analysis. Moderate quality evidence suggested that PEMF increased healing rate and relieved pain of fracture, and very low-quality evidence showed that PEMF accelerated healing time. Larger and higher quality randomized controlled trials and pre-clinical studies of optimal frequency, amplitude, and duration parameters are needed. © 2020 Bioelectromagnetics Society.

Pulsed Electromagnetic Field Inhibits Synovitis via Enhancing the Efferocytosis of Macrophages.

Synovitis plays an important role in the pathogenesis of arthritis, which is closely related to the joint swell and pain of patients. The purpose of this study was to investigate the anti-inflammatory effects of pulsed electromagnetic fields (PEMF) on synovitis and its underlying mechanisms. Destabilization of the medial meniscus (DMM) model and air pouch inflammation model were established to induce synovitis in C57BL/6 mice. The mice were then treated by PEMF (pulse waveform, 1.5 mT, 75 Hz, 10% duty cycle). The synovitis scores as well as the levels of IL-1β and TNF-α suggested that PEMF reduced the severity of synovitis in vivo. Moreover, the proportion of neutrophils in the synovial-like layer was decreased, while the proportion of macrophages increased after PEMF treatment. In addition, the phagocytosis of apoptotic neutrophils by macrophages (efferocytosis) was enhanced by PEMF. Furthermore, the data from western blot assay showed that the phosphorylation of P38 was inhibited by PEMF. In conclusion, our current data show that PEMF noninvasively exhibits the anti-inflammatory effect on synovitis via upregulation of the efferocytosis in macrophages, which may be involved in the phosphorylation of P38.