Scientific Basis of Electro-Stimulation

Antioxidants alleviate electric field-induced effects on lung tissue based on assays of heme oxygenase-1, protein carbonyl content, malondialdehyde, nitric oxide, and hydroxyproline

In order to test whether antioxidants have beneficiary effects on electric field induced damage, we determined the pulmonary levels of heme oxygenase-1 (HO-1), protein carbonyl content (PCO), malondialdehyde (MDA), nitric oxide (NO) and hydroxyproline (HP) under extremely low frequency (ELF) electric (E) field exposure (50 Hz, 12 kV/m, 7 days/for 8 h/day). While PCO levels significantly increased (p<0.05), insignificant changes (p>0.05) were observed in HO-1, MDA, NO and HP levels for electric field exposure groups compared to the control group. We have not observed any significant change in these parameters on the electric field group compared to the group where NAC and EGCG were separately applied along with electric field. However, during our previous studies, we have concluded that NAC and EGCG are potent antioxidants and we believe that new studies should be established by way of setting up different experimental conditions.

Electrical treatment of tibial non-union: a prospective, randomised, double-blind trial

Electrical stimulation in the treatment of bony non-union has been used in different forms for many years. However, there is still a lot of uncertainty about its efficacy. We, therefore, undertook a prospective, randomised, double-blind trial to try and determine its effect. Over a period of 5 years, 34 consecutive patients with a tibial non-union met our "criteria for inclusion". Each patient had an oblique fibular osteotomy, followed by a unilateral external fixator. They were then randomly allocated one of two machines. Group 1, the active group, received electrical stimulation from an active machine. Group 2, the dummy group, had an identical machine but without any current passing through the active coils. They were then followed up for 6 months and evaluated clinically and radiologically for bony union. Unfortunately, there was by chance, an imbalance in smoking habit between the two groups. The union rate in the subgroup that smoked was 75% (6/8) in the active group as compared to 46% (6/13) in the dummy group. The active group of non-smokers had 100% (10/10) union rate, compared to 67% (2/3) in the dummy group. Overall 24 out of the 34 patients progressed to union. Out of 18, 16 (89%) in the active group showed bony union as compared to 8/16 (50%) in the dummy. There was, thus, a statistically significant positive association between tibial union and electrical stimulation (odds ratio 8, 95% CI: 1.5-41, P=0.02).

Treatment of ununited tibial fractures: a comparison of surgery and pulsed electromagnetic fields (PEMF)

The use of pulsed electromagnetic fields (PEMF) is gaining acceptance for the treatment of ununited fractures. The results of 44 articles published in the English language literature have been compiled to assess the effectiveness of PEMF vs surgical therapy. For ununited tibial fractures, 81% of reported cases healed with PEMF vs 82% with surgery. After multiple failed surgeries, the success rate of PEMF is reported to be greater than with surgery; this discrepancy increases with additional numbers of prior surgeries. In infected nonunions, the results of surgical treatment decreased by 21% and were less than the results utilizing PEMF (69% vs 81%). In open fractures, surgical healing exceeded PEMF (89% vs 78%), whereas in closed injuries PEMF cases healed more frequently (85% vs 79%). In general, PEMF treatment of ununited fractures has proved to be more successful than noninvasive traditional management and at least as effective as surgical therapies. Given the costs and potential dangers of surgery, PEMF should be considered an effective alternative. Experience supports its role as a successful method of treatment for ununited fractures of the tibia.