Effects of pulsed low-frequency magnetic field therapy on pain intensity in patients with musculoskeletal chronic low back pain: study protocol for a randomised double-blind placebo-controlled trial

Efficacy of Static Magnetic Field Therapy on Pain Intensity, Functional Disability, Sleep Quality, and Depressive Symptoms in Patients with Mechanical Neck and Low Back Pain

INTRODUCTION

Mechanical neck pain (MNP) and mechanical low back pain (MLBP) can have a negative impact on the quality of life of patients and may be associated with high levels of disability. Magnetic field therapy has been used in the treatment of various diseases. This study was conducted to assess the effects of static magnetic field therapy generated by neodymium magnets in patients with MNP and MLBP.

METHODS

In this randomized, double-blind, sham-controlled, crossover study, patients with MNP and MLBP were randomly assigned to either the magnetic band or sham band treatment groups. After the initial 2-week phase (with participants randomly assigned to either treatment or sham control), both groups underwent a 1-week washout period. Subsequently, the groups were swapped and proceeded with a second 2-week phase. Visual analogue scale (VAS), Oswestry Low Back Pain Disability Questionnaire (ODI), Neck Disability Index (NDI), Insomnia Severity Index (ISI), and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the patients' pain severity, functional disability, sleep quality, and levels of depressive symptoms, respectively.

RESULTS

Of the 30 subjects, 17 (56.7%) had MLBP, whereas 13 (43.3%) had MNP. Magnetic band treatment (MBT) resulted in a significant decrease in the VAS score (p < 0.001) in all patients. MBT led to a significant decrease in the ODI score (p = 0.009) in patients with MLBP. A significant decrease in the NDI score was found in MBT (p < 0.001) in patients with MNP. The improvement in ISI and PHQ-9 scores was also significantly higher in MBT (p < 0.001).

CONCLUSION

For patients with MNP and MLBP who have not experienced sufficient benefits from conventional treatments, neodymium magnets can be considered as an alternative treatment option due to their significant properties.

Evaluation of deep oscillation therapy for the treatment of lumbar pain syndrome using motion capture systems: A systematic review

Low back pain is a painful disorder that prevents normal mobilization, increases muscle tension and whose first-line treatment is usually non-steroidal anti-inflammatory drugs, together with non-invasive manual therapies, such as deep oscillation therapy. This systematic review aims to investigate and examine the scientific evidence of the effectiveness of deep oscillation therapy in reducing pain and clinical symptomatology in patients with low back pain, through the use of motion capture technology. To carry out this systematic review, the guidelines of the PRISMA guide were followed. A literature search was performed from 2013 to March 2022 in the PubMed, Elsevier, Science Director, Cochrane Library, and Springer Link databases to collect information on low back pain, deep oscillation, and motion capture. The risk of bias of the articles was assessed using the Cochrane risk of bias tool. Finally, they were included 16 articles and 5 clinical trials which met the eligibility criteria. These articles discussed the effectiveness of deep oscillation therapy in reducing pain, eliminating inflammation, and increasing lumbar range of motion, as well as analyzing the use of motion capture systems in the analysis, diagnosis, and evaluation of a patient with low back pain before, during and after medical treatment. There is no strong scientific evidence that demonstrates the high effectiveness of deep oscillation therapy in patients with low back pain, using motion capture systems. This review outlines the background for future research directed at the use of deep oscillation therapy as a treatment for other types of musculoskeletal injuries.

BackMov: Individualized Motion Capture-Based Test to Assess Low Back Pain Mobility Recovery after Treatment

Low back pain (LBP) is a common issue that negatively affects a person's quality of life and imposes substantial healthcare expenses. In this study, we introduce the (Back-pain Movement) BackMov test, using inertial motion capture (MoCap) to assess lumbar movement changes in LBP patients. The test includes flexion-extension, rotation, and lateralization movements focused on the lumbar spine. To validate its reproducibility, we conducted a test-retest involving 37 healthy volunteers, yielding results to build a minimal detectable change (MDC) graph map that would allow us to see if changes in certain variables of LBP patients are significant in relation to their recovery. Subsequently, we evaluated its applicability by having 30 LBP patients perform the movement's test before and after treatment (15 received deep oscillation therapy; 15 underwent conventional therapy) and compared the outcomes with a specialist's evaluations. The test-retest results demonstrated high reproducibility, especially in variables such as range of motion, flexion and extension ranges, as well as velocities of lumbar movements, which stand as the more important variables that are correlated with LBP disability, thus changes in them may be important for patient recovery. Among the 30 patients, the specialist's evaluations were confirmed using a low-back-specific Short Form (SF)-36 Physical Functioning scale, and agreement was observed, in which all patients improved their well-being after both treatments. The results from the specialist analysis coincided with changes exceeding MDC values in the expected variables. In conclusion, the BackMov test offers sensitive variables for tracking mobility recovery from LBP, enabling objective assessments of improvement. This test has the potential to enhance decision-making and personalized patient monitoring in LBP management.

Efficacy of ultrasound versus short wave diathermy in the treatment of chronic low back pain in patients with lumbar disk herniation: a prospective randomized control study

BACKGROUND

Lumbar disk herniation (LDH) is a cause of chronic low back pain (CLBP) treated using physical therapy (PT), including exercise and physical modalities such as ultrasound (US) and short wave diathermy (SWD). Despite the use of US and SWD, there is inconclusive evidence on their efficacy. The aim of this study was to investigate the efficacy of US and SWD in the treatment of CLBP in patients with LDH.

METHODS

A prospective randomized control clinical study. Individuals with radicular CLBP and LDH on magnetic resonance imaging, presenting to the Physical and Rehabilitation Medicine Department were randomized into 3 treatment groups. All participants received 10 sessions of hotpack, transcutaneous nerve stimulation (TENS) and therapeutic exercises. In addition, Group 1 received 10 sessions of therapeutic US (1 MHz, 1.5W/cm2, 10 min), Group 2 SWD (27.12 MHz, wavelength 11.06 m, induction technique, 20 min) to the lower back. Group 3 (control group) received hotpack, TENS and therapeutic exercises alone. Visual analogue scale (VAS) for LBP, Modified Oswestry Disability Index (MODI) and Short Form 36 (SF-36) were evaluated pre and post treatment and at one and three months follow up.

RESULTS

In all groups, VAS for LBP and MODI improved with treatment and at the one and three month follow up (p < 0.001). In Groups 1 and 2, MODI scores continued to reduce at 1 and 3 months (p < 0.001 and p = 0.012 respectively). SF-36 physical, social function and pain parameters reduced in all groups (p < 0.05). Role limitation due to physical and emotional problems, emotional well-being, vitality and mental health improved in Groups 1 and 2 (p < 0.05).

CONCLUSIONS

Deep heating agents can be used as part of the physical therapy for CLBP in those with LDH with positive mid-term effects.

TRIAL REGISTRATION

NCT03835182, 02/04/2019.

A comparative study between transcutaneous electrical nerve stimulation and pulsed electromagnetic field therapy in the management of post-herpetic neuralgia of the sciatic nerve

OBJECTIVES

To compare the efficacy of pulsed electromagnetic field therapy (PEMFT) versus transcutaneous electrical nerve stimulation (TENS) in the treatment of post-herpetic neuralgia of the sciatic nerve.

METHODS

A double-blinded randomized clinical study has included 56 patients (18 males and 38 females). Participants were randomly and equally assigned into 2 groups. Both groups received conventional physical therapy treatment. Moreover, group (A) has an additional TENS, and group (B) had PEMFT. Both modalities were applied once daily, 3 times a week for 20 minutes for 8 successive weeks. Visual analog scale (VAS) and carbamazepine intake (CMI) dose have been assessed before and after interventions.

RESULTS

There was a significant decrease in VAS and CMI post-treatment in group A and B compared with that pretreatment (P > .001). The percent decrease in VAS and CMI in group A were 72.44% and 69.47% respectively and that for group B was 68.95% and 67.94% respectively. The findings revealed a non-significant difference in VAS and CMI (P > .05) between groups. The Means of VAS and CMI were (2.4 ± 0.78, 204.5 ± 16.76 and 2.67 ± 0.9, 210.57 ± 16.5) in group A and group B respectively. The mean difference for VAS and CMI was (-0.27 and -6.07) between groups post-treatment respectively.

CONCLUSION

Both TENS and PEMFT were effective and nearly equivalent in improving the post-herpetic neuralgia of the sciatic nerve as measured by in VAS and CMI. Clinical recommendations should be highlighted to instigate the using of TENS and PEMFT in the management of post-herpetic neuralgia of the sciatic nerve.

Substantiation of the additional prescription of magnetotherapy in the complex of rehabilitation of children with concomitant diseases of the nervous system during remission of cancer

Introduction. The increase in the number of children with oncological diseases requires development of effective methods of medical rehabilitation. Purpose: To determine the effectiveness of the use of low-frequency magnetotherapy (LFMT) in children with diseases of the nervous system, manifested in the period of remission of oncological diseases (OD) in the complex of sanatorium rehabilitation (SRR). Methods: Children with OD at the stage of rehabilitation in a sanatorium underwent a clinical examination: medical history, concomitant pathology, complaints, clinical examination, assessment of neurological status; instrumental studies: electroencephalography (EEG) - assessment of the bioelectrical activity of the brain; echoencephalography (EchoEG) - assessment of CSF dynamics; Doppler ultrasound (USDG) - assessment of cerebral circulation. For 25 children with concomitant diseases of the nervous system during the period of OD remission (17 people) and solid tumors (8 people), in addition to the general complex of SRR, magnetotherapy was prescribed for the cervical-collar zone according to the following method: magnetic induction 20 - 30 mT, exposure 10 - 15 minutes, every other day, for a course of 5 procedures. Results: The use of the therapeutic complex TFR with the additional prescription of magnetotherapy can reliably reduce childrenʹs complaints in remission of the OD for the impaired activity of the nervous system. According to the USDG indicators, statistically significant positive changes in cerebral hemodynamics were established. The results of ultrasound echoEG indicate the improvement of CSF dynamics. According to the EEG data, positive changes in the state of brain electrogenesis were established. Conclusion: The effectiveness of LFMT in children in the period of remission of oncohematological diseases with concomitant diseases of the nervous system has been substantiated. Keywords: children, oncological diseases, sanatorium rehabilitation, low-frequency magnetic therapy,

Extremely low frequency electromagnetic fields promote cognitive function and hippocampal neurogenesis of rats with cerebral ischemia

Extremely low frequency electromagnetic fields (ELF-EMF) can improve the learning and memory impairment of rats with Alzheimer’s disease, however, its effect on cerebral ischemia remains poorly understood. In this study, we established rat models of middle cerebral artery occlusion/reperfusion. One day after modeling, a group of rats were treated with ELF-EMF (50 Hz, 1 mT) for 2 hours daily on 28 successive days. Our results showed that rats treated with ELF-EMF required shorter swimming distances and latencies in the Morris water maze test than those of untreated rats. The number of times the platform was crossed and the time spent in the target quadrant were greater than those of untreated rats. The number of BrdU⁺ /NeuN⁺ cells, representing newly born neurons, in the hippocampal subgranular zone increased more in the treated than in untreated rats. Up-regulation in the expressions of Notch1, Hes1, and Hes5 proteins, which are the key factors of the Notch signaling pathway, was greatest in the treated rats. These findings suggest that ELF-EMF can enhance hippocampal neurogenesis of rats with cerebral ischemia, possibly by affecting the Notch signaling pathway. The study was approved by the Institutional Ethics Committee of Sichuan University, China (approval No. 2019255A) on March 5, 2019.