Pulsed Electromagnetic Fields (PEMF) in treating SCI

[Lindox]

My vet often uses diathermy on SCI dogs.
BUT..only after IV steroids. And only if the owners are in dire straights monetarily and can't handle a referral to a neurosurgeon.

He uses everything really in that case. His experience with diathermy has been about 50% show benefit..and 50% don't. Of course the 50% that show benefit have already shown about a 50% improvement in their neurological status after having their IV.

He has even used it for months on some that just don't improve at all..he has to shave these little rectangular places on their sides where the plates are placed. He agrees it is very helpful with promoting blood flow and that in itself is a good thing.

When used in the ones that show major improvement in neurological functions quite soon after the IV..well many many once again do walk..albeit like little drunken sailors..they walk. Unfortunately many of these dogs end up with another disc blowing and it's either surgery..or a cart for life.

[Faye]

Medical profession definitely not a big fan of MP here in Perth West australia even though they have nothing else to offer.

Canada also doesn't use it anymore based on their own studies.

See info here: http://carecure.org/forum/showthread.php?t=55942&highlight=methylprdnisolone

Originally Posted by IanTPoulter
That may be true, but disregarding the personalities and politics of the matter is this statement true?

If so a valuable tool for use in acute spinal cord injuries may be overlooked.

I agree!

Point really is that scientists will go where the funding is, whether there are better therapies or not. The drug industry is a major stakeholder in this process:

The Broken Promise of American Medicine

[IanTPoulter]

As I remember, both power and frequency settings can vary considerably depending upon the specific therapeutic application. The Polish study in patients with acute SCI indicated the following parameters 27 Mhz, 600 pulses per sec, 65 usec per pulse. See http://www.healingtherapies.info/Diapulse&AcuteSCI.htm for specifics on this study.

Laurance, Ive seen that study. Its interesting to see though that all the subjects started PEMF treatment within 24 hours of injury.
The reason I asked about the frequency and magnetic flux is 2 fold.
I think Robert Becker believes frequencies between 40 and 60 Mhz are electromagnetic smog and should not be used as they may be detrimental. Also I am curious to compare the Tesla strength (magnetic flux) of the Dispulse with the PEMF device my daughter is currently using.

[IanTPoulter]

There has been a lot of talk over the years about several drugs that have the potential to replace methylprednisone, unfortunately, none of them have been brought to market. Specifically MDP, EPO and Minocycline.

Antiquity , My understand in that they are all drugs freely available if prescribed by Doctors, is that right?

[Wise Young]

Faye, as you know, there have been many discussions here about MP. It is not true that MP is not being used in Canada any more. It is still an "option" for spinal cord injury therapies. In Alberta, it is no longer being used, by the choice of the doctors there. I recently sent a detailed literature review to the Canadian FDA on this question. Wise.

Canada also doesn't use it anymore based on their own studies.

See info here: http://carecure.org/forum/showthread.php?t=55942&highlight=methylprdnisolone

Originally Posted by IanTPoulter
That may be true, but disregarding the personalities and politics of the matter is this statement true?

If so a valuable tool for use in acute spinal cord injuries may be overlooked.

I agree!

Point really is that scientists will go where the funding is, whether there are better therapies or not. The drug industry is a major stakeholder in this process:

The Broken Promise of American Medicine

[antiquity]

Antiquity , My understand in that they are all drugs freely available if prescribed by Doctors, is that right?

Hi Ian, sorry for the misunderstanding. I meant FDA approved for the treatment of acute SCI. Yes, EPO and Minocycline are already approved for other indications.

[Laurance]

Diapulse

Hi Ian:

It’s been several years since I investigated Diapulse and given my “Teflon” memory, in which everything slides off, I just can’t remember what the magnetic flux generated by the device would be. Perhaps, you should check with the Diapulse Corporation. As I understand, different PEMF devices can vary greatly in their physiological impact, reflecting the old adage that “the devil is in the details.” It is difficult to generalize results between devices.

Jean Peduzzi, Wayne State (Michigan) told me that she had tested the Diapulse device in SCI rat models and results were negative. However, as I understand, these rats were irradiated over their entire bodies, in contrast to stimulating localized, differential effects when place over one part of the human body. In other words, if you were attempting to stimulate, for example, preferential blood flow to an injured spinal cord, it wouldn’t be any good for the whole body to receive the PEMF energy.

The device was also used with several of Dr. Carlo’s Lima’s olfactory-tissue transplantation patients.

My long-term speculation is that various forms of electromagnetic energy will be used to enhance the effectiveness of various stem and other cell transplantation. For example, Dr. Rochkind (Israel) examined the effects of embryonic spinal-cord-cell transplantation and laser therapy on recovery after SCI in rats (Neurol Res 2002; 24(4)). Results indicated that the best recovery of limb function and gait performance, electrophysiological conduction, and histological parameters (indicating implanted tissue growth) occurred after cell implantation and laser radiation.

In another example, Dr. Kimberly Byrnes et al (Washington, DC) demonstrated that laser irradiation alters gene expression of olfactory ensheathing cells (Lasers Surg Med, July 21, 2005).

This work is increasingly relevant because, as presented by Albert Bohbot at the recent Hong Kong SCI meeting, a number of patients, who have had neuronal, olfactory, or stem-cell tissue transplanted into their injured cords, have augmented transplantation with his laserpuncture therapy.

Finally, NASA scientists suggest that electromagnetic fields stimulate the growth of neuronal stem cells.

The big breakthroughs are going to be made when we open-mindedly pull together the divergent pieces of the puzzle. Most scientists can not do that because they are myopically focusing on only one piece of the puzzle. Given Wise’s background, he is perhaps an exception.

I have great respect for the writings of Robert Becker.

Laurance

[Wise Young]

Laurance, thanks so much for the wealth of information. I did not know, for example, that Jean Peduzzi tried the Diapulse on rats.

The mechanisms of the pulsed electromagnetic or laser therapies are not well understood of course but some recent studies are beginning to lend credence to the hypothesis that pulsed energy delivery to cells change cAMP and also calcium flux into cells. By the way, there is continued research on the subject that Ian and others may be interested in. There is continued controversy, however, as several of the papers contradict each other.

1. Eraslan G, Bilgili A, Akdogan M, Yarsan E, Essiz D and Altintas L (2006). Studies on antioxidant enzymes in mice exposed to pulsed electromagnetic fields. Ecotoxicol Environ Saf In this study, 56 female albino mice weighing 30-35g were used. The animals were divided into a control and an experimental group. The animals in the experimental group were subjected to a pulsed electromagnetic field (PEMF) with a field magnitude of 50Hz and 2mT for 8h each day between 0900 and 1700 for 90 days. In both control and experimental groups, blood was sampled at 45, 60, and 90 days in heparinized tubes and erythrocyte malondialdehyde levels, and superoxide dismutase, glutathione peroxidase, catalase, and glucose-6-phosphate dehydrogenase activities were determined. The results revealed that the PEMF applied chronically within the given period and field magnitude does not cause oxidative damage. Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Erciyes, Kayseri, Turkey. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16504294
2. Sakai Y, Patterson TE, Ibiwoye MO, Midura RJ, Zborowski M, Grabiner MD and Wolfman A (2006). Exposure of mouse preosteoblasts to pulsed electromagnetic fields reduces the amount of mature, type I collagen in the extracellular matrix. J Orthop Res 24: 242-53. We tested the hypothesis that exposure of a mouse preosteoblast cell line to pulsed electromagnetic fields (PEMF) would affect components of the extracellular matrix. We report that exposure of MC3T3-E1 cells to a single PEMF waveform significantly reduced the amount of mature, alpha1(I) collagen in the extracellular matrix (ECM) and the conditioned medium, without affecting the amount of total ECM protein. This decrease was not due to changes in the steady-state level of Col1A1 mRNA or to degradation of mature collagen. We then tested the effect of three distinct PEMF waveforms, two orthogonal coil orientations, and two waveform amplitude levels on the amount of alpha1(I) collagen in the conditioned medium. A sequence of factorial ANOVAs and stepwise regression modeling revealed that the period (duration) of the individual pulses accounted for a significant proportion of the variance associated with the amount of alpha1(I) collagen in the conditioned medium. The total variance accounted for, however, was small (R(2)=0.155, p<0.001 and R(2)=0.172, p<0.001, in the horizontal and vertical orientations, respectively). The positive and negative regression coefficients for the coil orientations revealed that the influence of pulse period was significantly different for the orthogonal coil orientations (p<0.001). The findings imply that the dominant influence of PEMF on the amount of mature, alpha1(I) collagen in the ECM is related to variables other than those expressed in the time-amplitude domain. The results provide objective direction toward identifying waveform characteristics that contribute to the observed between-waveform differences with regard to collagen. Advances in this area may lead toward improving waveforms and waveform delivery protocols. Department of Biomedical Engineering, Lerner Research Institute of The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16435357
3. Taylor KF, Inoue N, Rafiee B, Tis JE, McHale KA and Chao EY (2006). Effect of pulsed electromagnetic fields on maturation of regenerate bone in a rabbit limb lengthening model. J Orthop Res 24: 2-10. To study the effect of applying pulsed electromagnetic fields (PEMF) during the consolidation phase of limb lengthening, a mid-tibial osteotomy was performed in 18 adult New Zealand White rabbits and an external fixator was applied anteromedially. Animals were randomly assigned to treatment and control groups. After a 7-day latency period, the tibiae were distracted 0.5 mm every 12 h for 10 days. The treatment group received a 20-day course of PEMF for 60 min daily, coinciding with initiation of the consolidation phase. The control group received sham PEMF. Radiographs were performed weekly after distraction. Animals were euthanized 3 weeks after the end of distraction. Radiographic analysis revealed no significant difference in regenerate callus area between treatment and control tibiae immediately after distraction, at 1 week, 2 weeks, or 3 weeks after distraction ( p = 0.71, 0.22, 0.44, and 0.50, respectively). There was also no significant difference in percent callus mineralization ( p = 0.96, 0.69, 0.99, and 0.99, respectively). There was no significant difference between groups with respect to structural stiffness ( p = 0.80) or maximal torque to failure ( p = 0.62). However, there was a significant positive difference in mineral apposition rate between groups during the interval 1-2 weeks post-distraction ( p < 0.05). This difference was no longer evident by the interval 2-3 weeks post-distraction. While PEMF applied during the consolidation phase of limb lengthening did not appear to have a positive effect on bone regenerate, it increased osteoblastic activity in the cortical bone adjacent to the distraction site. Since the same PEMF signal was reported to be beneficial in the rabbit distraction osteogenesis when applied during distraction phase and consolidation phase, application of PEMF in the early phase may be more effective. Further work is necessary to determine optimal timing of the PEMF stimulation during distraction osteogenesis. Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Washington, DC 20307-5001, USA. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16419963
4. Luna Gonzalez F, Lopez Arevalo R, Meschian Coretti S, Urbano Labajos V and Delgado Rufino B (2005). Pulsed electromagnetic stimulation of regenerate bone in lengthening procedures. Acta Orthop Belg 71: 571-6. Distraction osteogenesis for limb lengthening represents the treatment of choice in patients with small stature or limb length discrepancies. Bone lengthening and callus formation requires a long therapy. Pulsed electromagnetic fields (PEMF) are normally used to enhance osteogenesis in patients with non-unions. In this study we investigated whether pulsed electromagnetic fields could be used effectively to encourage callus formation and maturation during limb lengthening procedures. Thirty patients underwent bilateral bone lengthening of the humerus, femur or tibia. At day 10 after surgery, PEMF stimulation was started on one side, for 8 hours/day. Stimulated distraction sites exhibited earlier callus formation and progression, and a higher callus density compared to non-stimulated sites. External fixation could be removed on average one month earlier in PEMF stimulated bones. Our results show that the use of pulsed electromagnetic fields stimulation during limb lengthening allows shortening the time of use of the external fixation. Servicio de Traumatologia, Hospital Clinico Universitario "Virgen de la Victoria", Malaga, Spain. glupsnif@hotmail.com http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16305082
5. Kroeling P, Gross AR and Goldsmith CH (2005). A Cochrane review of electrotherapy for mechanical neck disorders. Spine 30: E641-8. STUDY DESIGN: Systematic review. OBJECTIVE: To assess whether electrotherapy relieves pain or improves function/disability in adults with mechanical neck disorders (MND). SUMMARY OF BACKGROUND DATA: The effectiveness of electrotherapy as a physiotherapy option has remained unclear. METHODS: Databases were searched from root to March 2003. Independent reviewers conducted selection, data abstraction, and quality assessment. Relative risk and standard mean differences were calculated. RESULTS: Fourteen comparisons were included. For the pain outcome, we found limited evidence of benefit, ie, pulsed electromagnetic field (PEMF) therapy resulted in only immediate post-treatment pain relief for chronic MND and acute whiplash (WAD). Other findings included unclear or conflicting evidence (Galvanic current for acute or chronic occipital headache; iontophoresis for acute, subacute WAD; TENS for acute WAD, chronic MND; PEMF for medium- or long-term effects in acute WAD, chronic MND); and limited evidence of no benefit (diadynamic current for reduction of trigger point tenderness in chronic MND, cervicogenic headache; permanent magnets for chronic MND; electrical muscle stimulation (EMS) for chronic MND). CONCLUSIONS: In pain as well as other outcomes, the evidence for treatment of acute or chronic MND by different forms of electrotherapy is either lacking, limited, or conflicting. Ludwig-Maximilians-University, Munich, Germany. kroeling@med.uni-muenchen.de http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16261102
6. Kaszuba-Zwoinska J, Gil K, Ziomber A, Zaraska W, Pawlicki R, Krolczyk G, Matyja A and Thor PJ (2005). Loss of interstitial cells of Cajal after pulsating electromagnetic field (PEMF) in gastrointestinal tract of the rats. J Physiol Pharmacol 56: 421-32. Exposure to the magnetic field has remarkably increased lately due to fast urbanization and widely available magnetic field in diagnosis and treatment. However, biological effects of the magnetic field are not well recognized. The myoelectric activity recorded from the gastrointestinal and urinary systems is generated by specialized electrically active cells called interstitial cells of Cajal (ICCs). Thus it seems rational that ICC have significant vulnerability to physical factors like an electromagnetic field. The aim of this study was to evaluate the influence of pulsating electromagnetic field (PEMF) (frequency 10 kHz, 30ms, 300 muT burst, with frequency 1Hz) on ICCs density in the rat gastrointestinal tract. Rats were divided into two groups (n=32). The first group was exposed to PEMF continuously for 1, 2, 3, and 4 weeks (n = 16), and the second group (n=16) served as a control. Tissue samples of the rat stomach, duodenum and proximal colon were fixed and paraffin embedded. The tangential sections of 5 microm thickness were stained immunohistochemically with anti-c-Kit (sc-168) antibody and visualized finally by DAB as chromogen (brown end product). C-Kit positive branched ICC-like cells were detected under the light microscope, distinguished from the c-kit-negative non-branched smooth muscle cells and from the c-kit positive but non-branched mast cells and quantitatively analyzed by MultiScan computer program. Apoptosis detection was performed with rabbit anti-Bax polyclonal antibody (Calbiochem, Germany) and LSAB 2 visualization system. The surface of c-Kit immunopositive cells decreased after exposure to PEMF in each part of the gastrointestinal tract. Reduced density of ICCs was related to exposure time. The most sensitive to PEMF were ICCs in the fundus of the stomach and in the duodenum, less sensitive were ICCs in the colon and pacemaker areas of the stomach. No marked changes in ICC density in the pyloric part of the stomach were observed. We demonstrate that the PEMF induced apoptosis dependent decrease in ICC expression. Department of Pathophysiology, Jagiellonian University, Krakow, Poland. jkaszuba@cm-uj.krakow.pl http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16204764
7. Hannay G, Leavesley D and Pearcy M (2005). Timing of pulsed electromagnetic field stimulation does not affect the promotion of bone cell development. Bioelectromagnetics 26: 670-6. Pulsed electromagnetic field (PEMF) devices have been used clinically to promote the healing of surgically resistant fractures in vivo. However, there is a sparsity of data on how the timing of an applied PEMF effects the osteogenic cells that would be present within the fracture gap. The purpose of this study was to examine the response of osteoblast-like cells to a PEMF stimulus, mimicking that of a clinically available device, using four protocols for the timing of the stimulus. The PEMF signal consisted of a 5 ms pulse burst (containing 20 pulses) repeated at 15 Hz. Cultures of a human osteosarcoma cell line, SaOS-2, were exposed to the four timing protocols, each conducted over 3 days. Protocol one stimulated the cells for 8 h each day, protocol two stimulated the cells for 24 h on the first day, protocol three stimulated the cells for 24 h on the second day, and protocol four stimulated the cells for 24 h on the third day. Cells were seeded with either 25,000 or 50,000 cells/well (24-well cell culture plates). All assays showed reduced proliferation and increased differentiation (alkaline phosphatase activity) in the PEMF stimulated cultures compared with the control cultures, except for protocol four alkaline phosphatase measurements. No clear trend was observed between the four protocols; however this may be due to cell density. The results indicated that an osteoblast-like cell line is responsive to a 15 Hz PEMF stimulus, which will stimulate the cell line to into an increasing state of maturity. School of Engineering Systems & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. g.hannay@qut.edu.au http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16189825
8. Ahmadian S, Zarchi SR and Bolouri B (2006). Effects of extremely-low-frequency pulsed electromagnetic fields on collagen synthesis in rat skin. Biotechnol Appl Biochem 43: 71-5. To investigate the effects of extremely-low-frequency PEMFs (pulsed electromagnetic fields) on the synthesis of epidermal collagen, six groups of animals each consisting of eight mature male rats were selected randomly: one group for the control and five for the test. Using a parallel set of Helmholtz coils, a uniform field intensity of 2 mT at different frequencies of 25, 50 and 100 Hz yielded the most effective frequency to be 25 Hz. Then, at this frequency, two different field intensities of 1 and 4 mT were applied. The treatment time of 2.5 h/day lasted for 8 days, keeping the same procedure for the control group, except with the field turned off. On the ninth day, the rats were killed and skin samples from the dorsal region were taken for collagen assessment by measuring hydroxyproline content using the Stegemann-Stalder [(1967) Clin. Chim. Acta 8, 267-273] method. The results indicated that a PEMF of 2 mT at 25 Hz increased the collagen synthesis (P < 0.05). The other intensities and frequency setting did not have any noticeable effect; however, at a frequency of 25 Hz at 4 mT, collagen increase was also noticed. It was concluded that at 25 Hz under a field setting of 2 mT for the duration of 8 days, stimulation of skin at 2.5 h/day would cause increase in collagen synthesis in rat skin. Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Enghelab Ave., P.O. Box 13145-1384, Tehran, Iran. ahmadian@ibb.ut.ac.ir http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16162095
9. Fini M, Giavaresi G, Torricelli P, Cavani F, Setti S, Cane V and Giardino R (2005). Pulsed electromagnetic fields reduce knee osteoarthritic lesion progression in the aged Dunkin Hartley guinea pig. J Orthop Res 23: 899-908. An experimental in vivo study was performed to test if the effect of Pulsed Electromagnetic Fields (PEMFs) on chondrocyte metabolism and adenosine A2a agonist activity could have a chondroprotective effect on the knee of Dunkin Hartley guinea-pigs of 12 months with spontaneously developed osteoarthritis (OA). After a pilot study, 10 animals were randomly divided into two groups: PEMF-treated group (6 h/day for 3 months) and Sham-treated group. Microradiography and histomorphometry were performed on the entire articular surface of knee joints used in evaluating chondropathy severity, cartilage thickness (CT), cartilage surface Fibrillation Index (FI), subchondral bone plate thickness (SBT) and histomorphometric characteristics of trabecular epiphyseal bone. The PEMF-treated animals showed a significant reduction of chondropathy progression in all knee examined areas (p<0.05). CT was significantly higher (p<0.001) in the medial tibia plateaus of the PEMF-treated group when compared to the Sham-treated group. The highest value of FI was observed in the medial tibia plateau of the Sham-treated group (p<0.05). Significant lower values were observed in SBT of PEMF-treated group in comparison to Sham-treated group in all knee examined areas (p<0.05). The present study results show that PEMFs preserve the morphology of articular cartilage and slower the progression of OA lesions in the knee of aged osteoarthritic guinea pigs. The chondroprotective effect of PEMFs was demonstrated not only in the medial tibial plateau but also on the entire articular surface of the knee. Department of Experimental Surgery, Codivilla-Putti Research Institute, Rizzoli Institute of Orthopaedics, Via di Barbiano, 1/10, 40136 Bologna, Italy. milena.fini@ior.it http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16023006
10. Guven M, Gunay I, Ozgunen K and Zorludemir S (2005). Effect of pulsed magnetic field on regenerating rat sciatic nerve: an in-vitro electrophysiologic study. Int J Neurosci 115: 881-92. Some experimental studies report that low-frequency pulsed electromagnetic field (PEMF) stimulation may accelerate regeneration in peripheral nerves. In the present study, effects of PEMF on the regeneration of the crushed rat sciatic nerves were investigated with histological and in-vitro electrophysiological methods (sucrose-gap). After crush injury of the sciatic nerves, rats were divided into 5, 15, 25, 38 day-groups and exposed to PEMF (1.5 h/day, intensity; 1.5 mT, consecutive frequency; 10-40-100 Hz). In the 15th day post crush, compound action potential (CAP) amplitude was measured as 5.5+/-1 mV (crush group) and 5.4+/-1.2 mV (crush+PEMF group). In addition, half width of CAP extended ~3 fold in both groups and frequency-dependent amplitude inhibition (FDI) decreased approximately 20% at 100 Hz. In the 38th day, amplitude of CAP, half width of CAP and FDI were measured nearly intact nerve values in both groups. In histological examinations, Wallerian degeneration was observed similar progress between both groups. The results were compared between crush and crush + PEMF groups, it was found that the effect of PEMF was not significant. The authors conclude that PEMF were ineffective on rat sciatic nerve regeneration. Cukurova University, Medical School, Department of Biophysics, Adana, Turkey. guvenm@cu.edu.tr http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16019581
11. Sutbeyaz ST, Sezer N and Koseoglu BF (2006). The effect of pulsed electromagnetic fields in the treatment of cervical osteoarthritis: a randomized, double-blind, sham-controlled trial. Rheumatol Int 26: 320-4. The purpose of this study was to evaluate the effect of electromagnetic field therapy (PEMF) on pain, range of motion (ROM) and functional status in patients with cervical osteoarthritis (COA). Thirty-four patients with COA were included in a randomized, double-blind study. PEMF was administrated to the whole body using a mat 1.8x0.6 m in size. During the treatment, the patients lay on the mat for 30 min per session, twice a day for 3 weeks. Pain levels in the PEMF group decreased significantly after therapy (p<0.001), but no change was observed in the placebo group. The active ROM, paravertebral muscle spasm and neck pain and disability scale (NPDS) scores improved significantly after PEMF therapy (p<0.001) but no change was observed in the sham group. The results of this study are promising, in that PEMF treatment may offer a potential therapeutic adjunct to current COA therapies in the future. Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Turk ocagi S No: 3 Sihhiye, Ankara, Turkey. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15986086
12. Thamsborg G, Florescu A, Oturai P, Fallentin E, Tritsaris K and Dissing S (2005). Treatment of knee osteoarthritis with pulsed electromagnetic fields: a randomized, double-blind, placebo-controlled study. Osteoarthritis Cartilage 13: 575-81. OBJECTIVE: The investigation aimed at determining the effectiveness of pulsed electromagnetic fields (PEMF) in the treatment of osteoarthritis (OA) of the knee by conducting a randomized, double-blind, placebo-controlled clinical trial. DESIGN: The trial consisted of 2h daily treatment 5 days per week for 6 weeks in 83 patients with knee OA. Patient evaluations were done at baseline and after 2 and 6 weeks of treatment. A follow-up evaluation was done 6 weeks after treatment. Activities of daily living (ADL), pain and stiffness were evaluated using the Western Ontario and McMaster Universities (WOMAC) questionnaire. RESULTS: Within group analysis revealed a significant improvement in ADL, stiffness and pain in the PEMF-treated group at all evaluations. In the control group there was no effect on ADL after 2 weeks and a weak significance was seen after 6 and 12 weeks. Significant effects were seen on pain at all evaluations and on stiffness after 6 and 12 weeks. Between group analysis did not reveal significant improvements over time. Analysis of ADL score for the PEMF-treated group revealed a significant correlation between less improvement and increasing age. Analysis of patients <65 years using between group analysis revealed a significant improvement for stiffness on treated knee after 2 weeks, but this effect was not observed for ADL and pain. CONCLUSIONS: Applying between group analysis we were unable to demonstrate a beneficial symptomatic effect of PEMF in the treatment of knee OA in all patients. However, in patients <65 years of age there is significant and beneficial effect of treatment related to stiffness. Department of Geriatri and Rheumatology, Glostrup Hospital, 2600 Glostrup, Denmark. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15979009
13. Midura RJ, Ibiwoye MO, Powell KA, Sakai Y, Doehring T, Grabiner MD, Patterson TE, Zborowski M and Wolfman A (2005). Pulsed electromagnetic field treatments enhance the healing of fibular osteotomies. J Orthop Res 23: 1035-46. This study tested the hypothesis that pulsed electromagnetic field (PEMF) treatments augment and accelerate the healing of bone trauma. It utilized micro-computed tomography imaging of live rats that had received bilateral 0.2 mm fibular osteotomies (approximately 0.5% acute bone loss) as a means to assess the in vivo rate dynamics of hard callus formation and overall callus volume. Starting 5 days post-surgery, osteotomized right hind limbs were exposed 3 h daily to Physio-Stim PEMF, 7 days a week for up to 5 weeks of treatment. The contralateral hind limbs served as sham-treated, within-animal internal controls. Although both PEMF- and sham-treatment groups exhibited similar onset of hard callus at approximately 9 days after surgery, a 2-fold faster rate of hard callus formation was observed thereafter in PEMF-treated limbs, yielding a 2-fold increase in callus volume by 13-20 days after surgery. The quantity of the new woven bone tissue within the osteotomy sites was significantly better in PEMF-treated versus sham-treated fibulae as assessed via hard tissue histology. The apparent modulus of each callus was assessed via a cantilever bend test and indicated a 2-fold increase in callus stiffness in the PEMF-treated over sham-treated fibulae. PEMF-treated fibulae exhibited an apparent modulus at the end of 5-weeks that was approximately 80% that of unoperated fibulae. Overall, these data indicate that Physio-Stim PEMF treatment improved osteotomy repair. These beneficial effects on bone healing were not observed when a different PEMF waveform, Osteo-Stim, was used. This latter observation demonstrates the specificity in the relationship between waveform characteristics and biological outcomes. Department of Biomedical Engineering, The Orthopaedic Research Center, Lerner Research Institute of The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. midura@bme.ri.ccf.org http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15936919
14. Chang K, Chang WH, Huang S and Shih C (2005). Pulsed electromagnetic fields stimulation affects osteoclast formation by modulation of osteoprotegerin, RANK ligand and macrophage colony-stimulating factor. J Orthop Res 23: 1308-14. Electromagnetic stimulation has been documented to treat recalcitrant problems of musculoskeletal system. Yet, the underlying mechanisms are not completely understood. In this study, we investigated effect of pulsed electromagnetic fields (PEMF) with parameters modified from clinical bone growth stimulator on osteoclast formation, bone resorption, and cytokines associated with osteoclastogenesis. Marrow cells were harvested from both femora and tibiae of 6 week-old mice and cultured in 8-well chamber slides or 16-well calcium phosphate apatite-coated multitest slides. After 1-day incubation, marrow cells were exposed to PEMF at different electric field intensities for 2h/day and continued for 9 days. Osteoprotegerin (OPG), receptor activator of NFkappaB-ligand (RANKL) and macrophage colony-stimulating factor (M-CSF) concentrations of each group were determined after PEMF stimulation. Osteoclast identity was confirmed by both tartrate resistant acid phosphatase (TRAP) stain and bone resorption assay. A statistically significant increase and decrease of osteoclastogenesis and bone resorption areas were found when exposed to PEMF with different intensities. Besides, consistent correlations among OPG, RANKL, M-CSF, osteoclast numbers, and bone resorption after exposure to different intensities of PEMF were observed. These data demonstrated that PEMF with different intensities could regulate osteoclastogenesis, bone resorption, OPG, RANKL, and M-CSF concentrations in marrow culture system. Department of Biomedical Engineering, Chung-Yuan Christian University, Chung-Li 32023, Taiwan. kylechang@nhri.org.tw http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15913941
15. Kumar VS, Kumar DA, Kalaivani K, Gangadharan AC, Raju KV, Thejomoorthy P, Manohar BM and Puvanakrishnan R (2005). Optimization of pulsed electromagnetic field therapy for management of arthritis in rats. Bioelectromagnetics 26: 431-9. Studies were undertaken to find out the effects of low frequency pulsed electromagnetic field (PEMF) in adjuvant induced arthritis (AIA) in rats, a widely used model for screening potential therapies for rheumatoid arthritis (RA). AIA was induced by an intradermal injection of a suspension of heat killed Mycobacterium tuberculosis (500 mug/0.1 ml) into the right hind paw of male Wistar rats. This resulted in swelling, loss of body weight, increase in paw volume as well as the activity of lysosomal enzymes viz., acid phosphatase, cathepsin D, and beta-glucuronidase and significant radiological and histological changes. PEMF therapy for arthritis involved optimization of three significant factors, viz., frequency, intensity, and duration; and the waveform used is sinusoidal. The use of factorial design in lieu of conventional method resulted in the development of an ideal combination of these factors. PEMF was applied using a Fransleau-Braunbeck coil system. A magnetic field of 5 Hz x 4 muT x 90 min was found to be optimal in lowering the paw edema volume and decreasing the activity of lysosomal enzymes. Soft tissue swelling was shown to be reduced as evidenced by radiology. Histological studies confirmed reduction in inflammatory cells infiltration, hyperplasia, and hypertrophy of cells lining synovial membrane. PEMF was also shown to have a membrane stabilizing action by significantly inhibiting the rate of release of beta-glucuronidase from lysosomal rich and sub-cellular fractions. The results indicated that PEMF could be developed as a potential therapy in the treatment of arthritis in humans. Department of Pharmacology and Toxicology, Madras Veterinary College, Vepery, Chennai, India. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15887257
16. Kroeling P, Gross A and Houghton PE (2005). Electrotherapy for neck disorders. Cochrane Database Syst Rev CD004251. BACKGROUND: Neck disorders are common, disabling and costly. The effectiveness of electrotherapy as a physiotherapy option has remained unclear. OBJECTIVES: To assess whether electrotherapy, either alone or in combination with other treatments, relieves pain, or improves function/disability, patient satisfaction, and global perceived effect in adults with mechanical neck disorders (MND). SEARCH STRATEGY: Computer-assisted searches of bibliographic databases: CENTRAL, MEDLINE, EMBASE, MANTIS, CINAHL, and ICL, without language restrictions, from their beginning to March 2003. SELECTION CRITERIA: Randomised or controlled clinical trials with quasi-randomisation (alternate allocation, case record numbers, dates of birth, etc.), in any language, investigating the effects of electrotherapy as a treatment for MND. DATA COLLECTION AND ANALYSIS: At least two authors independently conducted citation identification, study selection, data abstraction, and methodological quality assessment. Using a random-effects model, relative risk, and standardized mean differences were calculated. The reasonableness of combining studies was assessed on clinical and statistical grounds. Due to heterogeneity, pooled effect measures were not calculated. MAIN RESULTS: Fourteen comparisons (525 people with MND), in 11 publications, were included in this review. The analysis was limited by underpowered low quality trials, paucity of literature, and heterogeneity of treatment subtypes. The results for the electrotherapy subtypes are: Limited evidence of benefit: low or high frequency pulsed electromagnetic field (PEMF) compared to placebo, provides immediate post treatment pain relief only for chronic MND, acute whiplash (WAD) Unclear or conflicting evidence: direct and modulated Galvanic current compared to other treatments for pain in acute, subacute, chronic occipital headache iontophoresis compared to other treatments for pain, RTW, and self-assessment of overall outcome in acute, subacute WAD TENS compared to placebo for pain in acute WAD, chronic MND PEMF compared to placebo for medium or long term effect on pain, patient assessment of improvement, ADL in acute WAD, chronic MND Limited evidence of no benefit: diadynamic current compared to placebo for reduction of trigger point tenderness in chronic MND with radicular findings, cervicogenic headache permanent magnets compared to a placebo for pain in chronic MND electric muscle stimulation compared to a sham control for pain in chronic MND. AUTHORS' CONCLUSIONS: We can not make any definitive statements on electrotherapy for MND. The current evidence on Galvanic current (direct or pulsed), iontophoresis, TENS, EMS, PEMF and permanent magnets is either lacking, limited, or conflicting. Possible new trials on these interventions should have larger patient samples and include more precise standardization and description of all treatment characteristics. Dept. of Physical Medicine and Rehabilitation, Ludwig-Maximilians-University of Munich, Marchionini-Str. 17, D-81377 Munchen, Germany. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15846703
17. De Mattei M, Gagliano N, Moscheni C, Dellavia C, Calastrini C, Pellati A, Gioia M, Caruso A and Stabellini G (2005). Changes in polyamines, c-myc and c-fos gene expression in osteoblast-like cells exposed to pulsed electromagnetic fields. Bioelectromagnetics 26: 207-14. Pulsed electromagnetic field (PEMF) stimulation promotes the healing of fractures in humans, though its effect is little known. The processes of tissue repair include protein synthesis and cell differentiation. The polyamines (PA) are compounds playing a relevant role in both protein synthesis processes and cell differentiation through c-myc and c-fos gene activation. Since several studies have demonstrated that PEMF acts on embryonic bone cells, human osteoblast-like cells and osteosarcoma TE-85 cell line, in this study we analyzed the effect on cell PAs, proliferation, and c-myc and c-fos gene expression of MG-63 human osteoblast-like cell cultures exposed to a clinically useful PEMF. The cells were grown in medium with 0.5 or 10% fetal calf serum (FCS). c-myc and c-fos gene expressions were determined by RT-PCR. Putrescine (PUT), spermidine (SPD), or spermine (SPM) levels were evaluated by HPLC. [(3)H]-thymidine was added to cultures for DNA analysis. The PEMF increased [(3)H]-thymidine incorporation (P < or = .01), while PUT decreased after treatment (P < or = .01); SPM and SPD were not significantly affected. c-myc was activated after 1 h and downregulated thereafter, while c-fos mRNA levels increased after 0.5 h and then decreased. PUT, SPD, SPM trends, and [(3)H]-thymidine incorporation were significantly related to PEMF treatment. These results indicate that exposure to PEMF exerts biological effects on the intracellular PUT of MG-63 cells and DNA synthesis, influencing the genes encoding c-myc and c-fos gene expression. These observations provide evidence that in vitro PEMF affects the mechanisms involved in cell proliferation and differentiation. Department of Morphology and Embryology, Section of Histology and Embryology, University of Ferrara, Italy. http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15768429
18. Saltzman C, Lightfoot A and Amendola A (2004). PEMF as treatment for delayed healing of foot and ankle arthrodesis. Foot Ankle Int 25: 771-3. BACKGROUND: Arthrodesis is the most common surgical treatment for foot and ankle arthritis. In adults, these procedures are associated with a 5% to 10% rate of nonunion. Pulsed electromagnetic field (PEMF) stimulation was approved by the Federal Drug Administration (FDA) for treatment of delayed unions after long-bone fractures and joint arthrodesis. The purpose of this study was to examine the results of PEMF treatment for delayed healing after foot and ankle arthrodesis. METHODS: Three hundred and thirty-four foot and ankle arthrodeses were done. Nineteen resulted in delayed unions that were treated with a protocol of immobilization, limited weightbearing, and PEMF stimulation for a median of 7 (range 5 to 27) months. All patients were followed clinically and radiographically. RESULTS: The use of PEMF, immobilization, and limited weightbearing to treat delayed union after foot and ankle arthrodesis was successful in 5 of 19 (26%) patients. Of the other 14 patients with nonunions, nine had revision surgery with autogenous grafting, continued immobilization, and PEMF stimulation. Seven of these eventually healed at a median of 5.5 (range 2 to 26) months and two did not heal. One patient had a below-knee amputation, and four refused further treatment. CONCLUSIONS: The protocol of PEMF, immobilization, and limited weightbearing had a relatively low success rate in this group of patients. We no longer use this protocol alone to treat delayed union after foot and ankle arthrodesis. University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. charles-saltzman@uiowa.edu http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15574233

[Cherry]

The big breakthroughs are going to be made when we open-mindedly pull together the divergent pieces of the puzzle. Most scientists can not do that because they are myopically focusing on only one piece of the puzzle. Given Wise’s background, he is perhaps an exception.


How true is that!

[albert bohbot]

In relation to Laurance's post, we posted on our website (www.laserponcture.org) the video of Ovidiu who had Dr Huang's therapy and laserpuncture.

Check out the "videos" and look for the name of "Ovidiu".

Albert