Danao-Camara, Theresa C.

Tabrah, F L

eVols at University of Hawaii at Manoa

The Use of Pulsed ElectromagneticFields (PEMF) in Osteoarthritis (OA) ofthe Knee Preliminary ReportTheresa Danao-Camara. MD, FACP. FACRStaff Rheumatologist, Straub Clinic & Hospital: Chief. Division of Internal Medicine Subspecialities.Straub Clinic & HospitalandFrank L. Tabrah. MDProfessor of Physiology and Emeritus Professor of Community Health.John A. Burns School of Medicine, University of Hawaii at Manoa; Medical Affairs Department.Straub Clinic & HospitalMagnets are widely used by arthritic patients forsymptom control. Clinical benefits have beenreported from the intermittent application 01pulsed electromagnetic fields to osteoarthriticjoi nts.’ However. puhl shed trials have usedcomplex electromagnetic fields generated beumhersomeexpensiveequipment. limiting trueportability and widespread use. We reportcomparable beneficial effects using a continuous sine ave input to 1-Ielmholz coils run onstandard household eleetricit\.Fifteen patients with osteoarthritis of at leastone knee as defThed by Altman4 were drawnfrom the outpatient Adult Rheumatology practice of one of the authors (TDC). Patients had tobe older than 18 years and symptomatic in thesubject knee for at least one year. Pain had to be incompletelyrelieved by analgesics. nonsteroidal antiinliammatory drugs(NSAIDs) and phsical therapy. No new treatments intra—artieularinjection into the subject Joint. PT. NSAIDs were allowed ss ithin amonth of. and during the study. Stable regimes were continued.Pregnant and premenopausal women not using contraception wereexcluded, as were patients with pacemakers or medical problemsjudged unstable.Subjects applied the supplied magnet to the designated knee forthree hours daily for thirty days. They then returned to the clinic forreevaluation, and to receise the second magnet, which was thensimilarly applied at home,Of the pairs of magnets sequentially used by each patient, onemagnet (hereinafter referred to as the “active magnet”) consisted of1-Ielmholz coils delivering a 0,4 milliTesla. peak to peak. electromagnetic field at 60 Hi. in a sine wave configuration (Fig I. i. Theother magnet appeai-ed identical in all respects. hut the fieldsaffecting the ioint s crc the earth’s magnetic field onl\ . plus ss hates er stray fields the individual might encounter in daily life ‘‘mac—to. e magnet. Subjects were assigned randomly to receive eithermagnet first.The folloving data were collected at baseline, at 3t) day’ tend oftreatment period \ Oh the first magnet. and at 60 days end oftreatment period with the second magnet patients assessment ofpain, and the patient’s assessment of function on a ten centimetervisual analog scale (VAS), minutes of morning stiffness of thesubject knee, range of motion. tenderness on an ordinal scale ofOto4 (0 no tenderness, 4 = withdrawal), swelling on an ordinal scaleof (3 to 4, knee circumference in cm, and time in seconds for thepatient to walk 50 feet, Neither the assessing physician nor thepatient knew which magnets were act is e or not.Of the fifteen patients enrolled and randoniiied. there were tourcurly withdrasn als from the eroup that receis ed the inact is e mac—net—one at three days and two at one week for lack of patient—(,(,ItoIueJ ni .00Figure 1 .— Clinical variables at baseline, after one month of activemagnet treatment and after one month of inactive magnet treatment.Baseline Active InactiveMagnet MagnetPain VAS 2.4 3.1Function VAS iPt: 4.3 6.7 4.8Function VAS iMD 5.1 6.7 5.2MornIng Stiffness m:nutes 33.5 6.0 21.5Loss of FROM tdegreest 5.4 2.0 5.2Tenderness )0’3) 0.8 0,4 1.2Swelling (0-3) 0.9 0.9Circumference )cmt 39.4 40,3 40,350 ft walk time seci 15,0 14.3 15.6Abbreviatons. useo in table: VAS — vsuai anaog scale’ Pt — patient assessment:MD— ohyslcIan assessment: FROM — ra’ge of motcn.288Integiuin ,e Pledaine: An -teadem,e !315r i/Pale:’ raiitinne,l iron, ;‘i eatio of the CCAM. JABSOM h Ii sin, that it in h a lvin the United Stat and intL rnatlonall\ in the i dihie ierit,lstudy oi altei nati\ e and enmplementarn therapie—. I Iii therm n eI ABSO\I belies Cs that it is important to educate in died -tud i-about th th epic the the patient ue u s-s hi h in iv u mcii et I oti Oni n on I a I pat c in ci thi t ns-ic h lies-c it i’ iii portent ti’ ste t a Dep rtnk n of 1111 i its\ledie inc it the John A Burn- School ot \Iedi iReferencesI •11I -1 ---‘LI -II T ‘lije Lr (Paired L/eerrnnagirerir Pie/Jr PLAJJ or ()srer,rrrrhrui(VA) ci the Knee Peelinn/noes.: Repr ct ‘eonnnued loon p 2815perceived effect Another withdrawal seas. for trave.l Ten patientscompleted the studsRe-cu Its obtained for the mon ti aed pa mmmc in are su ni ran sedTable I. Thirt.y iJavs of ictive. rnaCne.t use. improved pai.n, perceptionof function, and the range of motion of the joint, while reducing th.eduration of mornine stiffness in the knee and. increasune the raneemono n s 0 eites--t wa-’ noted on otnt ‘s c-lone reuniterence. cittone needed toss- of eelCartilace, like hone, has pie.zoe.l.ectffe properties leading to electrical outputs thought to he capahl.e of stimulating chondroe.yte.synthesis of matrix components Similar electrical changesoccur thrrsueh Faradas induction from apgiied t me-vats nc electromagnetic fields. Co,nple. chemreai responces ore detectable- s-sdx hours of PUMP exposureJ’Although pun mommy sutfness Intl r snge of mm in u-’pe m tohe beneficially affected by the active field used in this study, furthersainplins s-situ appropriate statdtieal evaluation is nccesrcar\ sIts alid njuantitatis- e coneluslvr,s Es-tended studtes ‘hould he desienedto histologicalls deterunne whether PUMP exposure has true chondroproteetive or repair potential in the intact joint, or both.-i ic flea it Transplant Ris iplents Raced inc Ce//ri/ui lie In, ‘i/to dr ‘InTheir Dniuircd Vr,n ; 1 Hcurisnr- Studs. i “nt/nm,! lion, p. Cd-?References1 Communication received from peychiathst Dr. Charles Bruce Greyson Univervty of Virgin:a astowiarded to author U Dr Gary E. Schwartz Department of Psychology and Medicine Univershy atAszona Jury 5 20002 For eeampe see Lode CT Psycb’at’r Corotea: or’s of Hear Tr”,’,m’u c’ Pain a:’:3 See ado iron WF era. Psvo5ooati-ooav ‘ Heat’ Trsrsoam Caro-ovres a‘9987223-228.4, Schwartz BEEt Ruseel LBS Do At Dynamtcai Systems Have Memory: Irpicahoun of the SystemicMemory Hypothesis for Science and Society In: Pribrsm KH Ed. Brain and Values: /s a BiologicalSc/ence of Va/ues Possible Hilesdale New Jersey: Lawrence Erlbaum Associates: 1998Harer I SR Pen P Orch t d Re r ‘ Ga — “ Cd e a’ B a LI cr0 ACaob-ioc,e. MA’Tve ‘‘1 PEss 1320p P , — ,, -.-. — —News-un NY Broaowe, BooRs, tel.7. Pearsalt P Schwartz GER Russek LBS C/ranges in Hear: Transpiunl Recipients the Parsi. iii thePersonalities of Their Donors Jot tntegrahve Med Fat. 2000.lOt a s I relt a (our otional ti,e In i ‘ne leco in , ‘ riot no 0noiu/ 8o -au ‘11 2 AJ Ii ,: n, ,lo H bci Au’s-y c I, s I- —‘l,rO -‘b -— L II - r-a,,:,, , or or II p r ji ,j r ,, a- n d I p “ ‘ ‘ or ‘o B II ‘10’ ‘ — : , ‘ ‘ - ‘References4,,y I H FI’ a I.l’(’)I ,,,300

The use of pulsed electromagnetic fields (PEMF) in osteoarthritis (OA) of the knee preliminary report.

http://evols.library.manoa.hawaii.edu/bitstream/10524/53743/1/2001-11p288-300.pdf

The use of pulsed electromagnetic fields (PEMF) in osteoarthritis (OA) of the knee preliminary report.

Abstract

Similar works

Full text

Available Versions

eVols at University of Hawaii at Manoa