The Library

Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review

Tools

McCarthy, Christopher James, Callaghan, Michael James and Oldham, Jacqueline Anne . (2006) Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review. BMC Musculoskeletal Disorders, Vol.7 (No.51). ISSN 1471-2474

Preview

PDF
WRAP_McCarthy_Pulsed_electromagnetic.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (244Kb)

Official URL: http://dx.doi.org/10.1186/1471-2474-7-51

Abstract

Background The rehabilitation of knee osteoarthritis often includes electrotherapeutic modalities as well as advice and exercise. One commonly used modality is pulsed electromagnetic field therapy (PEMF). PEMF uses electro magnetically generated fields to promote tissue repair and healing rates. Its equivocal benefit over placebo treatment has been previously suggested however recently a number of randomised controlled trials have been published that have allowed a systematic review to be conducted. Methods A systematic review of the literature from 1966 to 2005 was undertaken. Relevant computerised bibliographic databases were searched and papers reviewed independently by two reviewers for quality using validated criteria for assessment. The key outcomes of pain and functional disability were analysed with weighted and standardised mean differences being calculated. Results Five randomised controlled trials comparing PEMF with placebo were identified. The weighted mean differences of the five papers for improvement in pain and function, were small and their 95% confidence intervals included the null. Conclusion This systematic review provides further evidence that PEMF has little value in the management of knee osteoarthritis. There appears to be clear evidence for the recommendation that PEMF does not significantly reduce the pain of knee osteoarthritis.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Knee -- Diseases, Osteoarthritis, Electromagnetic fields, Systematic reviews
Journal or Publication Title:	BMC Musculoskeletal Disorders
Publisher:	BioMed Central Ltd.
ISSN:	1471-2474
Date:	15 June 2006
Volume:	Vol.7
Number:	No.51
Identification Number:	10.1186/1471-2474-7-51
Status:	Peer Reviewed
Access rights to Published version:	Open Access
References:	1. Spector TD, Hart DJ: How serious is knee osteoarthritis? Ann Rheum Disease 1992, 51:1105-1106. 2. Woolf AD, Pfleger B: Burden of major musculoskeletal conditions. Bulletin of the World Health Organisation 2003, 81:646-656 [http://PM:14710506]. 3. Marks R, Ghassemi M, Duarte R, Van Nguyen JP: Review of the literature on shortwave diathermy as applied to osteo-arthritis of the knee. Physiotherapy 1999, 85:304-316. 4. Van Nguyen JP, Marks R: Pulsed electromagnetic fields for treating osteoarthritis. Physiotherapy 2002, 88:458-470. 5. Hulme JM, Judd MG, Robinson VA, Tugwell P, Wells G, de Bie RA: Electromagnetic fields for the treatment of osteoarthritis. The Cochrane Library (Oxford) ** 2005;(2): (ID #CD003523) 2002. 6. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988, 15:1833-1840. 7. Centre for Health Economics University of York: EuroQol EQ-5D: User guide Version B edition. Centre for Health Economics, University of York; 1998. 8. Meenan RF, Gertmen PM, Mason M B: Measuring health in arthritis: the Arthritis Impact Measurement Scales. Arthritis and Rheumatism 1980, 23:146-152. 9. Ware JE, Snow K, Kosinski M, Gandek B: SF-36 health survey manual and interpretation guide Boston, New England Medical Centre; 1993. 10. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996, 17:1-12. 11. Trock DH, Bollet AJ, Dyer RH: A double blind trial of the clinical effects of pulsed electromagnetic fields in osteoarthritis. J Rheumatology 1993, 20:456-460. 12. Trock DH, Bollet AJ, Markoll R: The effect of pulsed electromagnetic fields in the treatment of osteoarthritis of the knee and cervical spine. Report of randomized, double blind, placebo controlled trials. J Rheumatol 1994, 21:1903-1911. 13. Zizic TM, Hoffman KC, Holt PA, Hungerford DS, O'Dell JR, Jacobs MA, Lewis CG, Deal CL, Caldwell JR, Cholewczynski JG, .: The treatment of osteoarthritis of the knee with pulsed electrical stimulation. J Rheumatol 1995, 22:1757-1761. 14. Pipitone N, Scott DL: Magnetic pulse treatment for knee osteoarthritis: a randomised, double-blind, placebo-controlled study. Curr Med Res Opin 2001, 17:190-196. 15. Thamsborg G, Florescu A, Oturai P, Fallentin E, Tritsaris K, Dissing S: Treatment of knee osteoarthritis with pulsed electromagnetic fields: a randomized, double-blind, placebo-controlled study. Osteoarthritis Cartilage 2005, 13:575-581. 16. Klaber Moffett JA, Richardson PH, Frost H, Osborn A: A placebo controlled double blind trial to evaluate the effectiveness of pulsed short wave therapy for osteoarthritic hip and knee pain. Pain 1996, 67:127. 17. Laufer Y, Zilberman R, Porat R, Nahir AM: Effect of pulsed shortwave diathermy on pain and function of subjects with osteoarthritis of the knee: a placebo-controlled double-blind clinical trial. Clin Rehabil 2005, 19:255-263. 18. Callaghan MJ, Whittaker PE, Grimes S, Smith L: An evaluation of pulsed shortwave on knee osteoarthritis using radioleucoscintigraphy: a randomised, double blind, controlled trial. Joint Bone Spine 2005, 72:150-155. 19. McCarthy CJ, Mills PM, Pullen R, Roberts C, Silman A, Oldham JA: Supplementing a home exercise programme with a classbased exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis. Rheumatology 2004, 43:880-886. 20. Roddy E, Zhang W, Doherty M, Arden NK, Barlow J, Birrell F, Carr A, Chakravarty K, Dickson J, Hay E, Hosie G, Hurley M, Jordan KM, McCarthy C, McMurdo M, Mockett S, O'Reilly S, Peat G, Pendleton A, Richards S: Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee--the MOVE consensus. Rheumatology (Oxford) 2005, 44:67-73.
URI:	http://wrap.warwick.ac.uk/id/eprint/554