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Wrinkles

Int J Dermatol. 1994 Sep;33(9):661-3.

Ultrastructural study of hyaluronic acid before and after the use of a pulsed electromagnetic field, electrorydesis, in the treatment of wrinkles.

Ghersetich I, Teofoli P, Benci M, Lotti T.

Department of Dermatology, University of Florence, Italy.

BACKGROUND. Treatment of wrinkles has become an increasing problem for dermatologists. Hyaluronic acid is a component of the family of glycosaminoglycans (GAGS, substances known for their property of retaining water), that significantly decreases with aging and in wrinkles. A new technique that uses a specific pulsed electromagnetic field, electrorydesis, has been introduced in the treatment of wrinkles associated with aging. The treatment is based on the reported in vitro effects of specific electromagnetic fields on fibroblast cultures (e.g., an increase in DNA synthesis and in the production of collagen and presumably also of GAGS).

METHODS. The in vivo effects of the electromagnetic field on aged skin (3 subjects aged 50, 56 and 60 years), with particular focus on the ultrastructural modifications and GAGS amount before and after the treatment, were evaluated by electron microscope.

RESULTS. The ultrastructural study (tissue stained with alcian blue) showed after treatment a significant increase (p < 0.005) of the electron-dense granules (corresponding to hyaluronic acid), located in collagen elastic fibers, and in the soluble matrix. This presumably leads to subsequent edema that was clinically evident after the treatment.

CONCLUSIONS. These data suggest that the increased levels of GAGS and the subsequent edema of the dermis could explain at least in part the clinical changes observed after electrorydesis treatment (e.g., swelling and “disappearance” of the wrinkle).

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Whiplash

Pain Res Manag. 2005 Spring;10(1):21-32.

Treatment of whiplash-associated disorders–part I: Non-invasive interventions.

Conlin A, Bhogal S, Sequeira K, Teasell R.

St Joseph’s Health Centre, Parkwood Hospital, London, Canada.

BACKGROUND: A whiplash-associated disorder (WAD) is an injury due to an acceleration-deceleration mechanism at the neck. WAD represents a very common and costly condition, both economically and socially. In 1995, the Quebec Task Force published a report that contained evidence-based recommendations regarding the treatment of WAD based on studies completed before 1993 and consensus-based recommendations.

OBJECTIVE: The objective of the present article–the first installment of a two-part series on interventions for WAD–is to provide a systematic review of the literature published between January 1993 and July 2003 on noninvasive interventions for WAD using meta-analytical techniques.

METHODS OF THE REVIEW: Three medical literature databases were searched for identification of all studies on the treatment of WAD. Randomized controlled trials (RCTs) and epidemiological studies were categorized by treatment modality and analyzed by outcome measure. The methodological quality of the RCTs was assessed. When possible, pooled analyses of the RCTs were completed for meta-analyses of the data. The results of all the studies were compiled and systematically reviewed.

RESULTS: Studies were categorized as exercise alone, multimodal intervention with exercise, mobilization, strength training, pulsed magnetic field treatment and chiropractic manipulation. A total of eight RCTs and 10 non-RCTs were evaluated. The mean score of methodological quality of the RCTs was five out of 10. Pooled analyses were completed across all treatment modalities and outcome measures. The outcomes of each study were summarized in tables.

CONCLUSIONS: There exists consistent evidence (published in two RCTs) in support of mobilization as an effective noninvasive intervention for acute WAD. Two RCTs also reported consistent evidence that exercise alone does not improve range of motion in patients with acute WAD. One RCT reported improvements in pain and range of motion in patients with WAD of undefined duration who underwent pulsed electromagnetic field treatment. Conflicting evidence in two RCTs exists regarding the effectiveness of multimodal intervention with exercise. Limited evidence, in the form of three non-RCTs, exists in support of chiropractic manipulation. Future research should be directed toward clarifying the role of exercise and manipulation in the treatment of WAD, and supporting or refuting the benefit of pulsed electromagnetic field treatment. Mobilization is recommended for the treatment of pain and compromised cervical range of motion in the acute WAD patient.

Neurorehabilitation
Issue:Volume 17, Number 1 / 2002
Pages:63 – 67
Evaluation of electromagnetic fields in the treatment of pain in patients with lumbar radiculopathy or the whiplash syndrome. Ch. Thuile A1 and M. Walzl A2 A1 International Society of Energy Medicine, Vienna, Austria
A2 State Clinic of Neurology and Psychiatry, Graz, Austria Abstract: Back pain and the whiplash syndrome are very common diseases involving tremendous costs and extensive medical effort. A quick and effective reduction of symptoms, especially pain, is required. In two prospective randomized studies, patients with either lumbar radiculopathy in the segments L5/S1 or the whiplash syndrome were investigated. Inclusion criteria were as follows: either clinically verified painful lumbar radiculopathy in the segments L5/S1 and a Laségue’s sign of 30 degrees (or more), or typical signs of the whiplash syndrome such as painful restriction of rotation and flexion/extension. Exclusion criteria were prolapsed intervertebral discs, systemic neurological diseases, epilepsy, and pregnancy. A total of 100 patients with lumbar radiculopathy and 92 with the whiplash syndrome were selected and entered in the study following a 1:1 ratio. Both groups (magnetic field treatment and controls) received standard medication consisting of diclofenac and tizanidine, while the magnetic field was only applied in group 1, twice a day, for a period of two weeks. In patients suffering from radiculopathy, the average time until pain relief and painless walking was 8.2 – 0.5 days in the magnetic field group, and 11.7 – 0.5 days in controls p < 0.04). In patients with the whiplash syndrome, pain was measured on a ten-point scale. Pain in the head was on average 4.6 before and 2.1 after treatment in those receiving magnetic field treatment, and 4.2/3.5 in controls. Neck pain was on average 6.3/1.9 as opposed to 5.3/4.6, and pain in the shoulder/arm was 2.4/0.8 as opposed to 2.8/2.2 (p < 0.03 for all regions). Hence, magnetic fields appear to have a considerable and statistically significant potential for reducing pain in cases of lumbar radiculopathy and the whiplash syndrome. References: G.B.J. Andersson, The Epidemiology of Spinal Disorder, in: The Adult Spine: Principles and Practice, J.W. Frymoyer, ed., Raven Press, New York, 1991. V. Grosser, K. Seide and D. Wolter, Berufliche Belastungen und bandscheibenbedingte Erkrankungen der LWS: Derzeit-iger Kausalwissenstand in der Literatur? in: Berufskrankheit 2108: Kausalit¨at und Abgrenzungskriterien, D. Wolter and K. Seide, eds., Springer, Berlin, 1995, pp. 26-38.

Best Pract Res Clin Rheumatol. 2007 Feb;21(1):93-108.

Straqtegies for prevention and mangagement of musculoskeletal conditions. Neck pain.

Jensen I, Harms-Ringdahl K.

Department of Clinical Neuroscience, Section of Personal Injury Prevention, Karolinska Institutet, and Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden. irene.jensen@ki.se

The aim of this article was to summarise the existing evidence concerning interventions for non-specific neck pain. Neck-and-shoulder pain is commonly experienced by both adolescents and adults. Although the prevalence appears to vary among different nations, the situation is essentially the same, at least in the industrialised nations. Explanations for the wide variation in incidence and prevalence include various methodological issues. Back and neck disorders represent one of the most common causes for both short- and long-term sick leave and disability pension. Evidenced risk factors for the onset and maintenance of non-specific neck and back pain include both individual and work-related psychosocial factors. Based on the existing evidence different forms of exercise can be strongly recommended for at-risk populations, as well as for the acute and chronic non-specific neck pain patient. Furthermore, for symptom relief this condition can be treated with transcutaneous electric nerve stimulation, low level laser therapy, pulse electromagnetic treatment or radiofrequency denervation.

Scand J Rehabil Med. 1992;24(1):51-9.

Low energy high frequency pulsed electromagnetic therapy for acute whiplash injuries.  A double blind randomized controlled stuy.

Foley-Nolan D. et.al. Mater Hospital, Dublin, Ireland.

The standard treatment of acute whiplash injuries (soft collar and analgesia) is frequently unsuccessful. Pulsed electromagnetic therapy PEMT has been shown to have pro-healing and anti-inflammatory effects. This study examines the effect of PEMT on the acute whiplash syndrome. PEMT as described is safe for domiciliary use and this study suggests that PEMT has a beneficial effect in the management of the acute whiplash injury.

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Viral Hepatitis

Vopr Kurortol Fizioter Lech Fiz Kult. 1997 Nov-Dec;(6):26-8.

The rehabilitation of patients with a history of viral hepatitis using UHF therapy (460 MHz).

[Article in Russian]

Filimonov RM, Spakhov KV, Ruzova TK.

Abstract

In early convalescence after viral hepatitis C the liver region of the patients was exposed to the decimetric waves to prevent transformation of the acute disease into a chronic one. A total of 45 relevant patients were exposed to electromagnetic field of ultrahigh frequency (460 MHz). A positive effect on the disease course and liver function was noted.

Lik Sprava. 1995 Sep-Dec;(9-12):140-4.

Decimeter-wave physiotherapy in viral hepatitis.

[Article in Russian]

Kents VV, Mavrodi? VM.

Abstract

Effectiveness was evaluated of magnetotherapy, inductothermy, UNF electric field and electromagnetic waves of decimetric wave band (460 MHz) on the projection of the liver, adrenals and thyroid gland in controlled trials enrolling a total of 835 patients with viral hepatitis (type A, B, associated forms). A conclusion is reached that optimum effectiveness of decimetric field on the projection of the adrenals and thyroid gland can be achieved through the application of minimum power and everyday alternation of exposures. It has been estimated that as many as 69 percent of the patients derive benefit from the above treatment.

Vopr Kurortol Fizioter Lech Fiz Kult. 1994 May-Jun;(3):19-22.

The efficacy of decimeter-wave therapy with exposure of the neuroendocrine organs in the treatment of viral hepatitis.

[Article in Russian]

Mavrodi? VM.

Abstract

A controlled trial entered 343 patients with virus hepatitis A, B and associated forms. In addition to standard treatment the patients’ adrenals and thyroid were exposed to electromagnetic waves (460 MHz) in alternative daily regimens and under minimal power. As shown by clinical, rheohepatographic, hormonal, immunological and follow-up evidence, positive results were achieved in 69% of the patients.

Vopr Kurortol Fizioter Lech Fiz Kult. 1993 Jul-Aug;(4):15-8.

The effect of the siting of exposure to decimeter-range electromagnetic waves on the function of the hypophyseal-thyroid and adrenal systems in viral hepatitis.

[Article in Russian]

Mavrodi? VM.

Abstract

The author studied time course of changes in the thyroid and adrenal systems as shown by the levels of T3, T4, T3/T4, TTH, hydrocortisone, ACTH in response to exposure to decimetric microwaves (460 MHz, 30 mW/cm2). The microwaves were directed to the area of hepatic, thyroid, adrenal projections and combinations thereof. An optimal effect was achieved at the course exposure of the adrenal projection.

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Veterinary

Res Vet Sci. 2018 May 7;119:1-8. doi: 10.1016/j.rvsc.2018.05.005. [Epub ahead of print]

Veterinary applications of pulsed electromagnetic field therapy.

Gaynor JS1, Hagberg S2, Gurfein BT3.

Author information

1 Peak Performance Veterinary Group, 5520 N Nevada Ave, Colorado Springs, CO 80918, USA. Electronic address: jgaynor@nopetpain.com. 2 Department of Neurosurgery, University of New Mexico School of Medicine, MSC 10 5615, Albuquerque, NM 87131, USA. Electronic address: shagberg@unm.edu. 3 Division of Experimental Medicine, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA 94110, USA. Electronic address: Blake.Gurfein@ucsf.edu.

Abstract

Pulsed electromagnetic field (PEMF) therapy can non-invasively treat a variety of pathologies by delivering electric and magnetic fields to tissues via inductive coils. The electromagnetic fields generated by these devices have been found to affect a variety of biological processes and basic science understanding of the underlying mechanisms of action of PEMF treatment has accelerated in the last 10?years. Accumulating clinical evidence supports the use of PEMF therapy in both animals and humans for specific clinical indications including bone healing, wound healing, osteoarthritis and inflammation, and treatment of post-operative pain and edema. While there is some confusion about PEMF as a clinical treatment modality, it is increasingly being prescribed by veterinarians. In an effort to unravel the confusion surrounding PEMF devices, this article reviews important PEMF history, device taxonomy, mechanisms of action, basic science and clinical evidence, and relevant trends in veterinary medicine. The data reviewed underscore the usefulness of PEMF treatment as a safe, non-invasive treatment modality that has the potential to become an important stand-alone or adjunctive treatment modality in veterinary care.

KEYWORDS:

Bone growth stimulator; Edema; Inflammation; Medical devices; Post-operative pain; Pulsed electromagnetic field Clin Tech Small Anim Pract. 2007 Nov;22(4):160-5. doi: 10.1053/j.ctsap.2007.09.004.

Select modalities.

Canapp DA1.

Author information

1 Veterinary Orthopedic and Sports Medicine Group, Ellicott City, MD 21042, USA. dcanapp@vetsportsmedicine.com

Abstract

Physical rehabilitation modalities such as therapeutic ultrasound (TU), transcutaneous electrical neuromuscular stimulation (TENS), neuromuscular electrical stimulation (NMES), cold or low-level laser therapy (LLLT), and pulsed magnetic field therapy (PMF) can all, when used properly, assist in treating orthopedic injuries, neurological conditions, and chronic conditions brought about by normal aging in our small animal companions. TU uses sound waves to produce both thermal and nonthermal effects that aid in tissue healing, repair, and function. TENS uses different frequencies of electrical current to decrease pain and inflammation. NMES also uses an electrical current to stimulate muscle contraction to assist in normal neuromuscular function in postorthopedic and neurological injuries. LLLT uses light energy to reduce pain, decrease inflammation, and stimulate healing at a cellular level. PMF uses magnetic field to stimulate normal cellular ion exchange and oxygen utilization and promote generalized healing of tissues. These modalities are discussed in detail covering mechanism of action, parameters, settings, and indications/contraindications of use in our small animals. Although these modalities are important in the physical rehabilitation of small animals, they need to be incorporated with a proper diagnosis, manual therapy, and home exercise program into a specific and individualized patient treatment protocol. J Orthop Res. 2002 Sep;20(5):1106-14.

Effect of pulsed electromagnetic fields (PEMF) on late-phase osteotomy gap healing in a canine tibial model.

Inoue N1, Ohnishi I, Chen D, Deitz LW, Schwardt JD, Chao EY.

Author information

1 Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD 21205-2196, USA.

Abstract

The effects of a pulsed electromagnetic field (PEMF) on late bone healing phases using an osteotomy gap model in the canine mid-tibia were investigated. A transverse mid-diaphyseal tibial osteotomy with a 2-mm gap was performed unilaterally in 12 adult mixed-breed dogs and stabilized with external fixation. Animals in the variable group (n = 6) were treated with PEMF for 1 h daily starting 4 weeks after surgery for a total of 8 weeks, whereas no stimulation signal was generated in the control group (n = 6). Functional load-bearing and radiographic assessments were conducted time-sequentially until euthanasia 12 weeks after surgery. Torsional tests and an analysis of undecalcified histology were performed on the retrieved mid-tibial diaphysis containing the osteotomy site. In the PEMF group, load-bearing of the operated limb recovered earlier when compared to the control group (p < 0.05). Load-bearing in the PEMF group at 8 weeks was greater than in the control group (p < 0.02). The periosteal callus area increased following surgery at 6 weeks (p < 0.05) and thereafter (p < 0.01) in the PEMF group, while a significant increase was observed at 8 and 10 weeks after surgery (p < 0.05) in the control group. Both the normalized maximum torque and torsional stiffness of the PEMF group were significantly greater than those of the control group (p < 0.04 and p < 0.007, respectively). Histomorphometric analyses revealed greater new-bone formation (p < 0.05) in the osteotomy gap tissue and increased mineral apposition rate (p < 0.04) and decreased porosity in the cortex adjacent to the osteotomy line (p < 0.02) in the PEMF group. PEMF stimulation of 1 h per day for 8 weeks provided faster recovery of load-bearing, a significant increase in new bone formation, and a higher mechanical strength of the healing mid-tibial osteotomy. This study revealed enhancing effects of PEMF on callus formation and maturation in the late-phase of bone healing.

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Vestibular Dysfunction – Vertigo

Vopr Kurortol Fizioter Lech Fiz Kult. 1994 Jan-Feb;(1):16-9.

The magnetic amplipulse therapy of vestibular dysfunctions of the vascular origin by using the Sedaton apparatus (experimental research).

[Article in Russian]

Mal’tsev AE.

The paper describes the results of combined utilization of magnetic field (MF), sinusoidal modulated current (SMC) and galvanic current (GC) generated by a specially devised unit “Sedaton”. This multimodality physiotherapy was tested in chronic experiments on 25 cats with experimental vascular and vestibular dysfunction. MF in combination with SMC displayed greater efficacy than in monotherapy. Positive physiological reactions were more pronounced.

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Uterine Myoma – Fibroids

Vopr Kurortol Fizioter Lech Fiz Kult. 2005 Jan-Feb;(1):26-8.

Efficacy of general magnetotherapy in conservative therapy of uterine myoma in women of reproductive age.

[Article in Russian]

Kulishova TV, Tabashnikova NA, Akker LV.

Sixty women of the reproductive age with uterine myoma were divided into two groups. Thirty patients of the study group received combined therapy plus general magnetotherapy (GMT). Patients of the control group received only combined treatment. Ultrasound investigation registered a reduction in the size of myoma nodes by 16.7% in the study group, while in the controls myoma size did not change (p < 0.05). 1-year follow-up data for the study group demonstrated no cases of the myoma growth while 16.6% of the controls showed growth of myoma nodes, in 6.6% of them supravaginal myoma amputation was made for rapidly growing myoma.

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Urinary Inflammation – Trauma

Urologiia. 2004 Mar-Apr;(2):20-2.

Combined therapy of interstitial cystitis using the “Aeltis-Synchro-02-Iarilo” device.

[Article in Russian]

Kalinina SN, Molchanov AV, Rutskaia NS.

Multiple modality therapy of interstitial cystitis (IC)–the disease characterized by nicturia, pelvic pains, imperative pollakiuria–is considered. As IC nature is not well known, its treatment remains empiric. Among the underlying causes, most probable are autoimmune, allergic, infectious, neurological, vascular. Therefore, the treatment should be multi-modality. Most usable now is combined chemotherapy. Perspective is also IC treatment with medicines in combination with physiotherapy (electromagnetolaser AELTIS-SYNCHRO-02-YARILO”). Endovesical electrophoresis can be also applied.

Obstet Gynecol Surv. 2000 Nov;55(11):715-20.

Electromagnetic pelvic floor stimulation: applications for the gynecologist.

Goldberg RP, Sand PK.

Evanston Continence Center, Northwestern University Medical School, Evanston Northwestern Healthcare, Illinois, USA. r-goldberg@nwu.edu

Abstract

The therapeutic potential of magnetic energy has been a subject of long-standing interest within both conventional and alternative medical practice. Numerous devices using magnetic fields, ranging from the dubious to truly innovative, have claimed a wide variety of clinical benefits. For gynecologists involved with the diagnosis and treatment of pelvic floor and bladder dysfunction, magnetic stimulation of the sacral nerve roots and peripheral nerves continues to evolve as a noninvasive treatment alternative. The conduction characteristics of magnetic energy confer several practical advantages for its use. This article reviews the use of electromagnetic stimulation for treatment of common urogynecologic conditions, and provides an historical overview of the therapeutic application of electromagnetic energy.

Urol Nefrol (Mosk). 1996 Sep-Oct;(5):10-4.

Magnetic-laser therapy in inflammatory and posttraumatic lesions of the urinary system.

[Article in Russian]

Loran OB, Kaprin AD, Gazimagomedov GA.

The authors discuss disputable problem of renal and ureteral tissue after trauma or inflammation. These cause irreversible morphological changes in the tissue. Poor results of the standard therapy urged the authors to try magnetic-laser therapy in urological clinic. The technique has been developed on experimental animal models. The resultant morphological characteristics of ureteral wall and parenchyma support the validity of magnetic-laser therapy in urological practice.

Eur J Surg Suppl. 1994;(574):83-6.

Electrochemical therapy of pelvic pain: effects of pulsed electromagnetic fields (PEMF) on tissue trauma.

Jorgensen WA, Frome BM, Wallach C.

International Pain Research Institute, Los Angeles, California.

Abstract

Unusually effective and long-lasting relief of pelvic pain of gynaecological origin has been obtained consistently by short exposures of affected areas to the application of a magnetic induction device producing short, sharp, magnetic-field pulses of a minimal amplitude to initiate the electrochemical phenomenon of electroporation within a 25 cm2 focal area. Treatments are short, fasting-acting, economical and in many instances have obviated surgery. This report describes typical cases such as dysmenorrhoea, endometriosis, ruptured ovarian cyst, acute lower urinary tract infection, post-operative haematoma, and persistent dyspareunia in which pulsed magnetic field treatment has not, in most cases, been supplemented by analgesic medication. Of 17 female patients presenting with a total of 20 episodes of pelvic pain, of which 11 episodes were acute, seven chronic and two acute as well as chronic, 16 patients representing 18 episodes (90%) experienced marked, even dramatic relief, while two patients representing two episodes reported less than complete pain relief.

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Urinary Incontinence

J Physiol Pharmacol.  2012 Sep;63(4):397-401.

Pulsating electromagnetic field stimulation of urothelial cells induces apoptosis and diminishes necrosis: new insight to magnetic therapy in urology.

Juszczak K, Kaszuba-Zwoinska J, Thor PJ.

Source

Department of Pathophysiology, Jagiellonian University, Medical College, Cracow, Poland. kajus13@poczta.onet.pl.

Abstract

The evidence of electromagnetic therapy (EMT) efficacy in stress and/or urge urinary incontinence, as well as in detrusor overactivity is generally lacking in the literature. The potential EMT action of neuromuscular tissue depolarization has been described. Because there is no data on the influence of pulsating electromagnetic fields (PEMF) on the urothelium, we evaluated the effect of PEMF stimulation on rat urothelial cultured cells (RUCC). In our study 15 Wistar rats were used for RUCC preparation. RUCC were exposed to PEMF (50 Hz, 45±5 mT) three times for 4 hours each with 24-hour intervals. The unexposed RUCC was in the same incubator, but in a distance of 35 cm from the PEMF generator. Annexin V-APC (AnV+) labelled was used to determine the percentage of apoptotic cells and propidium iodide (PI+), as standard flow cytometric viability probe to distinguish necrotic cells from viable ones. The results are presented in percentage values. The flow cytometric analysis was carried out on a FACS calibur flow cytometer using Cell-Quest software. In PEMF-unstimulated RUCC, the percentage of AnV+, PI+, and AnV+PI+ positive cells were 1.24±0.34%, 11.03±1.55%, and 12.43±1.96%, respectively. The percentages of AnV+, PI+, and AnV+PI+ positive cells obtained after PEMF stimulation were 1.45±0.16% (p=0.027), 7.03±1.76% (p<0.001), and 9.48±3.40% (p=0.003), respectively. The PEMF stimulation of RUCC induces apoptosis (increase of AnV+ cells) and inhibits necrosis (decrease of PI+ cells) of urothelial cells. This leads us to the conclusion that a low-frequency pulsating electromagnetic field stimulation induces apoptosis and diminishes necrosis of rat urothelial cells in culture.

Arch Gynecol Obstet. 2010 Jul;282(1):49-53. Epub 2009 Oct 16.

Long-term effects of extracorporeal magnetic innervations in the treatment of women with urinary incontinence: results of 3-year follow-up.

Do?anay M, Kilic S, Yilmaz N.

Department of Obstetrics and Gynecology, Zekai Tahir Burak Mother Health Training and Research Hospital, Ankara, Turkey. drmdoganay@gmail.com

Abstract

PURPOSE: This study is designed to evaluate the long-term efficacy of extracorporeal magnetic innervation (ExMI) in the treatment of women with urinary incontinence.

METHODS: Our prospective study included a period of 3 years between May 2005 and October 2008. A total of 137 consequent women with stress and urge incontinence were included in the study. Of the patients, 68 had stress incontinence and others had urge incontinence.

RESULTS: All of the patients with stress incontinence were successfully followed up and 32 (47%) were totally dry in negative stress test at the 6 months after ExMI therapy. In the same group, 27(39%) showed improvement in the frequency of daily leak episodes from 3.2 times to 1.2 times. In the urge incontinence group, all of the patients completed the treatment and they were successfully followed up. While 40 (58%) patients were dry and 18 (26%) significantly improved the average number of incontinence episodes decreased from 3.7 times to 1.7 times per day, treatment failed in the remaining 11 (16%) patients at the 6 months. At 6 months, the recurrence rate was 53%.

CONCLUSIONS: At the 6 months after 16 sessions of ExMI had a significant QOL, parallel to decrease in daily pad use and leakage episodes. Only 16 sessions are not effective definitive therapy. The beneficial effects are temporary and there is high recurrence.

BJU Int. 2009 May;103(10):1386-90. Epub 2009 Jan 14.

A double-blind randomized controlled trial of electromagnetic stimulation of the pelvic floor vs sham therapy in the treatment of women with stress urinary incontinence.

Gilling PJ, Wilson LC, Westenberg AM, McAllister WJ, Kennett KM, Frampton CM, Bell DF, Wrigley PM, Fraundorfer MR.

Departments of Urology and Physiotherapy, Tauranga Hospital, Tauranga, New Zealand.

Abstract

OBJECTIVE: To compare the efficacy of extracorporeal electromagnetic stimulation (ES) of the pelvic floor for treating stress urinary incontinence (SUI) vs sham ES.

PATIENTS AND METHODS: In all, 70 women with urodynamically confirmed SUI were randomized to receive active (35) or sham (35) ES. The NeoControl chair (NeoTonus, Marietta, GA, USA) was used, and treatment consisted of three sessions per week for 6 weeks. data were collected before and after treatment on all women, including a 20-min provocative pad-test with a predetermined bladder volume (primary outcome measure), a 3-day bladder diary and 24 h pad-test. Circumvaginal muscle (CVM) rating score, perineometry using two separate instruments and video-urodynamics were also used, and the Urinary Incontinence Quality of Life Scale (I-QOL) and King’s Health Questionnaires. Patients were fully re-evaluated 8 weeks after treatment, and the bladder diary, pad-test and questionnaires were repeated at 6 months. The urotherapist and physician were unaware to which treatment group the patient was assigned.

RESULTS: In the overall group of 70 patients there were significant improvements in each of the primary and secondary outcome measures at 8 weeks. There were also significant improvements in primary and secondary outcome measures in the active treatment group when compared with baseline measures. At 8 weeks, there were improvements in the mean (sd) values for the 20-min pad-test, of 39.5 (5.1) vs 19.4 (4.6) g (P < 0.001); the 24-h pad-test, of 24.0 (4.7) vs 10.1 (3.1) g (P < 0.01); the number of pads/day, of 0.9 (0.1) vs 0.6 (0.1) (P < 0.01), the I-QOL score, of 63.7 (2.8) vs 71.2 (3.3) (P < 0.001); and King’s Health Questionnaire score, of 9.6 (0.8) vs 6.9 (0.7) (P < 0.001). However, these improvements were not statistically significant when compared with the sham-treatment group. In those patients on active treatment who had a poor pelvic floor contraction at the initial assessment (defined by the CVM score and perineometry), there was a significant reduction (P < 0.05) in the 20-min pad-test leakage when compared with the sham-treatment group.

CONCLUSIONS: ES was no more effective overall than sham treatment in this patient group. However, in those women who were unable to generate adequate pelvic floor muscle contractions, there was an objective improvement in provocative pad testing when compared to sham treatment.

Urol Int. 2008;81(2):167-72. Epub 2008 Aug 29.

Extracorporeal magnetic innervation for the treatment of stress urinary incontinence: results of two-year follow-up.

Ho?can MB, Dilmen C, Perk H, Soyupek S, Arma?an A, Tükel O, Ekinci M.

Department of Urology, Alanya Medical Center, Ba?ent University, Antalya, Turkey. drburakhoscan@yahoo.com

Abstract

INTRODUCTION: Extracorporeal magnetic innervation (ExMI) is a relatively new technology used for pelvic muscle strengthening for the treatment of stress urinary incontinence. We aimed to evaluate the clinical efficacy of extracorporeal magnetic stimulation for the treatment of stress urinary incontinence.

MATERIALS AND METHODS: A total of 30 patients with demonstrable stress urinary incontinence were enrolled in this study. All were neurologically normal with normal urinalysis and none was pregnant. Evaluation before treatment included 3-day bladder diaries, a dynamic pad weight test, urodynamics, and a validated quality of life survey. Treatment sessions lasted 20 min, twice a week, for 6 weeks. After ExMI, all measures were repeated at follow-up including 3-day bladder diary, dynamic pad weight test, urodynamics and quality of life survey. The follow-up was done at 3, 12 and 24 months after ExMI therapy but urodynamics were performed only at first follow-up.

RESULTS: After ExMI therapy, 8 out of the 27 patients were cured (29.7%) and 13 patients were improved (48.1%) at 3 months. The cumulative success rate was 77.8%. Six patients did not show any improvement after treatment. Pad weight was reduced from 14.4 +/- 10.7 to 6.5 +/- 5.1 g. The mean score of quality of life survey at baseline was 61.6 and this increased to 75.4 at 12 weeks. The effect of ExMI approximately continued until the 1st year after therapy but gradually decreased and came close to baseline at the 2nd year after therapy.

CONCLUSION: As a result, ExMI therapy offers a new effective modality for pelvic floor muscle stimulation. ExMI also offers a noninvasive, effective and painless treatment for women with stress urinary incontinence. Further studies are needed to address how long the therapy will continue and benefits will last and whether retreatment or continuation therapy sessions will be necessary.

Scand J Urol Nephrol. 2008;42(5):433-6.

Extracorporeal magnetic innervation therapy: assessment of clinical efficacy in relation to urodynamic parameters.

Groenendijk PM, Halilovic M, Chandi DD, Heesakkers JP, Voorham-Van Der Zalm PJ, Lycklama Anijeholt AA.

Department of Urology, Reinier de Graaf Group, Delft, The Netherlands. groenenp@rdgg.nl

Abstract

OBJECTIVE: Clinical efficacy and urodynamic changes in women treated by extracorporeal magnetic innervation therapy (ExMI) were studied.

MATERIAL AND METHODS: Women, presenting with urge, stress and mixed urinary incontinence, were included in a prospective study. ExMI was applied by an electromagnetic chair. To document clinical efficacy, a voiding diary and visual analogue scale were completed before and after treatment, together with a pad test. Detrusor overactivity (DO) and urethral instability (URI) were urodynamically documented. Clinical success was defined as more than 50% improvement in symptoms.

RESULTS: Sixteen patients were included. At baseline, DO was observed in 10 patients, and URI in 12 patients. DO did disappear at follow-up in 60%, and a decrease in URI was seen in 66%. No significant clinical improvement was seen at follow-up.

CONCLUSION: Although significant changes in urodynamic variables were observed, no significant improvement in clinical efficacy was seen after ExMI.

Eur Urol. 2007 Sep;52(3):876-81. Epub 2007 Feb 20.

Extracorporeal magnetic stimulation is of limited clinical benefit to women with idiopathic detrusor overactivity: a randomized sham controlled trial.

Morris AR, O’Sullivan R, Dunkley P, Moore KH.

The Pelvic Floor Unit, St George Hospital, Kogarah, NSW 2217, Australia.

Abstract

OBJECTIVES: To observe the effect of both acute and medium-term magnetic stimulation of the pelvic floor on detrusor function amongst women with idiopathic detrusor overactivity (IDO).

METHODS: Two separate studies were undertaken amongst women with a sole diagnosis of IDO. The first study assessed the acute effect of magnetic stimulation (provided by Neocontrol ) on detrusor function during the filling phase of standard cystometry. Multiple filling cycles were performed with stimulation at a different key moment in each. This was done to establish that the device could influence the detrusor. Subsequently, a randomized sham control trial was performed to assess clinical efficacy. A total of 20 treatments, each of 20 minutes duration, were administered over six weeks with follow-up six weeks thereafter. Half the patients received therapy from a genuine device, the others receiving fake treatment on an identical looking/sounding sham device. The sham device contained a deflector plate to degrade the magnetic field and was located in a separate room. Outcome measures included changes in a 24 hour fluid volume chart, urine loss (24 hour pad test) and quality of life instruments.

RESULTS: Amongst 10 patients receiving stimulation during cystometry, volume at first involuntary detrusor contraction during filling rose from a median value of 240ml (Inter-quartile range (IQR) 210-300) to 285ml (IQR 231-320), p = 0.03 and maximum detrusor pressure decreased from 40cm water (IQR 34-45) to 33cm water (IQR 25-41), p<0.01. The RCT was completed by 29 of 44 (66%) recruits. Of these, 15 of 29 (52%) received active treatment and 14 of 29 (48%) sham therapy. Active therapy significantly reduced the number of urge episodes per day, p<0.01. With respect to baseline, actively treated patients experienced significant reduction in voids per day and quality of life but this trend did not reach significance when compared to the sham group, partly due to unexpected difficulty in recruitment which yielded an underpowered sample size for these outcome measures.

CONCLUSIONS: Magnetic stimulation reduces detrusor contractility in the acute phase of administration. Although the treatment was well tolerated and urge episodes reduced following prolonged therapy, no statistically significant improvement was observed in quality of life indices or measured 24 hour urinary loss. The treatment cannot be recommended for women with IDO.

BJU Int. 2006 May;97(5):1035-8.

Effects of magnetic stimulation in the treatment of pelvic floor dysfunction.

Voorham-van der Zalm PJ, Pelger RC, Stiggelbout AM, Elzevier HW, Lycklama à Nijeholt GA.

Department of Urology, Leiden University Medical Center, the Netherlands. pjvoorham@lumc.nl

Abstract

OBJECTIVE: To correlate, in a pilot study, the clinical results of extracorporeal magnetic innervation therapy (ExMI) of the pelvic floor muscles with functional changes in the pelvic floor musculature, urodynamics and quality of life.

PATIENTS AND METHODS: In all, 74 patients (65 women and nine men) with urge incontinence, urgency/frequency, stress incontinence, mixed incontinence and defecation problems were included in a prospective study of ExMI using a ‘electromagnetic chair’. All patients were treated twice weekly for 8 weeks. Digital palpation and biofeedback with a vaginal or anal probe were used for registration of the pelvic floor musculature. A urodynamic evaluation, a voiding diary, a pad-test, the King’s Health Questionnaire (KHQ) and a visual analogue scale (VAS) were completed by the patient at baseline and at the end of the study.

RESULTS: In the group as a whole, there were no significant differences in the voiding diary, pad-test, quality of life, VAS score, biofeedback registration and urodynamics before and after treatment. Additional stratification was applied to the total patient group, related to the pretreatment rest tone of the pelvic floor, the basal amplitude registered on electromyography, to age and to previous treatments. However, there were no significant differences in the data before and after treatment within all subgroups (stress incontinence, urge incontinence, urgency/frequency, defecation problems, overactive pelvic floor, age, previous treatments), except for the KHQ domain of ‘role limitations’, where there was a significant improvement in all groups.

CONCLUSION: ExMI did not change pelvic floor function in the present patients. The varying outcomes of several studies on ExMI stress the need for critical studies on the effect and the mode of action of electrostimulation and magnetic stimulation. In our opinion ‘the chair’ is suitable to train awareness of the location of the pelvic floor. However, active pelvic floor muscle exercises remain essential.

Curr Opin Urol. 2005 Jul;15(4):231-5.

A critical review on magnetic stimulation: what is its role in the management of pelvic floor disorders?

Quek P.

Department of Urology, Changi General Hospital, Singapore 529889. pharoahpug@yahoo.co.uk

Abstract

PURPOSE OF REVIEW: This review looks at the acute effects of magnetic stimulation on urodynamic parameters and reviews the data on its use in the management of urinary incontinence.

RECENT FINDINGS: Reported cure rates for stress incontinence immediately after a course of perineal magnetic stimulation range from 12.5 to 52.9% with good improvement occurring in 32% to 41%. However the effect seems temporary and dependent on the number of sessions. Sacral and pelvic floor magnetic stimulation have also been shown to increase cystometric capacity, inhibit detrusor overactivity and resolve overactive bladder symptoms acutely. Persistence of this effect with symptomatic improvement one week after sacral magnetic stimulation has been demonstrated. How magnetic stimulation suppresses detrusor contraction is not known. Prospective trials with the Neocontrol chair (Neotonus Inc, Marietta, Georgia, USA) also showed symptomatic improvement in 71 to 87% in the short term. However, the longer term data appear mixed.

SUMMARY: Overall, the data available vary too much in terms of treatment protocols, patient mix and symptom severity to determine which group of patients might benefit most and what the optimal stimulation parameters are for each condition. Mean reductions in leak parameters, although statistically significant, may not always be clinically satisfactory. The beneficial effects also appear to be temporary and continuous treatment will probably be required. Further trials are needed to determine the optimum stimulation protocols for different situations and to compare magnetic stimulation with other forms of conservative pelvic floor therapy.

Urol Int. 2005;74(3):224-8.

Preliminary results of the effect of extracorporeal magnetic stimulation on urinary incontinence after radical prostatectomy: a pilot study.

Yokoyama T, Inoue M, Fujita O, Nozaki K, Nose H, Kumon H.

Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan. uroyoko@md.okayama-u.ac.jp

Abstract

INTRODUCTION: Radical prostatectomy is a common procedure for the treatment of clinically localized prostate cancer. However, urinary incontinence is a significant potential source of morbidity following surgery. Extracorporeal magnetic stimulation (ExMS) is a new technology used for pelvic muscle strengthening in the treatment of stress urinary incontinence. We investigated the clinical effects of ExMS on urinary incontinence after retropubic radical prostatectomy.

PATIENTS AND METHODS: Ten patients who had suffered from urinary incontinence for more than 12 months following radical prostatectomy were enrolled in this study. The Neocontrol system was used. Treatment sessions were for 20 min, twice a week for 2 months. The frequency of the pulse field was 10 Hz for 10 min, followed by a second treatment at 50 Hz for 10 min. Objective and subjective measures included voiding diaries, 1-hour pad weight testing, and a quality of life survey at 1, 2, 3, and 6 months after starting the treatment. Urodynamic studies were performed before and after treatment.

RESULTS: Three patients became dry (30%), 3 patients improved (30%), and 4 patients showed stationary symptoms (40%). In the 1-hour pad weight testing, the mean pad weight decreased from 25 to 10.3 g, and the quality of life scores had improved from 70.5 to 84.9 2 months after treatment. The frequency of leak episodes per day was reduced from 5.0 times before to 1.9 times after treatment. In the urodynamic study, mean maximum cystometric capacity and Valsalva leak point pressure increased from 197 +/- 53.2 to 309 +/- 85.3 ml and from 67.3 +/- 22.6 to 97.1 +/- 22.7 cm H2O after treatment, respectively (p < 0.05). 3 of 6 patients who showed improvement returned to the baseline values within 12 months after treatment and requested maintenance ExMS therapy. No side effects were observed.

CONCLUSIONS: ExMS therapy offered a new option for urinary incontinence treatment after radical prostatectomy. Further studies are required to determine how long the benefits of treatment last and whether maintenance therapy is necessary.

Neurol Clin Neurophysiol. 2004 Nov 30;2004:44.

Study on optimization for current distribution in magnetic stimulation therapy for urinary incontinence.

Odagaki M, Suga K, Sasaki T, Hosaka H.

Graduate School of Science and Engineering, Tokyo Denki University, Japan. odagaki@b.dendai.ac.jp

Abstract

It has been reported that magnetic stimulation effectively eliminates urinary incontinence. However, this type of therapy has not been established as a practical treatment for urinary incontinence because of its poor power conversion efficiency and the leakage of current to regions other than that of the target of stimulation. It is therefore necessary to develop magnetic stimulators that are more efficient in stimulating the sphincter muscles and the peripheral nerves, and are more convenient than those presently available. By using a large-diameter coil, the magnetic stimulation method offers a larger current distribution over a wider area of the target region than electrical stimulation method, and the placement of the coil can be relatively easily changed to obtain better therapeutic results. We attempted, with a computer simulation model of the female abdomen, to simulate the distribution of the induced current density on the basis of biological tissue conductivity. We determined which method of stimulation is the most efficient by varying the stimulator coil location and size. A genetic algorithm (GA) was used for optimization.

Int J Urol. 2004 Aug;11(8):602-6.

Extracorporeal magnetic innervation treatment for urinary incontinence.

Yokoyama T, Fujita O, Nishiguchi J, Nozaki K, Nose H, Inoue M, Ozawa H, Kumon H.

Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan. uroyoko@md.okayama-u.ac.jp

Abstract

BACKGROUND: Extracorporeal magnetic innervation (ExMI) is a new technology used for pelvic muscle strengthening for the treatment of stress urinary incontinence. We explored whether this new technology is effective for patients with urge incontinence, as well as those with stress urinary incontinence.

METHODS: We studied 20 patients with urge incontinence and 17 patients with stress urinary incontinence. The Neocontrol system (Neotonus Inc., Marietta, GA) was used. Treatment sessions were for 20 min, twice a week for 8 weeks. Evaluations were performed by bladder diaries, one-hour pad weight testing, quality-of-life surveys and urodynamic studies.

RESULTS: Of the urge incontinence cases, five patients were cured (25.0%), 12 patients improved (60.0%) and three patients did not show any improvement (15.0%). Leak episodes per day reduced from 5.6 times to 1.9 times at 8 weeks (P < 0.05). Eight patients with urge incontinence recurred within 24 weeks after the last treatment (47.1%). Of the stress incontinence cases, nine patients were cured (52.9%), seven patients improved (41.1%) and one patient did not show any improvement (6%). In one-hour pad weight testing, the mean pad weight reduced from 7.9 g to 1.9 g at 8 weeks (P < 0.05). Three patients returned to the baseline values within 24 weeks after the last treatment (17.6%). No side-effects were experienced by any of the patients.

CONCLUSION: Although the results for urge incontinence were less effective than for stress urinary incontinence, ExMI therapy offers a new option for urge incontinence as well as stress urinary incontinence.

J Urol. 2004 Apr;171(4):1571-4; discussion 1574-5.

Urodynamic and clinical evaluation of 91 female patients with urinary incontinence treated with perineal magnetic stimulation: 1-year followup.

Almeida FG, Bruschini H, Srougi M.

Urology Departments Federal University of São Paulo-UNIFESP/EPM, São Paulo, Brazil.

Abstract

PURPOSE: We evaluate the perineal magnetic stimulation (PMS) effect on continence and quality of life in women with urinary incontinence.

MATERIALS AND METHODS: We prospective studied 91 women with demonstrable urinary incontinence treated with 16 sessions of PMS. Pretreatment and posttreatment evaluation was done by clinical history, physical examination, voiding diary, validated quality of life survey (I-QOL) and urodynamic study (UDS). Patients with no leakage after treatment were evaluated at 3, 6 and 12 months.

RESULTS: Mean patient age +/- SD was 60.5 +/- 10.1 years. Immediately after treatment the I-QOL score increased 35% (p <0.001), the number of pads daily decreased 40% (p <0.001), the number of leaks daily decreased 54% (p <0.001) and 34 patients (37%) became dry. Of the 91 patients 41 were evaluated before and after treatment by UDS. The average increase in vesical leak point pressure (VLPP) was 24.3% (p = 0.001) and initial VLPP in patients who became dry was greater than 80 cm H2O. After treatment 77% of patients with initial low pressure detrusor overactivity on UDS became free of this condition. One year after discontinuing PMS 94% of patients who became dry immediately after treatment had recurrence.

CONCLUSIONS: Immediately after 16 sessions of PMS women with urinary incontinence have significant improvement in the I-QOL score with decreased daily pad use and leakage episodes but 63% had failure. Therapy is more effective in patients with a VLPP of greater than 80 cm H2O. The beneficial effect is temporary with high and early recurrence after discontinuing treatment.

Urology. 2004 Feb;63(2):264-7.

Comparative study of effects of extracorporeal magnetic innervation versus electrical stimulation for urinary incontinence after radical prostatectomy.

Yokoyama T, Nishiguchi J, Watanabe T, Nose H, Nozaki K, Fujita O, Inoue M, Kumon H.

Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.

Abstract

OBJECTIVES: To perform a randomized comparative study to investigate the clinical effects of extracorporeal magnetic innervation (ExMI) and functional electrical stimulation (FES) on urinary incontinence after retropubic radical prostatectomy.

METHODS: Thirty-six patients with urinary incontinence after radical prostatectomy were randomly assigned to three groups (12 patients each in the FES, ExMI, and control groups). For FES, an anal electrode was used. Pulses of 20-Hz square waves at a 300-micros pulse duration were used for 15 minutes twice daily for 1 month. For ExMI, the Neocontrol system was used. The treatment sessions were for 20 minutes, twice a week for 2 months. The frequency of the pulse field was 10 Hz for 10 minutes, followed by a second treatment at 50 Hz for 10 minutes. For the control group, only pelvic floor muscle exercises were performed. Objective measures included bladder diaries, 24-hour pad weight testing, and a quality-of-life survey, at 1, 2, and 4 weeks and 2, 3, 4, 5, and 6 months after removing the catheter.

RESULTS: The leakage weight during the 24 hours after removing the catheter was 684, 698, and 664 g for the FES, ExMI, and control groups, respectively. At 1 month, it was 72, 83, and 175 g (FES versus control, P <0.05) and at 2 months was 54, 18, and 92 g (ExMI versus control, P <0.05) in the FES, ExMI, and control groups, respectively. Finally, 6 months later, the average 24-hour leakage weight was less than 10 g in all groups. Quality-of-life measures decreased after surgery, but gradually improved over time in all groups. No complications were noted in any of the groups.

CONCLUSIONS: ExMI and FES therapies offered earlier continence compared with the control group after radical prostatectomy. We consider ExMI and FES to be recommendable options for patients who want quick improvement of postoperative urinary incontinence.

Scand J Urol Nephrol. 2003;37(5):424-8.

Extracorporeal magnetic stimulation for the treatment of stress and urge incontinence in women–results of 1-year follow-up.

Unsal A, Saglam R, Cimentepe E.

Department of Urology, School of Medicine, Fatih University, Ciftlik Cd. No: 57, TR-06510 Emek, Ankara, Turkey. unsalali@hotmail.com

Abstract

OBJECTIVE: To evaluate the clinical efficacy of extracorporeal magnetic stimulation for the treatment of stress and urge urinary incontinence in women.

MATERIAL AND METHODS: A total of 35 patients with stress incontinence and 17 with urge incontinence were enrolled in this study. All patients were evaluated by means of a detailed history of incontinence, a gynecologic examination, urine culture, urinary system ultrasound and a urodynamic study. All patients were asked to keep a 3-day voiding diary. A pad-weighing test was done for each patient at their first visit. For treatment, the patients were seated on a special chair containing a magnetic field generator. Pelvic floor muscle stimulation was performed for 20 min (10 min at 5 Hz and 10 min at 50 Hz) twice a week for a total of 8 weeks. The mean follow-up period was 16.8 months (range 12-32 months). A total of 44 patients completed 1 year of follow-up and were re-evaluated by means of voiding diary, pad-weighing test and cystometric study.

RESULTS: Of the 44 patients, 11 (38%) with stress incontinence and 6 (40%) with urge incontinence were cured 1 year after the treatment. In addition, there was an improvement in symptoms in 12 patients (41%) in the stress group and 7 (47%) in the urge group. Pad weight was reduced from 15.4 to 5.8 g in the stress group and from 12.4 to 4.7 g in the urge group (p = 0.000 and 0.001, respectively). Mean Valsalva leak point pressure was increased from 87.3 +/- 15.9 to 118.0 +/- 11.0 cmH (2) O in the stress group (p = 0.000).

CONCLUSIONS: Extracorporeal magnetic stimulation therapy offers a non-invasive, effective and painless treatment for stress and urge incontinence in women.

Altern Ther Health Med. 2003 Jul-Aug;9(4):38-48.

Effects of a pulsed electromagnetic therapy on multiple sclerosis fatigue and quality of life: a double-blind, placebo controlled trial.

Lappin MS, Lawrie FW, Richards TL, Kramer ED.

Energy Medicine Developments, (North America), Inc., Burke, Va., USA.

Abstract

CONTEXT: There is a growing literature on the biological and clinical effects of pulsed electromagnetic fields. Some studies suggest that electromagnetic therapies may be useful in the treatment of chronic illnesses. This study is a follow-up to a placebo controlled pilot study in which multiple sclerosis (MS) patients exposed to weak, extremely low frequency pulsed electromagnetic fields showed significant improvements on a composite symptom measure.

OBJECTIVE: To evaluate the effects of a pulsed electromagnetic therapy on MS related fatigue, spasticity, bladder control, and overall quality of life.

DESIGN: A multi-site, double-blind, placebo controlled, crossover trial. Each subject received 4 weeks of the active and placebo treatments separated by a 2-week washout period.

SETTING: The University of Washington Medical Center in Seattle Wash, the Neurology Center of Fairfax in Fairfax, Va, and the headquarters of the Multiple Sclerosis Association of America in Cherry Hill, NJ.

SUBJECTS: 117 patients with clinically definite MS.

INTERVENTION: Daily exposure to a small, portable pulsing electromagnetic field generator.

MAIN OUTCOME: The MS Quality of Life Inventory (MSQLI) was used to assess changes in fatigue, bladder control, spasticity, and a quality of life composite.

RESULTS: Paired t-tests were used to assess treatment differences in the 117 subjects (81% of the initial sample) who completed both treatment sessions. Improvements in fatigue and overall quality of life were significantly greater on the active device. There were no treatment effects for bladder control and a disability composite, and mixed results for spasticity.

CONCLUSIONS: Evidence from this randomized, double-bind, placebo controlled trial is consistent with results from smaller studies suggesting that exposure to pulsing, weak electromagnetic fields can alleviate symptoms of MS. The clinical effects were small, however, and need to be replicated. Additional research is also needed to examine the possibility that ambulatory patients and patients taking interferons for their MS may be most responsive to this kind of treatment.

Urologe A. 2003 Jun;42(6):819-22. Epub 2003 Jan 17.

Magnet stimulation therapy: a simple solution for the treatment of stress and urge incontinence?

[Article in German]

Kirschner-Hermanns R, Jakse G.

Urologische Klinik, Universitätsklinikum, RWTH Aachen.

Abstract

AIM: Magnet stimulation therapy has been offered as a new, conservative therapy for stress and urge incontinence in Germany since 2001. Focussed, pulsating magnetic fields are used to stimulate the musculature of the floor of the pelvis. This publication describes our initial experience with this method.

PATIENTS AND METHODS: We treated 27 patients with magnetic stimulation. The individual patient sits clothed on a therapy-chair and is treated for 20 min twice a week for 2 weeks.

RESULTS: The best results were recorded in female patients with grades I and II stress incontinence who could not actively flex their pelvic-floor musculature during physiotherapy. A marked reduction in the frequency of micturition was obtained in 67% of patients with urge incontinence symptoms and non-responsiveness to anticholinergic therapy. Patients with a non-organically tangible pelvic-pain-syndrome did not benefit from the therapy.

CONCLUSIONS: Magnet stimulation therapy can act as a useful addition to conservative therapies for stress and urge incontinence. It is free of complications and does not involve the insertion of an electrode into the patient as is the case for vaginal and anal electrostimulation. However, this method does not appear to be useful for chronic, non-specific pain in the lower pelvis.

Urology. 2000 Dec 4;56(6 Suppl 1):82-6.

Update on extracorporeal magnetic innervation (EXMI) therapy for stress incontinence.

Galloway NT, El-Galley RE, Sand PK, Appell RA, Russell HW, Carlin SJ.

Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.

Pulsed magnetic technology has been developed for pelvic floor muscle strengthening for the treatment of urinary incontinence. This report includes an update of the prospective multicenter study of extracorporeal magnetic innervation (ExMI) therapy for stress incontinence and a discussion of the possible mechanisms of action. Issues of patient selection for ExMI therapy will also be discussed. One hundred and eleven women with demonstrable stress urinary incontinence were studied. The mean age was 55 +/- 13 years, and the mean duration of symptoms was 11 years. Ninety-seven completed ExMI therapy and analysis. Evaluation before treatment included bladder diaries, dynamic pad weight test, urodynamics, and a quality-of-life survey. For treatment the patients were seated fully clothed in a Neocontrol chair with a magnetic field therapy head in the seat. Treatment sessions were for 20 minutes, twice a week, for 6 weeks. After ExMI therapy, all of the measures were repeated at 8 weeks, including the dynamic pad weight testing and quality-of-life survey. At 6 months, further data were added, including repeat bladder diary, pad use, and quality-of-life survey. Forty-seven women completed 6 months of follow-up; of the 47, 13 patients were completely dry (28%) and 25 used no pad or less than 1 pad per day (53%). Pad use was reduced in 33 patients (70%). The median number of pads was reduced from 2.16 to 1 per day (Wilcoxon signed rank test, P <0.005). The frequency of leak episodes was reduced from 3.0 to 1.7 at 6 months (Wilcoxon signed rank test, P = 0.004). Detrusor instability was demonstrated in 10 before and 6 after ExMI (P <0.05). ExMI offers an alternative approach for the treatment of urinary incontinence. ExMI therapy is effective for both stress and urge incontinence. The best results are achieved in those patients who use no more than 3 pads a day and have had no prior continence surgery.

Obstet Gynecol Surv. 2000 Nov;55(11):715-20.

Electromagnetic pelvic floor stimulation: applications for the gynecologist.

Goldberg RP, Sand PK.

Evanston Continence Center, Northwestern University Medical School, Evanston Northwestern Healthcare, Illinois, USA. r-goldberg@nwu.edu

Abstract

The therapeutic potential of magnetic energy has been a subject of long-standing interest within both conventional and alternative medical practice. Numerous devices using magnetic fields, ranging from the dubious to truly innovative, have claimed a wide variety of clinical benefits. For gynecologists involved with the diagnosis and treatment of pelvic floor and bladder dysfunction, magnetic stimulation of the sacral nerve roots and peripheral nerves continues to evolve as a noninvasive treatment alternative. The conduction characteristics of magnetic energy confer several practical advantages for its use. This article reviews the use of electromagnetic stimulation for treatment of common urogynecologic conditions, and provides an historical overview of the therapeutic application of electromagnetic energy.

Urology. 1999 Jun;53(6):1108-11.

Extracorporeal magnetic innervation therapy for stress urinary incontinence.

Galloway NT, El-Galley RE, Sand PK, Appell RA, Russell HW, Carlan SJ.

Emory University School of Medicine, Atlanta, Georgia, USA.

Abstract

OBJECTIVES: To report the first data from a prospective clinical study to determine the feasibility of using extracorporeal magnetic innervation (ExMI) for the treatment of stress urinary incontinence.

METHODS: We studied 83 women with demonstrable stress urinary incontinence. Treatments were for 20 minutes, twice a week for 6 weeks. For treatment, the patient sits fully clothed on a special chair; within the seat is a magnetic field generator that produces the rapidly changing magnetic field flux. Objective measures included bladder diaries, dynamic pad weight testing, urodynamic studies, and quality of life survey.

RESULTS: Fifty patients have been followed up for longer than 3 months (33 patients for less than 3 months); 17 patients (34%) were dry, 16 (32%) were using not more than 1 pad per day, and 17 (34%) were using more than 1 pad per day. Pad use was reduced from 2.5 to 1.3 (P = 0.001) and leak episodes per day were reduced from 3.3 to 1.7 (P = 0.001). The pad weight was reduced from 20 to 15 g. Detrusor instability was found in 5 patients before but was demonstrated in only 1 patient after treatment.

CONCLUSIONS: ExMI therapy offers a new effective modality for pelvic floor muscle stimulation. ExMI is painless, there is no need for a probe, and no need to undress for treatments. Longer follow-up is required to determine how long the benefits of treatment last and whether retreatment will be necessary.

Posted on

Ulcer – Duodenal, Gastric, Peptic

Lik Sprava. 1994 Jan;(1):83-5.

The results of treating gastric and duodenal peptic ulcer by using the millimeter-range wavelength.

[Article in Russian]

Vinogradov VG, Kisel’ LK, Mager NV.

Abstract

Complex treatment of peptic ulcer with drugs and millimeter electromagnetic waves (MEW) allows to shorten stay in hospital by 2 weeks. Ambulatory MEW therapy may be effective even if used without any drugs, especially in young patients with fresh ulcer. Thus, MEW treatment is recommended by the authors to be widely applied for the treatment of peptic ulcer both in hospital and out-patient departments.

Lik Sprava. 1992 Aug;(8):36-8.

The local treatment of patients with a duodenal ulcer with millimeter-range electromagnetic radiation.

[Article in Ukrainian]

Zly? MV, Netiazhenko VZ, Zly? VV.

Abstract

A technique was designed for the treatment of duodenal ulcer patients by electromagnetic radiation of the millimeter range (ERMR); 30 patients were treated by this method, while 50 patients received traditional therapy; other patients were treated by lasers, cithemidin. Endoscopic ERMR treatment in combination with drugs was more effective than other methods.

Vrach Delo. 1991 May;(5):59-61.

The effect of hypnotic suggestion and millimeter-range electromagnetic radiation on the clinical and endoscopic indices in peptic ulcer patients.

[Article in Russian]

Nikula TD, Kan EB.

Abstract

The authors studied the effect of microwave resonance therapy, hypnosuggestion and their combinations on the dynamics of clinico-endoscopic indices in 182 patients with duodenal ulcer. It was established that these methods were highly effective allowing to control rapidly the pain syndrome, to achieve complete healing of the ulcer in 70-95% of cases within 14.8-16.7 days. The results were best when the two methods were combined.

Vrach Delo. 1990 May;(5):6-9.

The use of millimeter-range electromagnetic radiation for treating peptic ulcer.

[Article in Russian]

Dogotar’ VB, Tkach SM, Perederi? VG, Kuzenko IuG.

Abstract

The efficacy was studied of treatment of ulcer disease by means of microwave resonance radiation. It was established that this method of treatment has advantages over traditional drug therapy in patients harbouring the ulcer in the duodenum. The authors describe contraindications to the use of this method, determine the duration of treatment.

Posted on

Tumor Necrosis Factor

Biofizika. 2004 May-Jun;49(3):545-50.

A comparison of the effects of millimeter and centimeter waves on tumor necrosis factor production in mouse cells.

[Article in Russian]

Sinotova OA, Novoselova EG, Glushkova OV, Fesenko EE.

Abstract

The effects of millimeter (40 GHz) and centimeter (8.15-18.00 GHz) low-intensity waves on the production of tumor necrosis factor (TNE) in macrophages and lymphocytes from exposed mice as well as in exposed isolated cells were compared. It was found that the dynamics of TNF secretory activity of cells varies depending on the frequency and duration of exposure. The application of millimeter waves induced a nonmonotonous course of the dose-effect curve for TNF changes in macrophages and splenocytes. Alternately, a stimulation and a decrease in TNF production were observed following the application of millimeter waves. On the contrary, centimeter waves provoked an activation in cytokine production. It is proposed that, in contrast to millimeter waves, the single application of centimeter waves to animals (within 2 to 96 h) or isolated cells (within 0.5 to 2.5 h) induced a much more substantial stimulation of immunity.

Biofizika. 2002 Mar-Apr;47(2):376-81.

Immunomodulating effect of electromagnetic waves on production of tumor necrosis factor in mice with various rates of neoplasm growth.

[Article in Russian]

Glushkova OV, Novoselova EG, Sinotova OA, Vrublevskaia VV, Fesenko EE.

Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290 Russia.

Abstract

The effects of low-density centimeter waves (8.15-18 GHz, 1 microW/cm2, 1 h daily for 14 days; MW) on tumor necrosis factor production in macrophages of mice with different growth rate of a cancer solid model produced after hypodermic injection of Ehrlich carcinoma ascites cells into hind legs were studied. After irradiation, an increase in the concentration of tumor necrosis factor in immunocompetent cells of healthy and, specially, of tumor-bearing animals was observed; and the effect of stimulation was higher upon exposure of mice carrying rapidly growing tumors. We suggest that the significant immunomodulating effect of low-density microwaves can be utilized for tumor growth suppression.

Biofizika. 2001 Jan-Feb;46(1):131-5.

Effect of centimeter microwaves and the combined magnetic field on the tumor necrosis factor production in cells of mice with experimental tumors.

[Article in Russian]

Novoselova EG, Oga? VB, Sorokina OV, Novikov VV, Fesenko EE.

Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290 Russia.

Abstract

The effect of fractionated exposure to low-intensity microwaves (8.15-18 GHz, 1 microW/cm2, 1.5 h daily for 7 days) and combined weak magnetic field (constant 65 1 microT; alternating–100 nT, 3-10 Hz) on the production of tumor necrosis factor in macrophages of mice with experimental solid tumors produced by transplantation of Ehrlich ascites carcinoma was studied. It was found that exposure of mice to both microwaves and magnetic field enhanced the adaptive response of the organism to the onset of tumor growth: the production of tumor necrosis factor in peritoneal macrophages of tumor-bearing mice was higher than in unexposed mice.