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Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial.
Arch Phys Med Rehabil. 2009 Jul; 90(7):1102-9.AP

Abstract

OBJECTIVE

To determine whether repetitive and cumulative exposure to low-frequency pulsed electromagnetic fields (PEMF) targeting painful feet can reduce neuropathic pain (NP), influence sleep in symptomatic diabetic peripheral neuropathy (DPN), and influence nerve regeneration.

DESIGN

Randomized, double-blind, placebo-controlled parallel study.

SETTING

Sixteen academic and clinical sites in 13 states.

PARTICIPANTS

Subjects (N=225) with DPN stage II or III were randomly assigned to use identical devices generating PEMF or sham (placebo) 2 h/d to feet for 3 months.

INTERVENTIONS

Nerve conduction testing was performed serially.

MAIN OUTCOME MEASURES

Pain reduction scores using a visual analog scale (VAS), the Neuropathy Pain Scale (NPS), and the Patient's Global Impression of Change (PGIC). A subset of subjects underwent serial 3-mm punch skin biopsies from 3 standard lower limb sites for epidermal nerve fiber density (ENFD) quantification.

RESULTS

Subjects (N=225) were randomized with a dropout rate of 13.8%. There was a trend toward reductions in DPN symptoms on the PGIC, favoring the PEMF group (44% vs 31%; P=.04). There were no significant differences between PEMF and sham groups in the NP intensity on NPS or VAS. Twenty-seven subjects completed serial biopsies. Twenty-nine percent of PEMF subjects had an increase in distal leg ENFD of at least 0.5 SDs, while none did in the sham group (P=.04). Increases in distal thigh ENFD were significantly correlated with decreases in pain scores.

CONCLUSIONS

PEMF at this dosimetry was noneffective in reducing NP. However neurobiological effects on ENFD, PGIC and reduced itching scores suggest future studies are indicated with higher dosimetry (3000-5000 G), longer duration of exposure, and larger biopsy cohort.

Authors+Show Affiliations

Department of Neurology, New York Medical College, Valhalla, NY, USA. miwneuro@pol.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19577022

Citation

Weintraub, Michael I., et al. "Pulsed Electromagnetic Fields to Reduce Diabetic Neuropathic Pain and Stimulate Neuronal Repair: a Randomized Controlled Trial." Archives of Physical Medicine and Rehabilitation, vol. 90, no. 7, 2009, pp. 1102-9.
Weintraub MI, Herrmann DN, Smith AG, et al. Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial. Arch Phys Med Rehabil. 2009;90(7):1102-9.
Weintraub, M. I., Herrmann, D. N., Smith, A. G., Backonja, M. M., & Cole, S. P. (2009). Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 90(7), 1102-9. https://doi.org/10.1016/j.apmr.2009.01.019
Weintraub MI, et al. Pulsed Electromagnetic Fields to Reduce Diabetic Neuropathic Pain and Stimulate Neuronal Repair: a Randomized Controlled Trial. Arch Phys Med Rehabil. 2009;90(7):1102-9. PubMed PMID: 19577022.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pulsed electromagnetic fields to reduce diabetic neuropathic pain and stimulate neuronal repair: a randomized controlled trial. AU - Weintraub,Michael I, AU - Herrmann,David N, AU - Smith,A Gordon, AU - Backonja,Misha M, AU - Cole,Steven P, PY - 2008/10/03/received PY - 2008/12/16/revised PY - 2009/01/11/accepted PY - 2009/7/7/entrez PY - 2009/7/7/pubmed PY - 2009/7/22/medline SP - 1102 EP - 9 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 90 IS - 7 N2 - OBJECTIVE: To determine whether repetitive and cumulative exposure to low-frequency pulsed electromagnetic fields (PEMF) targeting painful feet can reduce neuropathic pain (NP), influence sleep in symptomatic diabetic peripheral neuropathy (DPN), and influence nerve regeneration. DESIGN: Randomized, double-blind, placebo-controlled parallel study. SETTING: Sixteen academic and clinical sites in 13 states. PARTICIPANTS: Subjects (N=225) with DPN stage II or III were randomly assigned to use identical devices generating PEMF or sham (placebo) 2 h/d to feet for 3 months. INTERVENTIONS: Nerve conduction testing was performed serially. MAIN OUTCOME MEASURES: Pain reduction scores using a visual analog scale (VAS), the Neuropathy Pain Scale (NPS), and the Patient's Global Impression of Change (PGIC). A subset of subjects underwent serial 3-mm punch skin biopsies from 3 standard lower limb sites for epidermal nerve fiber density (ENFD) quantification. RESULTS: Subjects (N=225) were randomized with a dropout rate of 13.8%. There was a trend toward reductions in DPN symptoms on the PGIC, favoring the PEMF group (44% vs 31%; P=.04). There were no significant differences between PEMF and sham groups in the NP intensity on NPS or VAS. Twenty-seven subjects completed serial biopsies. Twenty-nine percent of PEMF subjects had an increase in distal leg ENFD of at least 0.5 SDs, while none did in the sham group (P=.04). Increases in distal thigh ENFD were significantly correlated with decreases in pain scores. CONCLUSIONS: PEMF at this dosimetry was noneffective in reducing NP. However neurobiological effects on ENFD, PGIC and reduced itching scores suggest future studies are indicated with higher dosimetry (3000-5000 G), longer duration of exposure, and larger biopsy cohort. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/19577022/Pulsed_electromagnetic_fields_to_reduce_diabetic_neuropathic_pain_and_stimulate_neuronal_repair:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(09)00217-2 DB - PRIME DP - Unbound Medicine ER -