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Published in: Clinical Rheumatology 8/2007

01-08-2007 | Original Article

Therapeutic effect of pulsed electromagnetic field in conservative treatment of subacromial impingement syndrome

Authors: Ilknur Aktas, Kenan Akgun, Bahar Cakmak

Published in: Clinical Rheumatology | Issue 8/2007

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Abstract

Subacromial impingement syndrome (SIS) is a frequent cause of shoulder pain. Our purpose in this double-blinded, randomized, and controlled study was to demonstrate whether the pulsed electromagnetic field (PEMF) provides additional benefit when used with other conservative treatment modalities in acute phase rehabilitation program of SIS. Forty-six patients with unilateral shoulder pain who had been diagnosed as having SIS were included in this trial. The cases were randomly separated into two groups. All cases received a treatment program for 3 weeks consisting of Codman’s pendulum exercises and subsequent cold pack gel application on shoulders with pain 5 times a day, restriction of daily activities that require the hands to be used over the head, and meloxicam tablet 15 mg daily. One group was given PEMF; the other group was given sham PEMF daily, 25 min per session, 5 days per week for 3 weeks. Shoulder pain during rest and activity and which causes disturbance of sleep was evaluated using a visual analogue scale, and total Constant score investigated shoulder function. Daily living activities were evaluated by shoulder disability questionnaire. Results were assessed before and after treatment. When compared with the baseline values, significant improvements in all these variables were observed at the end of the treatment in both groups (p < 0.05). No significant difference between treatments was observed for any of these variables (p > 0.05). There is no convincing evidence that electromagnetic therapy is of additional benefit in acute phase rehabilitation program of SIS.
Literature
1.
go back to reference Meyer SJF, Dalinka MK (1990) Magnetic resonance imaging of the shoulder. Orthop Clin North Am 21:497–513PubMed Meyer SJF, Dalinka MK (1990) Magnetic resonance imaging of the shoulder. Orthop Clin North Am 21:497–513PubMed
2.
go back to reference Pope DP, Croft PR, Pritchard CM, Silman AJ (1997) Prevalence of shoulder pain in the community: the influence of case definition. Ann Rheum Dis 56:308–312PubMed Pope DP, Croft PR, Pritchard CM, Silman AJ (1997) Prevalence of shoulder pain in the community: the influence of case definition. Ann Rheum Dis 56:308–312PubMed
3.
go back to reference Neer CS (1983) Impingement lesions. Clin Orthop Relat Res 173:70–77PubMed Neer CS (1983) Impingement lesions. Clin Orthop Relat Res 173:70–77PubMed
4.
go back to reference Fongemie AE, Buss DD, Rolnick SJ (1998) Management of shoulder impingement syndrome and rotator cuff tears. Am Fam Phys 57:667–674 Fongemie AE, Buss DD, Rolnick SJ (1998) Management of shoulder impingement syndrome and rotator cuff tears. Am Fam Phys 57:667–674
5.
go back to reference Wasilevsky SA, Frankl U (1991) Rotator cuff pathology: arthroscopic assessment and treatment. Clin Orthop Relat Res 267:65–70 Wasilevsky SA, Frankl U (1991) Rotator cuff pathology: arthroscopic assessment and treatment. Clin Orthop Relat Res 267:65–70
6.
go back to reference Hawkins RJ, Abrams JS (1987) Impingement syndrome in the absence of rotator cuff tear. Orthop Clin North Am 18:373–382PubMed Hawkins RJ, Abrams JS (1987) Impingement syndrome in the absence of rotator cuff tear. Orthop Clin North Am 18:373–382PubMed
7.
go back to reference Kamkar A, Irrgang JJ, Whitney SL (1993) Nonoperative management of secondary shoulder impingement syndrome. J Orthop Sports Phys Ther 17:212–224PubMed Kamkar A, Irrgang JJ, Whitney SL (1993) Nonoperative management of secondary shoulder impingement syndrome. J Orthop Sports Phys Ther 17:212–224PubMed
8.
go back to reference Butters KP, Rockwood CA Jr (1988) Office evaluation and management of the shoulder impingement syndrome. Orthop Clin North Am 19:755–765PubMed Butters KP, Rockwood CA Jr (1988) Office evaluation and management of the shoulder impingement syndrome. Orthop Clin North Am 19:755–765PubMed
9.
go back to reference Bigliani LU, Levine WN (1997) Subacromial impingement syndrome. J Bone Jt Surg Am 79:1854–68 Bigliani LU, Levine WN (1997) Subacromial impingement syndrome. J Bone Jt Surg Am 79:1854–68
10.
go back to reference American Academy of Orthopedic Surgeons (2001) AAOS clinical guideline on shoulder pain: support document. American Academy of Orthopedic Surgeons, Rosemont (IL) American Academy of Orthopedic Surgeons (2001) AAOS clinical guideline on shoulder pain: support document. American Academy of Orthopedic Surgeons, Rosemont (IL)
11.
go back to reference Akgun K, Birtane M, Akarirmak U (2004) Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome? Clin Rheumatol 23:496–500PubMedCrossRef Akgun K, Birtane M, Akarirmak U (2004) Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome? Clin Rheumatol 23:496–500PubMedCrossRef
12.
go back to reference Buchbinder R, Green S, Youd JM (2003) Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 1:CD004016 Buchbinder R, Green S, Youd JM (2003) Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 1:CD004016
13.
go back to reference Tallia AF, Cardone DA (2003) Diagnostic and therapeutic injection of the shoulder region. Am Fam Phys 67:1271–1278 Tallia AF, Cardone DA (2003) Diagnostic and therapeutic injection of the shoulder region. Am Fam Phys 67:1271–1278
14.
go back to reference Paavola M, Kannus P, Janvinen TA, Jarvinen TL, Jozsa L, Jarvinen M (2002) Treatment of tendon disorders. Is there a role for corticosteroid injection? Foot Ankle Clin 7:501–513PubMedCrossRef Paavola M, Kannus P, Janvinen TA, Jarvinen TL, Jozsa L, Jarvinen M (2002) Treatment of tendon disorders. Is there a role for corticosteroid injection? Foot Ankle Clin 7:501–513PubMedCrossRef
15.
go back to reference Green S, Buchbinder R, Glazier R, Forbes A (1998) Systematic review of randomised controlled trials of interventions for painful shoulder. BMJ 316:354–360PubMed Green S, Buchbinder R, Glazier R, Forbes A (1998) Systematic review of randomised controlled trials of interventions for painful shoulder. BMJ 316:354–360PubMed
16.
go back to reference Quittan M, Schuhfried O, Wiesinger GF, Fialka-Moser V (2000) Clinical effectiveness of magnetic field therapy—a review of the literature. Acta Med Austriaca 27:61–68PubMed Quittan M, Schuhfried O, Wiesinger GF, Fialka-Moser V (2000) Clinical effectiveness of magnetic field therapy—a review of the literature. Acta Med Austriaca 27:61–68PubMed
17.
go back to reference Leclaire R, Bourgouin J (1991) Electromagnetic treatment of shoulder periarthritis: a randomized controlled trial of the efficiency and tolerance of magnetotherapy. Arch Phys Med Rehabil 72:284–287PubMed Leclaire R, Bourgouin J (1991) Electromagnetic treatment of shoulder periarthritis: a randomized controlled trial of the efficiency and tolerance of magnetotherapy. Arch Phys Med Rehabil 72:284–287PubMed
18.
go back to reference Binder A, Parr G, Hazleman B, Fitton-Jackson S (1984) Pulsed electromagnetic field therapy of persistent rotator cuff tendinitis. A double-blind controlled assessment. Lancet 31:695–698CrossRef Binder A, Parr G, Hazleman B, Fitton-Jackson S (1984) Pulsed electromagnetic field therapy of persistent rotator cuff tendinitis. A double-blind controlled assessment. Lancet 31:695–698CrossRef
19.
go back to reference Bassett CA (1993) Beneficial effects of electromagnetic fields. J Cell Biochem 51:387–393PubMed Bassett CA (1993) Beneficial effects of electromagnetic fields. J Cell Biochem 51:387–393PubMed
20.
go back to reference Lednev VV (1991) Possible mechanism for the influence of weak magnetic fields on biological systems. Bioelectromagnetics 12:71–75PubMedCrossRef Lednev VV (1991) Possible mechanism for the influence of weak magnetic fields on biological systems. Bioelectromagnetics 12:71–75PubMedCrossRef
21.
go back to reference Hendee SP, Faour FA, Christensen DA, Patrick B, Durney CH, Blumenthal DK (1996) The effects of weak extremely low frequency magnetic fields on calcium/calmodulin interactions. Biophys J 70:2915–2923PubMed Hendee SP, Faour FA, Christensen DA, Patrick B, Durney CH, Blumenthal DK (1996) The effects of weak extremely low frequency magnetic fields on calcium/calmodulin interactions. Biophys J 70:2915–2923PubMed
22.
go back to reference Blanchard JP, Blackman CF (1994) Clarification and application of an ion parametric resonance model for magnetic field interactions with biological systems. Bioelectromagnetics 15:217–238PubMedCrossRef Blanchard JP, Blackman CF (1994) Clarification and application of an ion parametric resonance model for magnetic field interactions with biological systems. Bioelectromagnetics 15:217–238PubMedCrossRef
23.
go back to reference Adey WR (1993) Biological effects of electromagnetic fields. J Cell Biochem 51:410–416PubMed Adey WR (1993) Biological effects of electromagnetic fields. J Cell Biochem 51:410–416PubMed
24.
go back to reference Paul F, Roath S, Melville D (1978) Differential blood cell separation using a high gradient magnetic field. Br J Haematol 38:273–280PubMed Paul F, Roath S, Melville D (1978) Differential blood cell separation using a high gradient magnetic field. Br J Haematol 38:273–280PubMed
25.
go back to reference Cheng N, Van Hoof H, Delport PH, Hoogmartens MJ, Mulie JC (1985) Treatment of non-union, congenital pseudarthroses and benign cystic lesions using pulsed electromagnetic fields. Reconstr Surg Traumatol 19:118–122PubMed Cheng N, Van Hoof H, Delport PH, Hoogmartens MJ, Mulie JC (1985) Treatment of non-union, congenital pseudarthroses and benign cystic lesions using pulsed electromagnetic fields. Reconstr Surg Traumatol 19:118–122PubMed
26.
go back to reference Mulier JC, Spaas F (1980) Out-patient treatment of surgically resistant non-unions by induced pulsing current-clinical results. Arch Orthop Trauma Surg 97:293–297PubMedCrossRef Mulier JC, Spaas F (1980) Out-patient treatment of surgically resistant non-unions by induced pulsing current-clinical results. Arch Orthop Trauma Surg 97:293–297PubMedCrossRef
27.
go back to reference Patino O, Grana D, Bolgiani A, Prezzavento G, Mino J, Merlo A, Benaim F (1996) Pulsed electromagnetic fields in experimental cutaneous wound healing in rats. J Burn Care Rehabil 17:528–531PubMedCrossRef Patino O, Grana D, Bolgiani A, Prezzavento G, Mino J, Merlo A, Benaim F (1996) Pulsed electromagnetic fields in experimental cutaneous wound healing in rats. J Burn Care Rehabil 17:528–531PubMedCrossRef
28.
go back to reference Orgel MG, O’Brien WJ, Murray HM (1984) Pulsing electromagnetic field therapy in nerve regeneration: an experimental study in the cat. Plast Reconstr Surg 73:173–183PubMedCrossRef Orgel MG, O’Brien WJ, Murray HM (1984) Pulsing electromagnetic field therapy in nerve regeneration: an experimental study in the cat. Plast Reconstr Surg 73:173–183PubMedCrossRef
29.
go back to reference Wilson DH, Jagadeesh P, Newman PP, Harriman DG (1974) The effects of pulsed electromagnetic energy on peripheral nerve regeneration. Ann N Y Acad Sci 238:575–585PubMedCrossRef Wilson DH, Jagadeesh P, Newman PP, Harriman DG (1974) The effects of pulsed electromagnetic energy on peripheral nerve regeneration. Ann N Y Acad Sci 238:575–585PubMedCrossRef
30.
go back to reference Trock DH, Bollet AJ, Dyer RH Jr, Fielding LP, Miner WK, Markoll R (1993) A double-blind trial of the clinical effects of pulsed electromagnetic fields in osteoarthritis. J Rheumatol 20:456–460PubMed Trock DH, Bollet AJ, Dyer RH Jr, Fielding LP, Miner WK, Markoll R (1993) A double-blind trial of the clinical effects of pulsed electromagnetic fields in osteoarthritis. J Rheumatol 20:456–460PubMed
31.
go back to reference Ciombor DM, Aaron RK, Wang S, Simon B (2003) Modification of osteoarthritis by pulsed electromagnetic field a morphological study. Osteoarthr Cartil 11:455–462PubMedCrossRef Ciombor DM, Aaron RK, Wang S, Simon B (2003) Modification of osteoarthritis by pulsed electromagnetic field a morphological study. Osteoarthr Cartil 11:455–462PubMedCrossRef
32.
go back to reference Lin Y, Nishimura R, Nozaki K, Sasaki N, Kadosawa T, Goto N, Date M, Takeuchi A (1992) Effects of pulsing EMFs on the ligament healing in rabbits. J Vet Med Sci 54:1017–1022PubMed Lin Y, Nishimura R, Nozaki K, Sasaki N, Kadosawa T, Goto N, Date M, Takeuchi A (1992) Effects of pulsing EMFs on the ligament healing in rabbits. J Vet Med Sci 54:1017–1022PubMed
33.
go back to reference Currier DP, Ray JM, Nyland J, Rooney JG, Noteboom JT, Kellogg R (1993) Effects of electrical and electromagnetic stimulation after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 17:177–184PubMed Currier DP, Ray JM, Nyland J, Rooney JG, Noteboom JT, Kellogg R (1993) Effects of electrical and electromagnetic stimulation after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 17:177–184PubMed
34.
go back to reference Lee EW, Maffulli N, Li CK, Chan KM (1997) Pulsed magnetic and electromagnetic fields in experimental achilles tendonitis in the rat: a prospective randomized study. Arch Phys Med Rehabil 78:399–404PubMedCrossRef Lee EW, Maffulli N, Li CK, Chan KM (1997) Pulsed magnetic and electromagnetic fields in experimental achilles tendonitis in the rat: a prospective randomized study. Arch Phys Med Rehabil 78:399–404PubMedCrossRef
35.
go back to reference Strauch B, Patel MK, Rosen DJ, Mahadevia S, Brindzei N, Pilla AA (2006) Pulsed magnetic field therapy increases tensile strength in a rat Achilles’ tendon repair model. J Hand Surg [Am] 31:1131–1135CrossRef Strauch B, Patel MK, Rosen DJ, Mahadevia S, Brindzei N, Pilla AA (2006) Pulsed magnetic field therapy increases tensile strength in a rat Achilles’ tendon repair model. J Hand Surg [Am] 31:1131–1135CrossRef
36.
go back to reference Cheing GL, Wan JW, Kai Lo S (2005) Ice and pulsed electromagnetic field to reduce pain and swelling after distal radius fractures. J Rehabil Med 37:372–377PubMedCrossRef Cheing GL, Wan JW, Kai Lo S (2005) Ice and pulsed electromagnetic field to reduce pain and swelling after distal radius fractures. J Rehabil Med 37:372–377PubMedCrossRef
37.
go back to reference Wilson DH (1972) Treatment of soft-tissue injuries by pulsed electrical energy. Br Med J 29:269–270CrossRef Wilson DH (1972) Treatment of soft-tissue injuries by pulsed electrical energy. Br Med J 29:269–270CrossRef
38.
go back to reference Mizushima Y, Akaoka I, Nishida Y (1975) Effects of magnetic field on inflammation. Experientia 151:1411–1412CrossRef Mizushima Y, Akaoka I, Nishida Y (1975) Effects of magnetic field on inflammation. Experientia 151:1411–1412CrossRef
39.
go back to reference Uzunca K, Birtane M, Tastekin N (2006) Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis. Clin Rheumatol (Apr 22, Epub ahead of print) Uzunca K, Birtane M, Tastekin N (2006) Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis. Clin Rheumatol (Apr 22, Epub ahead of print)
40.
go back to reference Calis M, Akgun K, Birtane M, Karacan I, Calis H, Tüzün F (2000) Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome. Ann Rheum Dis 59:44–47PubMedCrossRef Calis M, Akgun K, Birtane M, Karacan I, Calis H, Tüzün F (2000) Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome. Ann Rheum Dis 59:44–47PubMedCrossRef
41.
go back to reference Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56PubMedCrossRef Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56PubMedCrossRef
42.
go back to reference Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164PubMed
43.
go back to reference van der Windt DA, van der Heijden GJ, de Winter AF, Koes BW, Deville W, Bouter LM (1998) The responsiveness of the shoulder disability questionnaire. Ann Rheum Dis 57:82–87PubMedCrossRef van der Windt DA, van der Heijden GJ, de Winter AF, Koes BW, Deville W, Bouter LM (1998) The responsiveness of the shoulder disability questionnaire. Ann Rheum Dis 57:82–87PubMedCrossRef
44.
go back to reference Johansson K, Oberg B, Adolfsson L, Foldevi M (2002) A combination of systematic review and clinicians’ beliefs in interventions for subacromial pain. Br J Gen Pract 52:145–152PubMed Johansson K, Oberg B, Adolfsson L, Foldevi M (2002) A combination of systematic review and clinicians’ beliefs in interventions for subacromial pain. Br J Gen Pract 52:145–152PubMed
45.
go back to reference Wetzel BJ, Nindl G, Swez JA, Johnson MT (2002) Quantitative characterization of rat tendinitis to evaluate the efficacy of therapeutic interventions. Biomed Sci Instrum 38:157–162PubMed Wetzel BJ, Nindl G, Swez JA, Johnson MT (2002) Quantitative characterization of rat tendinitis to evaluate the efficacy of therapeutic interventions. Biomed Sci Instrum 38:157–162PubMed
46.
go back to reference Guerkov HH, Lohmann CH, Liu Y, Dean DD, Simon BJ, Heckman JD (2001) Pulsed electromagnetic fields increase growth factor release by nonunion cells. Clin Orthop Relat Res 384:265–279PubMedCrossRef Guerkov HH, Lohmann CH, Liu Y, Dean DD, Simon BJ, Heckman JD (2001) Pulsed electromagnetic fields increase growth factor release by nonunion cells. Clin Orthop Relat Res 384:265–279PubMedCrossRef
47.
go back to reference Wilk KE, Harrelson GL, Arrigo C (1998) Shoulder rehabilitation. In: Andrews JR, Harrelson GL, Wilk KE (eds) Physical rehabilitation of the injured athlete, 2nd edn. Saunders, Philadelphia, pp 173–227 Wilk KE, Harrelson GL, Arrigo C (1998) Shoulder rehabilitation. In: Andrews JR, Harrelson GL, Wilk KE (eds) Physical rehabilitation of the injured athlete, 2nd edn. Saunders, Philadelphia, pp 173–227
48.
go back to reference Jobe FW, Schwab DM, Wilk, Andrews JR (1996) Rehabilitation of the shoulder. In: Brotzman SB (ed) Clinical orthopaedic rehabilitation. Mosby, St.Louis, pp 91–141 Jobe FW, Schwab DM, Wilk, Andrews JR (1996) Rehabilitation of the shoulder. In: Brotzman SB (ed) Clinical orthopaedic rehabilitation. Mosby, St.Louis, pp 91–141
49.
go back to reference Chang WK (2004) Shoulder impingement syndrome. Phys Med Rehabil Clin North Am 15:493–510 Chang WK (2004) Shoulder impingement syndrome. Phys Med Rehabil Clin North Am 15:493–510
50.
go back to reference Foley-Nolan D, Barry C, Coughlan RJ, O’Connor P, Roden D (1990) Pulsed high frequency (27 MHz) electromagnetic therapy for persistent neck pain: a double blind, placebo-controlled study of 20 patients. Orthopedics 13:445–451PubMed Foley-Nolan D, Barry C, Coughlan RJ, O’Connor P, Roden D (1990) Pulsed high frequency (27 MHz) electromagnetic therapy for persistent neck pain: a double blind, placebo-controlled study of 20 patients. Orthopedics 13:445–451PubMed
51.
go back to reference Papi F, Ghione S, Rosa C, Del Seppia C, Luschi P ( 1995) Exposure to oscillating magnetic fields influences sensitivity to electrical stimuli. II. Experiments on humans. Bioelectromagnetics 16:295–300PubMedCrossRef Papi F, Ghione S, Rosa C, Del Seppia C, Luschi P ( 1995) Exposure to oscillating magnetic fields influences sensitivity to electrical stimuli. II. Experiments on humans. Bioelectromagnetics 16:295–300PubMedCrossRef
52.
go back to reference Rigato M, Battisti E, Fortunato M, Giordano N (2002) Comparison between the analgesic and therapeutic effects of a musically modulated electromagnetic field (TAMMEF) and those of a 100 Hz electromagnetic field: blind experiment on patients suffering from cervical spondylosis or shoulder periarthritis. J Med Eng Technol 26:253–258PubMedCrossRef Rigato M, Battisti E, Fortunato M, Giordano N (2002) Comparison between the analgesic and therapeutic effects of a musically modulated electromagnetic field (TAMMEF) and those of a 100 Hz electromagnetic field: blind experiment on patients suffering from cervical spondylosis or shoulder periarthritis. J Med Eng Technol 26:253–258PubMedCrossRef
Metadata
Title
Therapeutic effect of pulsed electromagnetic field in conservative treatment of subacromial impingement syndrome
Authors
Ilknur Aktas
Kenan Akgun
Bahar Cakmak
Publication date
01-08-2007
Publisher
Springer-Verlag
Published in
Clinical Rheumatology / Issue 8/2007
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-006-0464-2

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