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Evidence based practice
Research
Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis
  1. Ziying Wu1,
  2. Xiang Ding1,
  3. Guanghua Lei1,
  4. Chao Zeng1,
  5. Jie Wei2,3,
  6. Jiatian Li1,
  7. Hui Li1,
  8. Tuo Yang2,
  9. Yang Cui4,
  10. Yilin Xiong1,
  11. Yilun Wang1,
  12. Dongxing Xie1
  1. 1 Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
  2. 2 Department of Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
  3. 3 Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
  4. 4 International Medical Department, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
  1. Correspondence to Dr Yilun Wang; yilun_Wang{at}csu.edu.cn and Dr Dongxing Xie; xdx1024{at}csu.edu.cn

Abstract

Objective To investigate the efficacy and safety of the pulsed electromagnetic field (PEMF) therapy in treating osteoarthritis (OA).

Design Meta-analysis.

Data sources PubMed, Embase, the Cochrane Library and Web of Science were searched through 13 October 2017.

Eligibility criteria for selecting studies Randomised controlled trials compared the efficacy of PEMF therapy with sham control in patients with OA.

Data extraction and synthesis Pain, function, adverse effects and characteristics of participants were extracted. RevMan V.5.2 was used to perform statistical analyses.

Results Twelve trials were included, among which ten trials involved knee OA, two involved cervical OA and one involved hand OA. The PEMF group showed more significant pain alleviation than the sham group in knee OA (standardised mean differences (SMD)=−0.54, 95% CI −1.04 to –0.04, p=0.03) and hand OA (SMD=−2.85, 95% CI −3.65 to –2.04, p<0.00001), but not in cervical OA. Similarly, comparing with the sham–control treatment, significant function improvement was observed in the PEMF group in both knee and hand OA patients (SMD=−0.34, 95% CI −0.53 to –0.14, p=0.0006, and SMD=−1.49, 95% CI −2.12 to –0.86, p<0.00001, respectively), but not in patients with cervical OA. Sensitivity analyses suggested that the exposure duration <=30 min per session exhibited better effects compared with the exposure duration >30 min per session. Three trials reported adverse events, and the combined results showed that there was no significant difference between PEMF and the sham group.

Conclusions PEMF could alleviate pain and improve physical function for patients with knee and hand OA, but not for patients with cervical OA. Meanwhile, a short PEMF treatment duration (within 30 min) may achieve more favourable efficacy. However, given the limited number of study available in hand and cervical OA, the implication of this conclusion should be cautious for hand and cervical OA.

  • eoarthritis
  • pulsed electromagnetic field
  • meta-analysis
  • randomized controlled trial

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi-org.ezproxy.u-pec.fr/10.1136/bmjopen-2018-022879

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    Footnotes

    • ZW and XD contributed equally.

    • YW and DX contributed equally.

    • Contributors ZW, DX, XD and YW were responsible for the conception and design of the study. ZW, XD, DX and YW contributed to the study retrieval. YC and YX contributed to quality assessment. HL, TY and JL contributed to the data collection. JW and CZ contributed to statistical analysis. ZW, XD, DX and YW drafted the manuscript. CZ and GL contributed to the revision of the manuscript. All authors read and approved the final manuscript.

    • Funding This work was supported by the National Natural Science Foundation of China (81472130, 81672225, 81601941, 81501923, 81772413, 81702207, 81702206), the Postdoctoral Science Foundation of Central SouthUniversity (182130), the Young Investigator Grant of Xiangya Hospital, Central South University (2016Q03, 2016Q06), the ScientificResearch Project of the Development and Reform Commission of Hunan Province ([2013]1199), the Scientific Research Project of Science andTechnology Office of Hunan Province (2013SK2018), the Key Research and Development Program of Hunan Province (2016JC2038), the XiangyaClinical Big Data System Construction Project of Central South University (45), the Clinical Scientific Research Foundation of Xiangya Hospital, Central South University (2015L03), the Natural Science Foundation of Hunan Province (2017JJ3491, 2017JJ3492), the Postgraduate Independent Exploration and Innovation Project of Central South University (2018ts909), the Postgraduate Independent Exploration and Innovation Project of Hunan Province (CX2017B065), and the Wu Jieping Medical Foundation (320.6750.17258).

    • Disclaimer None of the authors have any financial and personal relationships with other people or organisations that could potentially and inappropriately influence this work and its conclusions.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data available.