Combined Rehabilitation Protocol in the Treatment of Osteoarthritis of the Knee: Comparative Study of Extremely Low-Frequency Magnetic Fields and Soft Elastic Knee Brace Effect

Abstract

The investigation of this observational case–control study aimed at determining the effectiveness of a combined treatment of extremely low-frequency electromagnetic fields (ELF) with a soft elastic knee brace versus ELF alone in knee osteoarthritis (KOA) with respect to a reduction in pain and functional recovery. We hypothesized that the combined use of ELF and a soft elastic knee brace may provide better results. Thirty-five patients (N = 35, divided into Group 1 = ELF and Group 2 = ELF with the soft elastic knee brace) were analyzed. The rehabilitative protocol consisted of 10 sessions of antiphlogistic and antiedema programs (first cycle) for 2 weeks, followed by twelve sessions of bone repair and connective tissue repair programs (second cycle) in patients with knee osteoarthritis (KOA) for 4 weeks. Patient evaluations were conducted at baseline (T0) and after 2 (T1) and 4 (T2) weeks of treatment. A follow-up evaluation was conducted 6 weeks after treatment (T3). The LIMFA© Therapy System was used to create multifrequency magnetoelectric fields with an intensity of 100 µT and a low-frequency field. The Incrediwear Cred 40 knee sleeve (Incred) was used for alleviating knee pain. The Visual Analogue Scale (VAS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Lysholm score (Ls) were used as outcome measures. The results showed that pain at rest (Vr), pain in motion (Vm), KOOS, and Ls were significantly affected by ELF over time. In conclusion, Group 2 had a better response in terms of pain resolution at rest (p < 0.05) and a concurrent better response at T3 in terms of functional recovery (p < 0.05).

Pulsed Electromagnetic Field Stimulation in Bone Healing and Joint Preservation: A Narrative Review of the Literature

“…The authors concluded that non-invasive PEMFs therapy can have a significant and rapid impact on pain from early knee osteoarthritis [49]. Similar results were also obtained by other authors [50][51][52].…”

Management and Rehabilitative Treatment in Osteoarthritis with a Novel Physical Therapy Approach: A Randomized Control Study

“…In the study by S. Masiero et al (2020), all patients (diagnosis of osteoarthritis, neck/back pain, or tendinopathies) underwent ten sessions of percutaneous short-wave diathermy, three times/week, with each session lasting 15–20 min, and using frequencies of 4 or 8 MHz and a heat intensity between 40 and 60 W. The authors suggest that the data reported a positive trend in reducing musculoskeletal pain in the short term [ 24 ]. Also, ultrasound waves of 1 MHz frequency were applied for 5 min to the target knee, as was direct current for 10 min for 10 treatment sessions together with 0.4% Dexamethasone sodium phosphate (DEX-P) phonophoresis (PH), with 0.4% DEX-P iontophoresis (ION) therapy compared: both therapeutic modalities were found to be effective and generally well tolerated after 10 treatment sessions [ 18 , 25 ]. In low-grade KOA patients according to the Kellgren–Lawrence classification, six sessions of pulsed electromagnetic field therapy (PEMFT) resulting in significantly better results than low-level laser therapy (LLLT) and an immediate positive effect on pain and physical function [ 26 ].…”

“…We aimed for a balanced sample size across treatment levels (sham, extensive, and intensive) while considering outpatient pain levels. Considering a 10% dropout rate [ 18 ], with 54 valid outpatients, potentially 48.6 would remain after dropouts, split equally into three groups (16.2 per group). We opted for a 2:1 ratio between treated and control groups.…”