Effectiveness of the Frequency Rhythmic Electrical Modulation System for the Treatment of Chronic and Painful Venous Leg Ulcers in Older Adults

Abstract

Frequency rhythmic electrical modulation system (FREMS) is an innovative type of transcutaneous electrotherapy used in a rehabilitation setting for the treatment of pain, especially in diabetic patients. In a randomized clinical trial, we tested the hypothesis that FREMS is effective in the treatment of chronic and painful venous leg ulcers in 20 older patients. Group A (10 patients) received FREMS and topical treatment, whereas group B (10 patients) received topical treatment alone. Over a period of 3 consecutive weeks, 15 treatment sessions were done for each group. Wound healing and tissue repair were evaluated with the Visitrack digital planimetry system and photos. Pain was evaluated using the Visual Analogic Scale (VAS). The measurements were done at baseline and after 5, 10, and 15 days of treatment, with follow-up measurements after 15 and 30 days from the last treatment session. Group A showed a statistically significant decrease in ulcer area during the treatment and follow-up. The VAS score showed a statistically significant decrease after 5 and 10 days of treatment. Group B showed a statistically decrease in ulcer area after 5, 10, and 15 days of treatment with a reduction of VAS score only at 15 days of follow-up. At the end of the treatment, the comparison of the change in ulcer area and the change in VAS score of each group showed a statistically significant difference between groups, suggesting the therapeutic and analgesic efficacy of FREMS in reducing pain and area of chronic venous leg ulcers in older adults. Further investigation is needed to determine its reproducibility in larger case series or randomized clinical trials with longer follow-up periods.

A current affair: electrotherapy in wound healing

“…SVPC increases the circulating vascular endothelial growth factor (VEGF) in the blood during the stimulation and induces nitric oxide formation the day after treatment 66. Moreover, SVPC has shown enhanced wound area reduction in the treatment of chronic, venous, and diabetic ulcers, in four RCTs,50,53,54,56 but the short period of the studies has not allowed to evaluate the wound healing rate. One RCT53 has used SVPC on chronic leg ulcers with an “until-healed” treatment duration.…”

The efficacy of electrical stimulation in lower extremity cutaneous wound healing: A systematic review

“…applied either antiseptic topical alone or in combination with FREMS to venous leg wounds for 3 weeks. They found FREMS led to a decrease in wound surface area by 90% at 30 days from treatment cessation which was significantly superior to that seen in the control arm . Jankovic and Binic used FREMS in a randomised control trial in 35 patients with chronic lower extremity wounds of various aetiologies.…”

Electrical stimulation to accelerate wound healing

“…Physicians are probably most familiar with pulsed electromagnetic field (PEMF) for repair of fracture non-unions and transcutaneous electrical nerve stimulation (TENS) for pain control (7, 8). Frequency rhythmic electrical modulation systems (FREMS) is a form of transcutaneous electrotherapy using electrical stimulation that automatically varies in terms of pulse, frequency, duration, and voltage (9). Even through the electrical stimulation and wound healing literature uses several different types of electrical stimulation, they all seem to have positive results.…”