Effects of extremely low frequency pulsed electromagnetic field added to kinesitherapy procedure on quality of life in patients with end stage renal disease on dialysis

Aleksandra Rakočević-Hrnjak; Miljanka Vuksanović; Nada Dimković; Aleksandar Djurović; Nataša Petronijević; Milan Petronijević

doi:10.2298/VSP160620007R

Aleksandra Rakočević-Hrnjak University Medical Center Zvezdara, Centre of Physical Medicine and Rehabilitation, Belgrade, Serbia
Miljanka Vuksanović University Medical Center Zvezdara, Clinic of Internal Medicine, Belgrade, Serbia
Nada Dimković University Medical Center Zvezdara, Clinic of Internal Medicine, Belgrade, Serbia
Aleksandar Djurović University of Belgrade, Faculty of Medicine, Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
Nataša Petronijević University of Belgrade, Faculty of Medicine, Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
Milan Petronijević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP160620007R

Keywords: electromagnetic fields;, magnetic field therapy;, kidney failure, chronic;, dialysis;, quality of life;, surveys and questionnaires;, treatment outcome.

Abstract

Introduction. Extreme Low Frequency Pulsed Electromagnetic Magnetic Field (ELF-PEMF) has a wide range of therapeutic applications which has expanded during the last decades. ELF-PEMF as non-invasive, long term safe method of physical therapy can influence a variety of aspects in chronic diseases including quality of life. Patients with chronic kidney disease (CKD) especially with end stage renal disease (ESRD) treated by dialysis have lower health-related quality of life and changed normal way of living because of ESRD-related co morbid illnesses, associated conditions and complex dyalisis procedures. The objective of this study was to assess the effectiveness of long-term ELF-PEMF in concordance with exercising on the quality of life in ESRD patients on dialysis.

Methods. Total of 151 patients with ESRD on dialysis program were subjected on voluntary basis to the treatment with ELF-PEMF (18 Hz, 2 mT) applied during 40 minutes after ten consecutive dialysis procedures, four times through one year (120 treatments in total during three years) together with kinesitherapy (study group) or only to kinesitherapy (control group). The quality of life was assessed through SF36v2 and FACIT Fatigue v4 questionnaires.

Results. After the three-year prospective clinical trial 124 patients have completed the study. In study group (n=54), treatment with ELF-PEMF significantly improved FACIT Fatigue v4 scale score as well as physical health, physical functioning, bodily pain and energy/fatigue domains of SF=36v2 scale. There were no effects on mental health domain, limitations due to physical health problems, limitations due to personal or emotional problems, emotional well-being, social functioning, and general health perceptions. In the control group (n=70), no beneficial effects on FACIT Fatigue v4 scale and SF36v2 scale item were noticed.

Conclusion. ELF-PEMF could be a additional and safe strategy for improving the quality of life in patients with ESRD on dialysis.

References

REFERENCE

Bassett CA. Fundamental and practical aspects of therapeu¬tic uses of pulsed electromagnetic fields (pEMFs). Crit Rev Bio-med Eng 1989; 17: 451–529.

Shupak NM. Therapeutic uses of pulsed magnetic-field expo-sure: A review. Radio Science Bulletin 2003; 307: 9–32.

Goldstein C, Sprague S, Petrisor BA. Electrical stimulation for fracture healing: current evidence. J Orthop Trauma 2010; 24 Suppl 1: S62–5.

Tabrah F, Hoffmeier M, Gilbert F, Batkin S, Bassett CA. Bone density changes in osteoporosis-prone women ex¬posed to pulsed electromagnetic fields (PEMFs). J Bone Miner Res 1990; 5(5): 437–42.

Negm A, Lorbergs A, Macintyre NJ. Efficacy of low fre¬quency pulsed subsensory threshold electrical stimulation vs placebo on pain and physical function in people with knee osteoarthri-tis: Systematic review with meta-analysis. Osteoarthr Cartilage 2013; 21(9): 1281–9.

Hug K, Röösli M. Therapeutic effects of whole-body de¬vices applying pulsed electromagnetic fields (PEMF): A systematic literature review. Bioelectromagnetics 2012; 33(2): 95–105.

Wagner J, Jhaveri KD, Rosen L, Sunday S, Mathew AT, Fishbane S. Increased bone fractures among elderly United States he-modialysis patients. Nephrol Dial Transplant 2014; 29(1): 146–51.

Graham-Brown MP, Churchward DR, Smith AC, Baines RJ, Bur-ton JO. A 4-month programme of in-centre nocturnal haemo-dialysis was associated with improvements in pa¬tient out-comes. Clin Kidney J 2015; 8(6): 789–95.

Kousolula G, Lagou L, Lena M, Alikari V, Theofilou P, Polikandrioti M. Quality of Life in Hemodialysis Patients. Ma-ter Sociomed 2015; 27(5): 305–9.

Gonçalves FA, Dalosso IF, Borba JM, Bucaneve J, Valerio NM, Okamoto CT, et al. Quality of life in chronic renal pa¬tients on hemodialysis or peritoneal dialysis: A compara¬tive study in a referral service of Curitiba - PR. J Bras Ne¬frol 2015; 37(4): 467–74.

Bujang MA, Musa R, Liu WJ, Chew TF, Lim CT, Morad Z. De-pression, anxiety and stress among patients with dialysis and the association with quality of life. Asian J Psychiatr 2015; 18: 49–52.

Saad MM, El Douaihy Y, Boumitri C, Rondla C, Moussaly E, Daoud M, et al. Predictors of quality of life in patients with end-stage renal disease on hemodialysis. Int J Nephrol Reno-vasc Dis 2015; 8: 119–23.

Barcellos FC, Santos IS, Umpierre D, Bohlke M, Hallal PC. Ef-fects of exercise in the whole spectrum of chronic kid¬ney dis-ease: A systematic review. Clin Kidney J 2015; 8(6): 753–65.

Rakočević-Hrnjak A, Vuksanović M, Dimković N, Đurović A, Petronijević N, Petronijević M. The effects of extreme low fre-quency pulsed electromagnetic field on bone min¬eral density and incidence of fractures in patients with end stage renal dis-ease on dialysis: Three year follow up study. Vojnosanit Pregl 2017; doi.org/10.2298/VSP160617212R

Ware JE, Kosinski M, Keller SD. SF-36 physical and mental health summary scales: A user manual. Boston MA: The Health Institute, New England Medical Center; 1995.

Webster K, Cella D, Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: Prop-erties, applications, and interpretation. Health Qual Life Outcomes. 2003; 1: 79.

Esteve Simo V, Junqué Jiménez A, Moreno Guzmán F, Carneiro Oliveira J, Fulquet Nicolas M, Pou Potau M, et al. Benefits of a low intensity exercise programme during haemodialysis ses-sions in elderly patients. Nefrologia 2015; 35(4): 385–94. (English, Spanish)

Bergner M. Quality of life, health status, and clinical re¬search. Med Care 1989; 27(3 Suppl): S148–56.

Bachl N, Ruoff G, Wessner B, Tschan H. Electromagnetic in-terventions in musculoskeletal disorders. Clin Sports Med 2008; 27(1): 87–105, viii.

Bragin DE, Statom GL, Hagberg S, Nemoto EM. Increases in mi-crovascular perfusion and tissue oxygenation via pulsed elec-tromagnetic fields in the healthy rat brain. J. Neuro¬surg 2015; 122(5): 1239–47.

Rajabi AH, Jaffe M, Arinzeh TL. Piezoelectric materials for tis-sue regeneration: A review. Acta Biomater 2015; 24: 12–23.

Sathvik BS, Parthasarathi G, Narahari MG, Gurudev KC. An as-sessment of the quality of life in hemodialysis pa¬tients using the WHOQOL-BREF questionnaire. Indian J Nephrol 2008; 18(4): 141–9.

Stack AG, Molony DA, Rives T, Tyson J, Murthy BV. Associa-tion of physical activity with mortality in the US dialysis pop-ulation. Am J Kidney Dis 2005; 45(4): 690–701.

Harper WL, Schmidt WK, Kubat NJ, Isenberg RA. An open-label pilot study of pulsed electromagnetic field therapy in the treatment of failed backsurgery syndrome pain. Int Med Case Rep J 2014; 8: 13–22.

Maestu C, Blanco M, Nevado A, Romero J, Rodriguez-Rubio P, Galindo J, et al. Reduction of pain thresholds in fi¬bromyalgia after very low-intensity magnetic stimulation: a double-blinded, randomized placebo-controlled clinical trial. Pain Res Manag 2013; 18(6): e101–6.

Sutbeyaz ST, Sezer N, Koseoglu F, Kibar S. Low-frequency pulsed electromagnetic field therapy in fibromyalgia: A ran-domized, double-blind, sham-controlled clinical study. Clin J Pain 2009; 25(8): 722–8.

Weintraub MI, Herrmann DN, Smith GA, Backonja MM, Cole SP. Pulsed electromagnetic fields to reduce diabetic neuro-pathic pain and stimulate neuronal repair: A ran¬domized con-trolled trial. Arch Phys Med Rehabil 2009; 90(7): 1102–9.

Wróbel MP, Szymborska-Kajanek A, Wystrychowski G, Binisz-kiewicz T, Sieroń-Stołtny K, Sieroń A, et al. Impact of low fre-quency pulsed magnetic fields on pain intensity, quality of life and sleep disturbances in patients with pain¬ful diabetic poly-neuropathy. Diabetes Metab 2008; 34(4 Pt 1): 349–54.

Thomas AW, Graham K, Prato FS, McKay J, Forster PM, Moulin DE, et al. A randomized, double-blind, placebo-controlled clinical trial using a low-frequency magnetic field in the treat-ment of musculoskeletal chronic pain. Pain Res Manag 2007; 12(4): 249–58.

Zhang M, Kim JC, Li Y, Shapiro BB, Porszasz J, Bross R, et al. Relation between anxiety, depression, and physical ac¬tivity and performance in maintenance hemodialysis pa¬tients. J Ren Nutr 2014; 24(4): 252–60.

Anand S, Johansen KL, Grimes B, Kaysen GA, Dalrymple LS, Kutner NG, et al. Physical activity and self-reported symptoms of insomnia, restless legs syndrome, and depres¬sion: the com-prehensive dialysis study. Hemodial Int 2013; 17(1): 50–8.

Jassal VS, Karaboyas A, Comment LA, Bieber BA, Morgen¬stern H, Sen A, Tentori F et al. Functional Dependence and Mortal-ity in the International Dialysis Outcomes and Practice Pat-terns Study (DOPPS). Am J Kidney Dis 2016; 67(2): 283–92.

Martiny C, Silva ACO, Neto JP, Nardi AE. Psychiatric disor¬ders in patients with end-stage renal disease. J Ren Care 2012; 38(3): 131–7.

Haase R, Piatkowski J, Ziemssen T. Long-term effects of Bio-Electromagnetic-Energy Regulation therapy on fatigue in pa-tients with multiple sclerosis. Altern Ther Health Med 2011; 17(6): 22–8.

Lappin MS, Lawrie FW, Richards TL, Kramer ED. Effects of a pulsed electromagnetic therapy on multiple sclerosis fa¬tigue and quality of life: A double-blind, placebo con¬trolled trial. Altern Ther Health Med 2003; 9(4): 38–48.