Abstract
Objective: To assess the effectiveness of therapeutic electromagnetic energy in the management of conditions associated with an aging and older adult population.
Methods: A systematic review of literature from 2008 to 2018 was completed in PubMed, CINAHL, and Science Direct. We also reviewed sources to identify additional relevant studies. Studies in this review were limited to randomized controlled trials that evaluated the effects of shortwave diathermy or pulsed electromagnetic energy units in treating conditions commonly experienced by adults older than 50 years. Study quality was determined using the Physiotherapy Evidence Database (PEDro) classification scale.
Results: Fifteen randomized controlled trials met our search criteria. Multiple pathologies were evaluated with the studies examining treatment effects of knee osteoarthritis (n = 12), frozen shoulder (n = 1), postoperative rotator cuff repair (n = 1), and postmenopausal osteoporosis (n = 1). Of the 12 studies that examined knee osteoarthritis, 2 compared pulsed electromagnetic field to placebo or sham, 2 compared the addition of shortwave diathermy to strengthening activities alone, 3 evaluated shortwave diathermy dosage, 3 compared shortwave diathermy to other modalities, and 2 reviewed the benefits of adding pulsed electromagnetic field to other modalities and exercise. Due to the high degree of variability in protocols and outcome measures among studies, meta-analysis was not appropriate. Studies on knee osteoarthritis reported that the use of pulsed electromagnetic field and shortwave diathermy provides statistically significant improvement in pain and function compared with placebo, sham, or control, although there appears to be no benefit in using either form of electromagnetic radiation in addition to or in place of another modality. It also appears that dosage does not significantly change short-term outcomes. These findings are similar to those identified in other recently published systematic reviews that focused exclusively on knee osteoarthritis. Subjects with shoulder pathologies showed improvements in pain, mobility (range of motion), function, activities of daily living, and pain medication usage with pulsed electromagnetic field or shortwave diathermy. Changes in postmenopausal bone density were similar when pulsed electromagnetic field was compared with medication.
Conclusion: Shortwave diathermy and pulsed electromagnetic frequency demonstrate similar clinical benefits as other modalities for improving pain, function, and quality of life in the short-term. Further research is needed to better evaluate the parameters of electromagnetic energy and effects for other conditions commonly affecting aging and older adults and at other treatment sites on the body.