Long-term effect of full-body pulsed electromagnetic field and exercise protocol in the treatment of men with osteopenia or osteoporosis: A randomized placebo-controlled trial Author: Anwar Ebid1, Mohamed El-Boshy2, Shamekh El-Shamy1, Ali Thabet1, Mohamed Abedalla3, Tariq Ali4 Affiliation: <sup>1</sup> Physical Therapy, Umm Al-Qura University, Makkah, Saudi Arabia. <sup>2</sup> Laboratory Medicine, Umm Al-Qura University, Makkah, Saudi Arabia. <sup>3</sup> Internal Medicine, Ministry of Health KSA, Makkah, Saudi Arabia. <sup>4</sup> Umm Al-Qura University Medical Center, Umm Al-Qura University, Makkah, Saudi Arabia. Conference/Journal: F1000Res Date published: 2021 Jul 26 Other: Volume ID: 10 , Pages: 649 , Special Notes: doi: 10.12688/f1000research.54519.3. , Word Count: 293 Background: Osteoporosis is the most prevalent metabolic disease affecting bones. Objective: To investigate the long-term effect of pulsed electromagnetic field (PEMF) combined with exercise protocol on bone mineral density (BMD) and bone markers in men with osteopenia or osteoporosis. Methods: Ninety-five males with osteopenia or osteoporosis (mean age, 51.26 ± 2.41 years; mean height, 176 ± 2.02 cm; mean weight, 83.08 ± 2.60 kg; mean body-mass index (BMI), 26.08 ± 1.09 kg/m 2) participated in the study, and they were randomly assigned to one of three groups: Group 1 received a full-body PEMF and exercise protocol (PEMF +EX), Group 2 received a placebo full-body PEMF and exercise protocol (PPEMF +EX), and Group 3 received a full-body PEMF alone (PEMF). PEMF was applied for the whole body using a full-body mat three times per week for 12 weeks, with an exercise protocol that includes flexibility, aerobic exercise, strengthening, weight-bearing, and balance exercises followed by whole-body vibration (WBV) training. Outcome measures include BMD of total hip and lumbar spine and bone markers [serum osteocalcin (s-OC), Serum amino-terminal cross-linking telopeptide of type I collagen (s-NTX), Serum carboxy-terminal cross-linking telopeptide of type I collagen (s-CTX), Parathyroid hormones (PTH), Bone-specific Alkaline Phosphatase (BSAP), and 25-hydroxy vitamin D (Vit D)]. Results: The BMD of total hip and lumbar spine was significantly increased post-treatment in all groups, and more so in Group 1 and Group 2 than Group 3. There was a significant difference in bone markers in all groups, more so in Group 1 and Group 2 than in Group 3. Conclusion: PEMF combined with exercise protocol exerts a potent role for treating OP, is more effective than exercise and PEMF alone for increasing BMD and enhancing bone formation, and suppresses bone-resorption markers after 12-weeks of treatment with the impact lasting up to 6 months. Keywords: Exercise protocol; Pulsed electromagnetic field; bone mineral density; osteopenia; osteoporosis. PMID: 34900231 PMCID: PMC8637238 DOI: 10.12688/f1000research.54519.3