Effectiveness of Pulsed Electromagnetic Fields on Bone Healing: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Author: Lihong Peng, Chenying Fu, Feng Xiong, Qing Zhang, Zejun Liang, Li Chen, Chengqi He, Quan Wei
Affiliation:
1 Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China.
2 Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, P.R. China.
3 State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P. R. China.
Conference/Journal: Bioelectromagnetics
Date published: 2020 Jun 3
Other:
Special Notes: doi: 10.1002/bem.22271. , Word Count: 253
PMID: 32495506 DOI: 10.1002/bem.22271
Abstract
The effect of pulsed electromagnetic field (PEMF) on bone healing is still uncertain and it has not been established as a standardized treatment. The aim of this systematic review and meta-analysis is to evaluate the effect of PEMF on bone healing in patients with fracture. We searched CNKI, Wan Fang, VIP, EMbase, PubMed, CENTRAL, Web of Science, Physiotherapy Evidence Database, and Open Grey websites for randomized controlled trials (published before July 2019 in English or Chinese) comparing any form of PEMF to sham. Reference lists were also searched. Related data were extracted by two investigators independently. The bias risk of the articles and the evidence strength of the outcomes were evaluated. Twenty-two studies were eligible and included in our analysis (n = 1,468 participants). The pooled results of 14 studies (n = 1,131 participants) demonstrated that healing rate in PEMF group was 79.7% (443/556), and that in the control group was 64.3% (370/575). PEMF increased healing rate (RR = 1.22; 95% confidence interval [CI] = 1.10-1.35; I2 = 48%) by the Mantel-Haenszel analysis, relieved pain (standardized mean difference (SMD) = -0.49; 95% CI = -0.88 to -0.10; I2 = 60%) by the inverse variance analysis, and accelerated healing time (SMD = -1.01; 95% CI = -2.01 to -0.00; I2 = 90%) by the inverse variance analysis. Moderate quality evidence suggested that PEMF increased healing rate and relieved pain of fracture, and very low-quality evidence showed that PEMF accelerated healing time. Larger and higher quality randomized controlled trials and pre-clinical studies of optimal frequency, amplitude, and duration parameters are needed. © 2020 Bioelectromagnetics Society.
Keywords: fracture healing; physical therapy; pulsed electromagnetic fields; rehabilitation; systematic review/meta-analysis.
© 2020 Bioelectromagnetics Society.
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