The effectiveness of ice and pulsed electromagnetic field (PEMF) in reducing swelling due to forearm fracture

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The effectiveness of ice and pulsed electromagnetic field (PEMF) in reducing swelling due to forearm fracture

 

Author: Wan, Wai-han
Title: The effectiveness of ice and pulsed electromagnetic field (PEMF) in reducing swelling due to forearm fracture
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Forearm -- Fractures -- Treatment
Electrotherapeutics
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: vii, 85 leaves : col. ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1710666
URI: http://theses.lib.polyu.edu.hk/handle/200/3484
Abstract: Distal radius fracture is a common condition seen in the out-patient physiotherapy departments. Patients often present with swollen hand and pain after immobilization. Ice, compression and elevation are the standard physiotherapy treatment for controlling acute swelling. Pulsed electromagnetic field (PEMF) is a proven modality in promoting fracture healing. The therapeutic effects have been attributed to an increase in vascularization and improvement of tissue oxygenation. Clinically, physiotherapists very often combine these two treatment modalities, i.e. ice plus PEMF, in reducing swelling. However there is a lack of evidence to show the effectiveness of such combined treatment. A single-blinded randomized controlled study was used to examine the relative effectiveness of PEMF, ice therapy, and the combined of both treatments in reducing swelling of simple radius fracture after the immobilization period. Eighty-three patients were randomly allocated into four groups, attended a 30-minute treatment session for 5 consecutive days, received either i) ice plus PEMF (Group 1); ii) ice plus placebo PEMF (Group 2); iii) PEMF alone (Group 3) and (iv) placebo PEMF (Group 4). PEMF was delivered at the frequency of 50 Hz, with the field intensity of 99 gauss and the treatment lasted for 30 minutes. Outcome measures included the visual analogue scale (VAS), volumetric and circumferential measurements of the forearm and range of motion (ROM). Recordings were taken on Day 1, 3 and 5 before the treatment. Repeated measures analysis of variance (ANOVA) was used for data analysis. No interaction was found between PEMF and Ice (p > 0.05). Re-organization of groups was made during data analysis. Specifically, the two groups receiving Ice therapy (Group 1 and 2) were compared to the two groups, which did not receive Ice therapy (Group 3 and 4). The two groups receiving PEMF treatment (Group 1 and 3) were compared to the two groups, which did not receive PEMF treatment (Group 2 and 4). By Day 5, the VAS of the Ice group was found to be significantly lower than that of the Without-Ice group (p = 0.001). The Ice group showed a 39% reduction in the average VAS score and a 22.5% for the Without-Ice group. The volumetric measurement of the Ice group was found to be significantly lower than that of the Without-Ice group (p = 0.001). The Ice group showed a 5.05% reduction in the volumetric measurement and a 2.55% for the Without-Ice group. Similar results were in pronation and ulnar deviation range. The Ice group showed a 50% gain in pronation range and a 27% for the Without-Ice group (p = 0.023). For the ulnar deviation range, the Ice group showed a 46.7% gain in ulnar deviation range and a 29.8% for the Without-Ice group (p =0.033). In examining the effectiveness of the combined treatment, no significant between-group difference was found between the group who received combined treatment (ice plus PEMF group) and other groups. In conclusion, ice therapy, pulsed electromagnetic field stimulation or ice plus pulsed electromagnetic field produced cumulative effects in reducing swelling after distal radius fracture. Comparatively, the therapeutic outcomes of ice therapy were better than those treatments without-ice. PEMF treatment was not significantly better than sham PEMF; and ice plus PEMF treatment was not better than ice alone or PEMF alone. So, this clinical study do not support that the combination of ice and PEMF treatment is more effective than ice alone or PEMF alone.

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