BACKGROUND
Neuromodulation is defined as the modification of neurological function, which includes neuron and glial cell activity, by delivering electric, magnetic, or chemical stimuli to specific neurologic target sites. 1 ) Magnetic stimulation, in particular, has garnered considerable attention as a therapeutic modality. This technique employs electromagnetic induction, whereby a pulsating magnetic field generated by a stimulation coil induces eddy currents within the body. 2 ) Magnetic stimulation, which evolved from transcranial magnetic stimulation first reported in humans in 1985, subsequently advanced into practical applications of repetitive stimulation. 3 ) Simultaneously, magnetic stimulation of peripheral nerves was introduced. 4 , 5 ) Peripheral magnetic stimulation (PMS) can stimulate deep motor and proprioceptive nerves without affecting superficial pain-sensitive nerves, because it does not directly affect cutaneous nociceptors. 6 ) PMS causes less pain and discomfort than electrical stimulation. 7 ) Furthermore, its ability to be applied over clothing without direct skin contact enhances its clinical application.
Pain, a key therapeutic target for PMS, acts by activating the supraspinal descending inhibition system. 8 ) Smania et al. 9 ) reported that PMS was more effective than transcutaneous electrical nerve stimulation (TENS) for treating myofascial pain. Furthermore, a meta-analysis indicated that PMS substantially reduced pain intensity in individuals with low back pain and knee osteoarthritis. 10 , 11 ) Despite limited evidence, PMS has proven effective in treating musculoskeletal pain and is generally well tolerated.
Despite its increasing use across various conditions, there is no consensus regarding the outcomes and effectiveness of PMS. Kamo et al. 12 ) investigated the effects of PMS on the activities of daily living (ADL) and physical function in individuals with stroke through a systematic review and meta-analysis, which demonstrated no substantial improvements in ADL, upper limb function, or muscle strength. Conversely, Chen et al. 13 ) reported that PMS may positively affect upper limb motor impairment, proximal upper limb muscle strength, and activity limitations in this population. Similarly, a systematic review concluded that PMS is a feasible, well-tolerated, and safe treatment option for muscle dysfunction in individuals with chronic obstructive pulmonary disease (COPD) 14 ) and may contribute to improved muscle strength. 15 , 16 ) However, only a few studies have examined the efficacy of PMS in this population, indicating a need for further research. 14 ) Previous randomized controlled trials have demonstrated positive effects of PMS across various conditions. Reported benefits include improved function in individuals with low back pain 17 ) ; enhanced vastus lateralis muscle strength, gait speed, and balance in individuals post-hip replacement 18 ) ; increased upper limb muscle strength in those with amyotrophic lateral sclerosis 19 ) ; improved pelvic floor muscle strength in those with postpartum pelvic floor dysfunction 20 ) ; enhanced cervical flexor muscle strength in healthy adults 21 ) ; and increased swallowing speed and capacity in individuals with stroke. 22 ) Conversely, no major effects of PMS on lower limb function have been observed in individuals with knee osteoarthritis. 23 )
The limited research and uncertainty regarding PMS effects on various dysfunctions and diseases likely stem from diversity in study populations (diseases), intervention settings, durations, and poorly defined outcomes. Meta-analyses on stroke survivors have yielded conflicting results, underscoring the need for additional studies with large sample sizes to strengthen the evidence. 12 , 13 ) Systematic reviews have focused on quadriceps function in individuals with COPD 14 ) and dysphagia across different populations. 24 ) However, the number of studies in these areas remains limited. Furthermore, previous systematic reviews and meta-analyses have provided limited coverage of disease types and functional impairments. In addition, organizing essential information for clinical application, such as PMS settings, outcomes, and treatment sites, has been challenging to synthesize comprehensively. Therefore, a comprehensive scoping review with a clear search strategy is warranted to provide a systematic overview of study populations (diseases), interventional content, and outcomes in existing studies and address the extensive evidence on PMS. Organizing this information is expected to clarify the diseases and functional impairments most appropriate for PMS application, as well as the relevant treatment settings and outcomes, thereby supporting more effective clinical practice. To date, however, no scoping review has been conducted to summarize the current clinical applications of PMS, and existing studies for future development remain unclear.
This scoping review aimed to identify, summarize, and map the relevant literature regarding the use of PMS for various diseases and related dysfunctions, highlighting areas for future research. Specifically, this scoping review addressed the following questions:
i) What types of diseases or populations have been treated with PMS?
ii) What are the treatment sites for PMS?
iii) What functional impairments are addressed through PMS?
iv) What outcomes are associated with PMS treatment?
v) What are the characteristics of PMS interventions, including frequency, intensity, stimulation session, duration, and overall treatment length?
METHODS
This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. 25 ) Reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). 26 ) The protocol was registered with the Open Science Framework (https://osf.io/5q7mg/), and the corresponding protocol paper has been published. 27 )
Search Strategy
A search strategy was developed with an experienced research librarian to ensure thoroughness and precision in identifying relevant articles using key search terms. A systematic search of published literature from database inception to February 2024 was conducted. The databases searched included PubMed/MEDLINE, Cumulated Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Library, Web of Science, and PEDro. The search strategy was structured as follows: [(magnetic stimulation) AND (physical function)]. Detailed descriptions of the search terms and strategies applied to the databases are provided in Tables 1 – 4 .
Table 1.
Search strategy and results for PubMed/MEDLINE
| Search number | Query | Search details | Results |
| 1 | ((((((“Muscle Strength”[Mesh]) OR “Gait”[Mesh]) OR “Sarcopenia/rehabilitation”[Mesh]) OR “Frailty/rehabilitation”[Mesh]) OR “Activities of Daily Living”[Mesh]) OR “Deglutition”[Mesh]) OR (“Deglutition Disorders/rehabilitation”[Mesh] OR “Deglutition Disorders/therapy”[Mesh]) | “Muscle Strength”[MeSH Terms] OR “Gait”[MeSH Terms] OR “sarcopenia/rehabilitation”[MeSH Terms] OR “frailty/rehabilitation”[MeSH Terms] OR “Activities of Daily Living”[MeSH Terms] OR “Deglutition”[MeSH Terms] OR “deglutition disorders/rehabilitation”[MeSH Terms] OR “deglutition disorders/therapy”[MeSH Terms] | 236,531 |
| 2 | dysphagia[Title/Abstract] OR deglutition[Title/Abstract] OR gait[Title/Abstract] OR muscle mass[Title/Abstract] OR sarcopenia[Title/Abstract] OR frailty[Title/Abstract] OR exercise capacity[Title/Abstract] OR walking test*[Title/Abstract] OR short physical performance battery[Title/Abstract] OR physical function*[Title/Abstract] OR disability[Title/Abstract] OR activities of daily living[Title/Abstract] OR swallowing function*[Title/Abstract] OR tongue pressure*[Title/Abstract] OR muscle strengt*[Title/Abstract] | “dysphagia”[Title/Abstract] OR “deglutition”[Title/Abstract] OR “gait”[Title/Abstract] OR “muscle mass”[Title/Abstract] OR “sarcopenia”[Title/Abstract] OR “frailty”[Title/Abstract] OR “exercise capacity”[Title/Abstract] OR “walking test*”[Title/Abstract] OR “short physical performance battery”[Title/Abstract] OR “physical function*”[Title/Abstract] OR “disability”[Title/Abstract] OR “activities of daily living”[Title/Abstract] OR “swallowing function*”[Title/Abstract] OR “tongue pressure*”[Title/Abstract] OR “muscle strengt*”[Title/Abstract] | 464,185 |
| 3 | #1 OR #2 | “Muscle Strength”[MeSH Terms] OR “Gait”[MeSH Terms] OR “sarcopenia/rehabilitation”[MeSH Terms] OR “frailty/rehabilitation”[MeSH Terms] OR “Activities of Daily Living”[MeSH Terms] OR “Deglutition”[MeSH Terms] OR “deglutition disorders/rehabilitation”[MeSH Terms] OR “deglutition disorders/therapy”[MeSH Terms] OR “dysphagia”[Title/Abstract] OR “Deglutition”[Title/Abstract] OR “Gait”[Title/Abstract] OR “muscle mass”[Title/Abstract] OR “sarcopenia”[Title/Abstract] OR “frailty”[Title/Abstract] OR “exercise capacity”[Title/Abstract] OR “walking test*”[Title/Abstract] OR “short physical performance battery”[Title/Abstract] OR “physical function*”[Title/Abstract] OR “disability”[Title/Abstract] OR “Activities of Daily Living”[Title/Abstract] OR “swallowing function*”[Title/Abstract] OR “tongue pressure*”[Title/Abstract] OR “muscle strengt*”[Title/Abstract] | 606,783 |
| 4 | “Magnetic Field Therapy”[Mesh:NoExp] | “Magnetic Field Therapy”[MeSH Terms:noexp] | 1309 |
| 5 | peripheral magnetic stimulation[Title/Abstract] OR rpms[Title/Abstract] OR magnetic treatment*[Title/Abstract] OR magnetotherapy[Title/Abstract] OR magnetic field therap*[Title/Abstract] | “peripheral magnetic stimulation”[Title/Abstract] OR “rpms”[Title/Abstract] OR “magnetic treatment*”[Title/Abstract] OR “magnetotherapy”[Title/Abstract] OR “magnetic field therap*”[Title/Abstract] | 923 |
| 6 | #4 OR #5 | “Magnetic Field Therapy”[MeSH Terms:noexp] OR “peripheral magnetic stimulation”[Title/Abstract] OR “rpms”[Title/Abstract] OR “magnetic treatment*”[Title/Abstract] OR “magnetotherapy”[Title/Abstract] OR “magnetic field therap*”[Title/Abstract] | 2117 |
| 7 | #3 AND #6 | (“Muscle Strength”[MeSH Terms] OR “Gait”[MeSH Terms] OR “sarcopenia/rehabilitation”[MeSH Terms] OR “frailty/rehabilitation”[MeSH Terms] OR “Activities of Daily Living”[MeSH Terms] OR “Deglutition”[MeSH Terms] OR (“deglutition disorders/rehabilitation”[MeSH Terms] OR “deglutition disorders/therapy”[MeSH Terms]) OR (“dysphagia”[Title/Abstract] OR “Deglutition”[Title/Abstract] OR “Gait”[Title/Abstract] OR “muscle mass”[Title/Abstract] OR “sarcopenia”[Title/Abstract] OR “frailty”[Title/Abstract] OR “exercise capacity”[Title/Abstract] OR “walking test*”[Title/Abstract] OR “short physical performance battery”[Title/Abstract] OR “physical function*”[Title/Abstract] OR “disability”[Title/Abstract] OR “Activities of Daily Living”[Title/Abstract] OR “swallowing function*”[Title/Abstract] OR “tongue pressure*”[Title/Abstract] OR “muscle strengt*”[Title/Abstract])) AND (“Magnetic Field Therapy”[MeSH Terms:noexp] OR (“peripheral magnetic stimulation”[Title/Abstract] OR “rpms”[Title/Abstract] OR “magnetic treatment*”[Title/Abstract] OR “magnetotherapy”[Title/Abstract] OR “magnetic field therap*”[Title/Abstract])) | 173 |
| 8 | #7 AND English[Language] | (“Muscle Strength”[MeSH Terms] OR “Gait”[MeSH Terms] OR “sarcopenia/rehabilitation”[MeSH Terms] OR “frailty/rehabilitation”[MeSH Terms] OR “Activities of Daily Living”[MeSH Terms] OR “Deglutition”[MeSH Terms] OR (“deglutition disorders/rehabilitation”[MeSH Terms] OR “deglutition disorders/therapy”[MeSH Terms]) OR (“dysphagia”[Title/Abstract] OR “Deglutition”[Title/Abstract] OR “Gait”[Title/Abstract] OR “muscle mass”[Title/Abstract] OR “sarcopenia”[Title/Abstract] OR “frailty”[Title/Abstract] OR “exercise capacity”[Title/Abstract] OR “walking test*”[Title/Abstract] OR “short physical performance battery”[Title/Abstract] OR “physical function*”[Title/Abstract] OR “disability”[Title/Abstract] OR “Activities of Daily Living”[Title/Abstract] OR “swallowing function*”[Title/Abstract] OR “tongue pressure*”[Title/Abstract] OR “muscle strengt*”[Title/Abstract])) AND (“Magnetic Field Therapy”[MeSH Terms:noexp] OR (“peripheral magnetic stimulation”[Title/Abstract] OR “rpms”[Title/Abstract] OR “magnetic treatment*”[Title/Abstract] OR “magnetotherapy”[Title/Abstract] OR “magnetic field therap*”[Title/Abstract])) AND “English”[Language] | 155 |
| 9 | (animals[MeSH Terms]) NOT (humans[MeSH Terms]) | “animals”[MeSH Terms] NOT “humans”[MeSH Terms] | 5,189,739 |
| 10 | #8 NOT #9 | ((“Muscle Strength”[MeSH Terms] OR “Gait”[MeSH Terms] OR “sarcopenia/rehabilitation”[MeSH Terms] OR “frailty/rehabilitation”[MeSH Terms] OR “Activities of Daily Living”[MeSH Terms] OR “Deglutition”[MeSH Terms] OR (“deglutition disorders/rehabilitation”[MeSH Terms] OR “deglutition disorders/therapy”[MeSH Terms]) OR (“dysphagia”[Title/Abstract] OR “Deglutition”[Title/Abstract] OR “Gait”[Title/Abstract] OR “muscle mass”[Title/Abstract] OR “sarcopenia”[Title/Abstract] OR “frailty”[Title/Abstract] OR “exercise capacity”[Title/Abstract] OR “walking test*”[Title/Abstract] OR “short physical performance battery”[Title/Abstract] OR “physical function*”[Title/Abstract] OR “disability”[Title/Abstract] OR “Activities of Daily Living”[Title/Abstract] OR “swallowing function*”[Title/Abstract] OR “tongue pressure*”[Title/Abstract] OR “muscle strengt*”[Title/Abstract])) AND (“Magnetic Field Therapy”[MeSH Terms:noexp] OR (“peripheral magnetic stimulation”[Title/Abstract] OR “rpms”[Title/Abstract] OR “magnetic treatment*”[Title/Abstract] OR “magnetotherapy”[Title/Abstract] OR “magnetic field therap*”[Title/Abstract])) AND “English”[Language]) NOT (“animals”[MeSH Terms] NOT “humans”[MeSH Terms]) | 146 |
Table 2.
Search strategy and results for Cochrane Library
| Search number | Search | Hits |
| 1 | MeSH descriptor: [Magnetic Field Therapy] this term only | 224 |
| 2 | (“peripheral magnetic stimulation”):ti,ab,kw OR (rpms):ti,ab,kw OR (magnetic NEXT treatment*):ti,ab,kw OR (magnetotherapy):ti,ab,kw OR (magnetic NEXT field NEXT therap*):ti,ab,kw | 584 |
| 3 | #1 OR #2 | 584 |
| 4 | MeSH descriptor: [Muscle Strength] explode all trees | 8775 |
| 5 | MeSH descriptor: [Gait] explode all trees | 3330 |
| 6 | MeSH descriptor: [Sarcopenia] explode all trees and with qualifier (s): [rehabilitation − RH] | 22 |
| 7 | MeSH descriptor: [Frailty] explode all trees and with qualifier (s): [rehabilitation − RH] | 19 |
| 8 | MeSH descriptor: [Activities of Daily Living] explode all trees | 13,153 |
| 9 | MeSH descriptor: [Deglutition] explode all trees | 606 |
| 10 | MeSH descriptor: [Deglutition Disorders] explode all trees and with qualifier (s): [therapy − TH, rehabilitation − RH] | 579 |
| 11 | {OR #4-#10} | 25,152 |
| 12 | (dysphagia):ti,ab,kw OR (deglutition):ti,ab,kw OR (gait):ti,ab,kw OR (“muscle mass”):ti,ab,kw OR (sarcopenia):ti,ab,kw | 26,034 |
| 13 | (frailty):ti,ab,kw OR (“exercise capacity”):ti,ab,kw OR (walking NEXT test*):ti,ab,kw OR (“short physical performance battery”):ti,ab,kw OR (physical NEXT function*):ti,ab,kw | 26,943 |
| 14 | (disability):ti,ab,kw OR (“activities of daily living”):ti,ab,kw OR (swallowing NEXT function*):ti,ab,kw OR (tongue NEXT pressure*):ti,ab,kw OR (muscle NEXT strengt*):ti,ab,kw | 76,574 |
| 15 | {OR #12-#14} | 114,236 |
| 16 | #11 OR #15 | 121,461 |
| 17 | #3 AND #16 | 121 |
Table 3.
Search strategy and results for CINAHL Complete
| Search number | Query | Results |
| S01 | (MH “Magnet Therapy”) | 1299 |
| S02 | “peripheral magnetic stimulation” OR rpms OR magnetic W0 treatments OR magnetotherapy OR magnetic W0 field W0 therap* | 1834 |
| S03 | S1 OR S2 | 2278 |
| S04 | (MH “Muscle Strength+”) | 30,938 |
| S05 | (MH “Gait+”) | 15,360 |
| S06 | (MH “Sarcopenia/RH”) | 64 |
| S07 | (MH “Frailty Syndrome/RH”) | 54 |
| S08 | (MH “Activities of Daily Living+”) | 80,445 |
| S09 | (MH “Deglutition”) | 4382 |
| S10 | (MH “Deglutition Disorders/RH/TH”) | 754 |
| S11 | dysphagia OR deglutition OR gait OR “muscle mass” OR sarcopenia OR frailty OR “exercise capacity” OR walking W0 tests OR “short physical performance battery” OR physical W0 function* OR disability OR “activities of daily living” | 325,166 |
| S12 | swallowing W0 function* OR tongue W0 pressure* OR muscle W0 strength* | 40,789 |
| S13 | S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11 OR S12 | 399,781 |
| S14 | S3 AND S13 | 217 |
| S15 | S3 AND S13 (English only) | 210 |
Table 4.
Search strategy and results for Web of Science Core Collection and PEDro
| Database | Search number | Search query | Results |
| Web of Science Core Collection | |||
| 1 | ((((((((((((((TS=(muscle NEAR/0 strength)) OR TS=(gait)) OR TS=(sarcopenia)) OR TS=(frailty)) OR TS=(“activities of daily living”)) OR TS=(deglutition)) OR TS=(dysphagia)) OR TS=(muscle NEAR/1 mass)) OR TS=(exercise NEAR/0 capacity)) OR TS=(walking NEAR/0 test*)) OR TS=(“short physical performance battery”)) OR TS=(physical NEAR/0 function*)) OR TS=(disability)) OR TS=(swallowing NEAR/0 function*)) OR TS=(tongue NEAR/0 pressure*) | 494,491 | |
| 2 | (((TS=(magnetic NEAR/0 field NEAR/0 therapy)) OR TS=(“peripheral magnetic stimulation”)) OR TS=(magnetic NEAR/1 treatment*)) OR TS=(magnetotherapy) | 3128 | |
| 3 | #1 AND #2 | 115 | |
| 4 | #1 AND #2 and Proceeding Paper (Exclude − Document Types) | 112 | |
| 5 | #1 AND #2 and Proceeding Paper (Exclude − Document Types) and English (Languages) | 111 | |
| PEDro | |||
| 1 | magnetic stimulation (abstract & title) | 216 |
Study Selection and Eligibility Criteria
Studies were selected using a three-step process that involved managing search results, removing duplicates, screening titles and abstracts, and conducting full-text reviews. The inclusion criteria were as follows: 1) randomized controlled trials, observational studies, case series, and case reports; 2) original human studies; 3) publication in English; and 4) studies examining the effects of PMS on physical function. Conference abstracts, review articles, and editorials were excluded. Reference lists of review articles were evaluated, and relevant studies were extracted. After removing duplicates, two reviewers (TF and JN) independently evaluated study eligibility by reviewing the titles and abstracts based on the inclusion criteria. Full-text articles were reviewed to confirm eligibility or when abstracts and titles lacked sufficient information. Any disagreements were resolved by consensus, and if consensus could not be reached, a third reviewer was consulted. The final inclusion of eligible studies was determined through consensus meetings involving all authors.
Data Extraction
Data were extracted using a chart table developed by the authors. Two reviewers (TF and JN) extracted the following data from each study: 1) first author’s last name, 2) publication year, 3) nationality, 4) study design, 5) disease, 6) number of participants, 7) age, 8) sex, 9) functional impairment, 10) treatment site, 11) PMS treatment details (including frequency, intensity, stimulation session, and duration), 12) outcomes, and 13) main results. When necessary, the authors were contacted for further information and data clarification. 28 )
Data Presentation
Data are presented in tables and figures, along with a narrative summary aligned with the objectives and scope of this review. Online tools were used to generate some figures (https://www.mapchart.net/).
RESULTS
The initial literature search identified 804 articles, which were reduced to 634 after excluding duplicates. Title and abstract screening identified 124 eligible articles for full-text review. In addition, reference lists from 27 review articles were screened. Ultimately, 97 articles were identified as suitable for this scoping review ( Fig. 1 ).
Study Overview
Characteristics of the included studies are summarized in Table 5 . All included articles were published after 1993. In total, 15 studies were conducted in Turkey 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ) ; 10 in the United States 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ) ; 9 in Italy 19 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ) ; 8 in Japan 21 , 22 , 62 , 63 , 64 , 65 , 66 , 67 ) ; 7 in Germany 68 , 69 , 70 , 71 , 72 , 73 , 74 ) ; 6 in Canada 75 , 76 , 77 , 78 , 79 , 80 ) and South Korea 17 , 18 , 23 , 81 , 82 , 83 ) ; 5 in China 20 , 84 , 85 , 86 , 87 ) ; 4 in Egypt 88 , 89 , 90 , 91 ) and Poland 92 , 93 , 94 , 95 ) ; 2 in New Zealand, 96 , 97 ) Saudi Arabia, 98 , 99 ) Slovenia, 100 , 101 ) Spain, 15 , 16 ) the United Kingdom, 102 , 103 ) and Brazil 104 , 105 ) ; and 1 in Australia, 106 ) Austria, 107 ) Denmark, 108 ) Iran, 109 ) Israel, 110 ) Lithuania, 111 ) Nigeria, 112 ) Romania, 113 ) Russia, 114 ) Singapore, 115 ) and Switzerland ( Fig. 2 ). 116 )
Table 5.
Characteristics of included studies
10MWT, 10-m walk test; 3MWT, 3-min walking test; 5TST, five times Sit-to-Stand test; ALS, amyotrophic lateral sclerosis; BBS, Berg balance scale; BBT, box and block test; BI, Barthel Index; CMS, Constant Murley Score; CRPS, Complex Regional Pain Syndrome; DASH, disabilities of the arm, shoulder, and hand; ELF-EMF, extremely low frequency electromagnetic field; ExMI, extracorporeal magnetic innervation; FAC, functional ambulation category; FFMI, fat free mass index; FIM, functional independence measure; FIQ, Fibromyalgia Impact Questionnaire; FMS, functional magnetic stimulation; HAQ, Health Assessment Questionnaire; HIFEM, high-intensity focused electromagnetic field; KOOS, Knee Injury and Osteoarthritis Score; LE-FMA, lower-extremity Fugl-Meyer Assessment; MRC, Medical Research Council; MRI, magnetic resonance imaging; NA, not available; NPDS, Neck Pain and Disability Scale;; NRCT, non-randomized controlled trial; MS, magnetic stimulation; PEME, pulsed electromagnetic energy; PEMF, pulsed electromagnetic field therapy; PEMT, pulsed electromagnetic therapy; PFDI, Pelvic Floor Disability Index; PMF, pulsed magnetic field; PSFS, Patient-specific Functional Scale; RCT, randomized controlled trial; RMDQ-24, Roland-Morris Disability Questionnaire-24; SPADI, Shoulder Pain and Disability Index; TUG, Timed Up-and-Go test; UCLA, University of California Los Angeles; UES, upper oesophageal sphincter; WFMT, Wolf motor function test.
| Author, year | Country | Study design | Population (disease, number, gender, age) | Functional impairment | Treatment site | PMS (frequency, intensity, stimulation session, duration) | Outcomes | Main results |
| Abdelhalim et al., 2019 | Saudi Arabia | NRCT | Low back pain n=42 Female, 33.3% Age: PEMF: 37.03±6.74 years Sham: 36.85±7.14 years | Pain and dysfunction | Low back | PEMF 5–10 Hz frequency Intensity: patient tolerance Three sessions/week 4 weeks | ∙ Modified ODI ∙ Modified Schober test | All outcome measures were significantly improved statistically in the experimental group at the end of the intervention. There were non-significant differences in all outcome measures in the sham group. |
| Afzalifard et al., 2022 | Iran | RCT | Shoulder Impingement Syndrome n=60 Female, NA Age: NA | Shoulder pain and disability | Shoulder | Magnet therapy 18 Hz frequency 100 Hz frequency Intensity: 100 mT 30 min/session Three times/week 4 weeks | ∙ DASH ∙ Active ROM | Using magnet therapy with two frequencies of 18 and 100 Hz along with routine electrotherapy and exercise therapy had no additional positive effect on the recovery process of patients with shoulder impingement syndrome. |
| Alazab et al., 2022 | Egypt | RCT | Stroke n=60 Female, 40.0% Age: NA | Shoulder subluxation-related dysfunction | Shoulder | rPMS 30 Hz frequency Intensity: not reported Two times/week 2 months | ∙ UE-FMA | A significant increase detected in UE-FMA for rPMS in comparison with control after treatment (P=0.03). |
| Alzayed and Alsaadi, 2020 | Saudi Arabia | RCT | Low back pain n=42 Female, 47.6% Age: PEMF: 41.45±9.45 years Sham: 42.61±9.69 years | Low back pain | Low back | PEMF Strong intensity 20 min | ∙ RMDQ-24 | Treatment group experienced a faster improvement in disability than the placebo group. Analysis showed a significant improvement in the disability scores in the treatment group at week 3, whereas an improvement in the placebo group was detected at week 6. Significant improvement in both groups was sustained for weeks 6, 9, and 13. There was no difference between the groups in scores of disability at weeks 6 and 13. |
| Ay and Evcik, 2009 | Turkey | RCT | Knee osteoarthritis n=55 Female, PEMF: 70% Placebo: 76% Age: PEMF: 58.9±8.8 years Placebo: 57.7±6.5 years | Pain and dysfunction | Knee | PEMF 50 Hz frequency Intensity: 105 μT 30 min/session Five times/week 3 weeks | ∙ ROM ∙ Lequesne Algofunctional Index of knee | Statistically significant improvement was observed in some of the subgroups of Lequesne index including ADL compared to placebo. No statistically significant difference in total of the scale between two groups. Between-group analysis showed no beneficial symptomatic effect of PEMF in the treatment of knee OA in all patients. |
| Aydin et al., 2018 | Turkey | RCT | Lumbar spinal stenosis n=49 Female, PEMF: 72.0% Placebo: 70.8% Age: PEMF: 61.6±8.6 years Placebo: 64.6±5.0 years | Chronic back pain | Back | PEMF 25 Hz frequency Intensity: 80 G 15 min/session Five sessions/week 2 weeks | ∙ ODI ∙ TUG | PEMF appears to be useful in terms of functional mobility and physical disability in lumbar spinal stenosis patients. |
| Baek et al., 2018 | Korea | RCT | Hip replacement after proximal femur fracture n=22 Female, 86.4% Age: rPMS: 77.09±6.78 years Sham: 80.36±7.97 years | Muscle dysfunction | Vastus lateralis | rPMS 10 Hz (on time: 1.5 s, off time: 6 s) frequency Intensity: visible movement of the knee is triggered 25 min 15 sessions Five times per week 3 weeks | ∙ Vastus lateralis strength ∙ Tandem test ∙ Gait speed | Both RMS value of the vastus lateralis and the ratio of RMS values after rPMS were significantly improved. Tandem standing time and usual gait speed in rPMS group were significantly increased. |
| Bagnato et al., 2016 | Italy | RCT | Knee osteoarthritis n=60 Female, 71.7% Age: 67.7±10.9 years | Knee pain | Knee | PEMF 27.12 Hz frequency Peak burst output power of the 12-cm antenna is 0.0098 W Minimum 12 h at night 1 month | ∙ WOMAC | PEMF induced a significant improvement in WOMAC scores compared with placebo. |
| Beaulieu et al., 2015 | Canada | RCT | Chronic stroke n=18 Female, 61.1% Age: rPMS: 51±15 years Sham: 55±11 years | Ankle impairments | Paretic tibialis anterior | rPMS Theta-burst frequency: 5-Hz bursts of three 50-Hz pulses each (2 s on, 8 s off) Intensity: 42% of the maximal stimulator output 190 s One session | ∙ Active/passive ROM (dorsiflexion) ∙ Isometric muscle strength (dorsiflexion) | In the rPMS group, ankle dorsiflexion mobility and maximal isometric strength increased. |
| Beaulieu et al., 2017 | Canada | Crossover RCT | Chronic stroke n=15 Female, 30.8% Age: 51.1±15.9 years | Sensorimotor impairments | Paretic ankle muscles | rPMS 20 Hz (on: 3 s, off: 19 s) frequency Intensity: inducing the maximal amplitudes of dorsiflexion/eversion 40 repetitions One session | ∙ Active/passive ROM (dorsiflexion, foot evertors) ∙ Isometric muscle strength (dorsiflexion, foot evertors) | Ankle muscle strength was significantly improved by rPMS. |
| Benedetti et al., 2020 | Italy | RCT | Type I CRPS n=30 Female, 90.0% Age: Treatment: 56.6±10.4 years Control: 56.8±14.1 years | Pain and functional decline | Whole body, hand | Bio-electro-magnetic-energy-regulation Low frequency (<33.3 Hz) Intensity: 7–35µT 20 min/session 10 consecutive days | ∙ Handgrip strength ∙ DASH ∙ Maryland Foot Score | The treatment group yielded better results in the short term, in terms of pain reduction and functional improvement in both the upper and lower limbs. |
| Bonfert et al., 2023 | Germany | Case report | Cerebral palsy n=1 Male Age: 8 years | Motor impairment | Gluteal muscles | Functional repetitive neuromuscular magnetic stimulation 25 and 35 Hz frequency Intensity: 3 T 45 min/session 12 sessions 3 weeks | ∙ Gross motor function measure ∙ 10MWT ∙ Balance assessment (posturography) | At day 4 after the intervention, the patient reported clinical benefits and improvements of standing and walking assessed by Gross Motor Function Measure dimensions. Body sway as measured by center of pressure displacement during posturography decreased. |
| Bustamante et al., 2008 | Spain | RCT | COPD n=15 Female, 0.0% Age: MS: 59±8 years Control: 68±10 years | Muscle dysfunction | Quadriceps | MS 15–8 Hz frequency Intensity: 40%–70% of the maximal output of the stimulator 15 min/session 3 days/week 3 weeks | ∙ FFMI ∙ 6MWT ∙ Proportion of type I muscle fibers (biopsy) | Compared to controls, magnetic stimulation muscle training induced a significant increase in type I fiber size. |
| Bustamante et al., 2010 | Spain | RCT | COPD n=18 Female, 0% Age: rPMS: 61±6 years Control: 62±8 years | Muscle dysfunction | Quadriceps muscle | rPMS 15 Hz frequency Intensity: 40% of the maximum stimulation (2T) Intensity was increased by 2%–3% every two sessions, ending the protocol at an intensity of 70% at 7 Hz 15 min/session Three times/week 8 weeks | ∙ FFMI ∙ Quadriceps strength ∙ 6MWT | All patients completed the training with increasing intensity of stimulation, displaying a significant improvement in voluntary quadriceps strength (17.5% of the baseline value) and exercise capacity, with a mean increase of 23 m in the 6MWT. |
| But, 2003 | Slovenia | RCT | Women with urinary incontinence n=52 Female, 100% Age: 55.8 (34–78) years | Urinary incontinence | Pelvic floor muscle | FMS 10 Hz frequency Intensity: 10 µT Wearing the device day and night 2 months | ∙ Pelvic floor muscle power ∙ Time of pelvic floor muscle contractions | In patients from the active group, significant improvements were observed in the power of the pelvic floor muscle contractions (P=0.0071) and in the duration of the pelvic floor muscle contractions (P=0.038). |
| Bölükbaş et al., 2005 | Turkey | NRCT | Urinary incontinence n=22 Female, 100.0% Age: 47.91±11.1 years | Urinary incontinence | Pelvic floor | FMS 10, 50 Hz frequency 20 min/session Two sessions/week 6 weeks | ∙ Pelvic floor muscle strength | The pelvic floor muscle strength increased significantly during stimulation compared with prestimulation. |
| Callaghan et al., 2005 | UK | RCT | Knee osteoarthritis n=27 Female, 48.1% Age: High dose: 58.3±7.3 years Low dose: 59.5±6.7 years Placebo: 63.5±7.9 years | Pain and dysfunction | Knee | Pulsed short wave 27 MHz frequency Intensity: 10 or 20 W 20 min/session Six sessions 2 weeks | ∙ ROM ∙ Quadriceps muscle strength ∙ Walking speed | Functional measures revealed no pre- and post-treatment differences between the groups (P >0.05), except for improved knee ROM in the placebo group (P <0.05). |
| Chen et al., 2020 | China | NRCT | Stroke n=32 Female, 28.1% Age: rPMS: 49.0±18.2 years Sham: 45.6±8.3 years | Stroke-related upper-extremity dysfunction | Upper extremity: shoulder joint (proximal joint) to the wrist joint (distal joint) | rPMS 5 Hz frequency (muscle groups with spasticity) 20 Hz frequency (antagonistic muscles) MAS score of the antagonistic muscle was 1, a 5-Hz stimulation was still used. Intensity: 100% of the muscle contraction threshold at a resting state 30 min Single session | ∙ UE-FMA | UE-FMA was improved (P <0.05) after single session of rPMS. |
| Cichoń et al., 2017 | Poland | RCT | Ischemic stroke n=57 Female, Study: 64.8% Control: 65.6% Age: Study: 68.0±15.6 years Control: 70.9±15.3 years | Post-ischemic stroke condition | Pelvic girdle | PEMF 40 Hz frequency Intensity: 7 mT 15 min 5 days/week 4 weeks | ∙ BI | Results show that ELF-EMF induced a significant improvement in ADL. |
| Cichoń et al., 2018 | Poland | RCT | Stroke n=57 Female, Study: 64.8% Control: 65.6% Age: Study: 68.0±15.6 years Control: 70.9±15.3 years | Post-acute stroke condition | Pelvic girdle | PEMF 40 Hz Intensity: 5 mT 15 min 5 days/week 4 weeks | ∙ BI | The ADL value in patients treated with ELF-EMF increased by about 25% compared with the control group. |
| Culligan et al., 2005 | USA | RCT | Primiparous n=51 Female, 50.0% Age: 64.14±13.61 years | Pelvic floor dysfunction | Pelvic floor | ExMI 50 Hz frequency 20 min/session Two sessions/week 8 weeks | ∙ Pelvic floor muscle strength | No differences in pelvic muscle strength between patients receiving active or sham ExMI treatments in the early postpartum period. |
| Cömertoğlu et al., 2022 | Turkey | RCT | CRPS-1 n=32 Female, 50.0% Age: 50.1±13.1 years | Pain and dysfunction | Hand | PEMF 8 Hz frequency Intensity: 3.2 mT 75–95 min/session Five times/week 4 weeks | ∙ Handgrip strength ∙ Pinch strength ∙ Moberg pick up test ∙ Duruöz Hand Index | PEMF in addition to conventional rehabilitation did not provide additional benefit for pain and hand functions in CRPS-1. |
| Dudonienė et al., 2023 | Lithuania | RCT | Women with stress urinary incontinence n=48 Female, 100.0% Age: FMS: 40.25±6.49 years Pelvic floor muscle training: 37.58±5.86 years | Stress urinary incontinence | Pelvic floor muscle | FMS 35 (first 20 min)→5 (last 10 min) Hz frequency Intensity: not reported 30 min/session 12 sessions Two times/week 6 weeks | ∙ Pelvic floor muscle strength ∙ Pelvic floor muscle endurance | Pelvic floor muscle strength and endurance increased (P <0.05) in both groups with a medium (d=0.52) to large (d=1.56) effect size. |
| Dündar et al., 2016 | Turkey | RCT | Knee osteoarthritis n=40 Female, 72.5% Age: PEMF: 56.8±14.5 years Sham: 57.6±13.8 years | Pain and dysfunction | Knee | PEMF 50 Hz frequency Intensity: 100 µT 20 min/session Five sessions/week 4 weeks | ∙ WOMAC | WOMAC scores significantly improved in both treatment groups. There was no overall statistically significant difference between the groups. |
| Elshiwi et al., 2019 | Egypt | RCT | Low back pain n=50 Female, PEMF: 48.0% Control: 52.0% Age: PEMF: 36.73±2.52 years Control: 37.27±2.52 years | Pain and dysfunction | Low back | PEMF 50 Hz frequency Intensity: 20 Gauss 20 min/session Three times/week 4 weeks | ∙ ODI ∙ ROM | Adding pulsed electromagnetic field to conventional physical therapy yields superior clinical improvement in pain, functional disability, and lumbar ROM in patients with non-specific low back pain when compared with conventional physical therapy alone. |
| Fary et al., 2011 | Australia | RCT | Knee osteoarthritis n=70 Female, 47.1% Age: Active: 70.7±8.9 years Placebo: 68.9±11.4 years | Pain and dysfunction | Knee | Pulsed electrical stimulation 100 Hz frequency Intensity: NA 7 h/day 26 weeks | ∙ WOMAC ∙ Parous women activity profile ∙ Actigraph | There were no differences between groups for changes in WOMAC or activity measures. |
| Fawaz et al., 2023 | Egypt | RCT | Post-stroke n=80 Female, 30.0% Age: 57.33±10.67 years | Post-stroke hemiparesis | Shoulder abductors, elbow extensors, wrist extensors, supinator muscle | rPMS 30 Hz frequency Intensity: 10% above the level that evoked wrist movement taken at rest (average for all cases was between 35% and 45%) 30 min/ whole session Five sessions/week 3 weeks | ∙ UE-FMA ∙ Extensor digitorum muscle cross-sectional area ∙ FIM ∙ Active ROM | Post rehabilitation program, UE-FMA and FIM both showed highly significant improvement in the active group compared to controls. Regarding active ROM of the shoulder abductors, triceps, wrist extensors, and supinators, significant differences were found in the active group in comparison to controls. |
| Flamand and Schneider, 2014 | Canada | Case report | Cerebral palsy n=1 Female, 0% Age: 7 years | Motor deficits | Sciatic and tibial nerves and over the common peroneal nerve | rPMS Three pulses at 50 Hz, repeated every 200 ms (5 Hz) Intensity: palpable muscle contractions and ankle movements Sciatic nerve: 180 s Tibial nerve: 60 s Common peroneal nerve: 2 s trains of pulses repeated every 10 s during 300 s Five rPMS sessions (S1-S5, each successive Thursday and Tuesday) | ∙ Active/passive ROM (dorsiflexion) ∙ Gait (walking velocity, stride length, cadence, cycle duration) | An increase of active dorsiflexion range of movement and increased gait parameters were observed. |
| Fujimura et al., 2020 | Japan | Pre–post, single-arm study | Stroke n=12 Female, 41.7% Age: 61±17 years | Shoulder subluxations | Shoulder (supraspinatus and posterior deltoid/infraspinatus muscles) | rPMS 30 Hz (on: 2 s, off: 3 s) frequency 17 min/day 5 days/week 4 weeks | ∙ Active ROM (shoulder abduction) ∙ UE-FMA | Active ROM of shoulder abduction and UE-FMA improved significantly after treatment. |
| Fukuda et al., 2011 | Brazil | RCT | Knee osteoarthritis n=112 Female, 100.0% Age: High dose: 63.0±9.0 years Low dose: 62.0±8.0 years Placebo: 57.0±9.0 years Control: 61.0±10.0 years | Pain and dysfunction | Knee | Pulsed short wave 145 Hz frequency Intensity: 14.5 W 19 or 38 min/session Three sessions/week 3 weeks | ∙ KOOS | Both treatment groups showed a significant improvement in function compared with the control and placebo groups. There were no differences in results between doses, although a low dose appeared to be more effective in the long term. |
| Galace de Freitas et al., 2014 | Brazil | RCT | Shoulder impingement syndrome n=56 Female, 64.3% Age: 50.5±8.9 years | Pain and muscle dysfunction | Shoulder | PEMF 50 Hz frequency Intensity: 20mT or 200G 30 min Three times/week 3 weeks | ∙ CMS ∙ UCLA ∙ Shoulder lateral rotation muscle strength ∙ Shoulder medial rotation muscle strength ∙ Shoulder elevation muscle strength | Patients in the active PEMF group had a higher level of function at all follow-up time frames compared with baseline. PEMF group had increased strength for lateral rotation at 9 weeks, and increased strength for medial rotation at 9 weeks and 3 months when compared with baseline. |
| Galovic et al., 2018 | Slovenia | RCT | Low back pain n=60 Female, 58.3% Age: PEMF: 57.45±11.55 years Placebo: 11.05±10.71 years | Pain and dysfunction | Low back | PEMF 10 Hz frequency Intensity: 50% of maximum intensity 20 min/session Five sessions/week 3 weeks | ∙ ODI | In both groups, the level of the function assessed with the ODI improved immediately after the therapy and 1 month after the completed therapy, but the differences among groups were not statistically significant. |
| Garland et al., 2007 | USA | RCT | Knee osteoarthritis n=58 Female, 65.5% Age: Active: 64.3±10.2 years Placebo: 69.9±11.4 years | Pain and dysfunction | Knee | Pulsed electrical stimulator 100 Hz frequency Intensity: 12 V 6 h/day 3 months | ∙ WOMAC | Active treatment provided superior outcomes between baseline and 3-month follow-up measurements in WOMAC function. |
| Gilling et al., 2009 | New Zealand | RCT | Stress urinary incontinence n=70 Female, 100.0% Age: Intervention: 54.0±2.0 years Sham: 54.8±2.2 years | Stress urinary incontinence | Pelvic floor | Electromagnetic stimulation 10, 50 Hz frequency 20 min/session Three sessions/week 8 weeks | ∙ Pelvic floor muscle strength | There was a statistically significant improvement in the active arm at 8 weeks in pelvic floor muscle strength. There was no significant difference between the groups. |
| Giusti et al., 2013 | Italy | RCT | Older adults with low bone mineral density n=41 Female, 7.3% Age: PEMF: 84 (74–96) years Placebo: 87 (75–100) years | Low physical performance | Whole body | PEMF Low-power laser: wavelength 500–700 nm Low-energy infrared pulsed light: wavelength 700–1050 nm TENS: maximum amplitude 200 V 10 min One session | ∙ Gait speed | In the intervention group, self-selected gait speed increased significantly from baseline. In the placebo group, all gait parameters except for support base remained unchanged. |
| Giusti et al., 2014 | Italy | Retrospective, single-arm study | Older adults n=266 Female, 91% Age: 77.1±5.6 years | History of falls | Whole body | PEMF Low-power laser: wavelength 500–700 nm Low-energy infrared pulsed light: wavelength 700–1050 nm TENS: maximum amplitude 200 V 10 min Every 2 months 1 year | ∙ Gait speed | The results suggest that continuous exposure to PEMF improves self-selected gait speed in older adults at risk of falling. |
| Gremion et al., 2009 | Switzerland | RCT | Knee osteoarthritis n=89 Female, 44.9% Age: Pulsed signal therapy: 58±13 years Physiotherapy: 61±8 years | Disability | Knee | Pulsed signal therapy 15 Hz frequency Intensity: 12.5G 60 min/session 9 days | ∙ Knee ROM ∙ Lequesne Index of Severity | Both treatments resulted in significant improvements in pain and physical function. A statistical difference was observed only for ADL, where the physiotherapy was more efficient. |
| Grosse et al., 2023 | Germany | Prospective, pre–post, single-arm study | Cerebral palsy n=8 Female, 62.5% Age: 10.4±2.5 years | Motor impairment | Gluteal muscles | Functional repetitive neuromuscular magnetic stimulation 25 and 35 Hz frequency Intensity: 3 T 20 min/session 12 sessions 3 weeks | ∙ Canadian Occupational Performance Measure | The Canadian Occupational Performance Measure demonstrated clinically important benefits for performance in 28%. Functional repetitive neuromuscular magnetic stimulation is a safe and well-accepted neuromodulatory approach that could improve the activity and participation of children and adolescents with bilateral spastic cerebral palsy. |
| Gumussoy et al., 2021 | Turkey | RCT | Stress incontinence n=51 Female, 100.0% Age: 50.92±8.88 years | Stress incontinence | Pelvic floor muscle | ExMI 10 and 50 Hz frequency Intensity: NA 20 min/session Two times/week 8 weeks | ∙ Pelvic floor muscle contraction force | Findings indicate that use of magnetic innervation does not improve pelvic floor muscle strength when compared to pelvic floor muscle training alone. |
| Hattapoğlu et al., 2019 | Turkey | RCT | Cervical disc herniation n=64 Female, 28.1% Age: PEMF: 42.96±10.35 years Sham: 47.15±11.03 years | Neck pain and disability | Cervical region | PEMF 50 Hz frequency Intensity: 0.6 mT 20 min 5 days/week 3 weeks | ∙ NPDS | A significant improvement was found in the disability of both groups after treatment when compared to those before treatment. |
| Iannitti et al., 2013 | USA | Pre–post, two-arm study | Knee osteoarthritis n=28 Female, NA Age: 69.9±1.5 years | Pain and muscle dysfunction | Knee | PEMF 6–100 Hz (low frequency) and 500–2000 Hz (high frequency) for 15 min, and 6–100 Hz (low frequency) and 100–5000 Hz (high frequency) for 15 min Intensity: 50–100G 30 min Three times/week 6 weeks | ∙ WOMAC | PEMF therapy improves physical function in elderly patients affected by knee osteoarthritis. |
| Jiang et al., 2022 | China | RCT | Subacute stroke n=44 Female, 38.6% Age: rPMS: 54.62±10.89 years Control: 56.09±16.59 years | Severe upper-extremity impairment | Triceps brachii, extensor digitorum | rPMS 20 Hz stimulation for 0.5 s per session, with a 2-s interval between sessions, 120 sessions per muscle, a total of 2400 pulses per treatment Triceps brachii: Intensity gradually increased from 0% of maximum output until 30° elbow extension was induced Extensor digitorum: Intensity gradually increased from 0% until wrist joint was extended by 45° Daily 2 weeks | ∙ UE-FMA | The rPMS group showed more significant improvements in the FMA. |
| Kagaya et al., 2019 | Japan | Pre–post, single-arm study | Healthy volunteers n=11 Female, 0% Age: 32±9 years | Dysphagia | Suprahyoid muscles | rPMS 30 Hz (on: 2 s) frequency Intensity: Movement of the hyoid bone without intolerable pain | ∙ Displacement of hyoid bone | Magnetic stimulation resulted in 10.9±2.8 mm forward displacement and 8.3±4.1 mm upward displacement of the hyoid bone. |
| Kanat et al., 2013 | Turkey | RCT | Hand osteoarthritis n=50 Female, 100% Age: PEMF: 64±13 years Sham: 62±12 years | Pain and muscle dysfunction | Hand | PEMF 25 Hz frequency Intensity: 5–80 G 10 days 20 min/day | ∙ Handgrip strength ∙ Pinch grip strength ∙ Duruöz Hand OA Index ∙ AUSCAN Hand OA Index | The significant improvement was observed in Duruöz and Auscan Hand Osteoarthritis Indexes. |
| Kandemir et al., 2024 | Turkey | RCT | Subacromial impingement syndrome n=80 Female, 61.3% Age: PEMF 49.82±8.05 years Sham 49.62±9.40 years | Subacromial impingement syndrome | Shoulder | PEMF 50 Hz frequency 85 Gauss intensity 30 min/day 5 days/week 4 weeks | ∙ ROM (flexion, abduction, internal and external rotation) ∙ Muscle strength (internal and external rotation) ∙ Functional capacity (CMS, SPADI) | In the comparison between the PEMF and sham groups, more improvement was found in the PEMF group in active flexion, abduction ROM, and most parameters of functional capacity. No statistically significant difference was found between the groups in muscle strength. |
| Karakaş and Gök, 2020 | Turkey | RCT | Chronic non-specific neck pain n=63 Female, 76.2% Age: 45.1 (25–59) years | Pain and dysfunction | Neck | PEMF 10–100 Hz frequency Intensity: 50% 20 min/session Five times/week 3 weeks | ∙ NPDS | PEMF does not provide further improvement in pain and functionality when applied in addition to conventional physical therapy. |
| Katz, 2020 | USA | Case study | n=2 Female, 50.0% Age: 26 and 47 years | NA | Biceps/triceps, calves | HIFEM 20 min/session Two times/week 2 weeks | ∙ Muscle mass (MRI) | Analysis of MRI images showed an average increase in all three muscle groups (biceps muscle mass, triceps muscle mass, and gastrocnemius muscle mass). |
| Katz and Duncan, 2021 | USA | Pre–post, single-arm study | n=20 Female, 67.5% Age: PEMF: 65.6±6.6 years Sham: 64.6±11.5 years | NA | Arms, calves | HIFEM 20 min | ∙ Muscle mass (1, 3, and 6 months) | Ultrasound images revealed a significant increase in the muscle mass of all studied muscles (biceps brachii, triceps brachii, and gastrocnemius), with the most noticeable improvement in biceps brachii. |
| Ke et al., 2022 | China | RCT | Intracerebral hemorrhage n=26 Female, 46.2% Age: rPMS: 58 (46.5–63.0) years Sham: 56 (46.5–61.5) years | Motor paralysis | Center of the axilla and the popliteal fossa | rPMS 20 Hz frequency On 1 s, off 19 s, 1800 pulses 40%–60% output intensity of stimulator 30 min/day at each stimulation site 10 consecutive days | ∙ UE-FMA ∙ LE-FMA ∙ MRC scale | Statistically significant differences observed between the rPMS group and sham rPMS group for UE-FMA, LE-FMA, proximal MRC of upper extremity, proximal MRC of lower extremity, and distal MRC scores of lower extremity. |
| Kim and Nam, 2021 | Korea | RCT | Low back pain n=25 Female, rPMS: 76.9% Control: 66.7% Age: rPMS: 34.93±11.51 years Control: 39±13.11 years | Pain and dysfunction | Low back | rPMS | ∙ Korean ODI | In the rPMS group, significant decrease was observed in the Korean ODI after treatment, and there was significant difference in the Korean ODI compared to the control group. Results suggest that rPMS improves the disability in low back pain patients. |
| Kinoshita et al., 2020 | Japan | Case series | Stroke n=7 Female, 42.9% Age: 61±17 years | Hemiparesis and gait disturbance | Lower limb (gluteus maximus muscle, gluteus medius, hamstring muscle, musculus quadriceps femoris, gastrocnemius, and soleus) | rPMS 20 Hz (on: 3 s, off: 27 s) frequency Intensity: 10% above the minimal level that evoked a hip, knee, or ankle movement when the patient was at rest 40 min/day 6 days/week | ∙ 10MWT ∙ FAC ∙ 6MWT ∙ BBS ∙ Step length, symmetry | Significant improvements in walking speed, gait ability, and balance ability, but no significant effect on endurance capacity or step length. |
| Krammer et al., 2015 | New Zealand | RCT | Low back pain n=40 Female, 50.0% Age: PEME: 35.7 years Placebo: 30.2 years | Pain and dysfunction | Low back | PEME 27.12 MHz frequency Intensity: 0.03 mT 4 weeks | ∙ ODI ∙ PSFS | The group treated with active pulsed electromagnetic energy failed to demonstrate any significant additional improvements in ODI and PSFS. |
| Krath et al., 2017 | Germany | RCT | Low back pain n=87 Female, 54.0% Age: Intervention: 61.93±10.34 years Control: 59.02±11.2 years | Pain and dysfunction | Low back | Electromagnetic transduction therapy 3 Hz frequency Intensity: 80 mT 20 min/session Two sessions/week 8 sessions | ∙ ODI | In both intervention groups, low back-related pain and the degree of disability decreased significantly at follow-up visits. Combination of electromagnetic transduction therapy and conventional therapy proved significantly superior to conventional therapy alone. |
| Krewer et al., 2014 | Germany | RCT | Stroke n=63 Female, 39.7% Age: rPMS: 55±13 years Sham: 54±13 years | Hemiparesis | Upper extremity | rPMS 25 Hz frequency Intensity: 10% above the level that evoked a wrist or elbow movement taken at rest 20 min/session Two times/day 2 weeks | ∙ UE-FMA ∙ BI | Arm motor function did not significantly change over the study period in either group, whereas rPMS had a positive effect on sensory function. |
| Krzyżańska et al., 2020 | Poland | NRCT | Distal radius fracture n=52 Female, 86.5% Age: PEMF: 58.1±18.2 years Con: 63.6±10.4 years | Cast immobilization caused by fracture | Hand, wrist, distal forearm | PEMF 20–30 Hz frequency 6–10 mT 22 sessions (from seventh treatment, patients received PEMF once a day for 10 days, and then three times a week) 30 min/session 6 weeks | ∙ ROM ∙ Handgrip strength ∙ DASH | PEMF group reported significant changes after 3 and 6 weeks of treatment: greater mobility of upper-limb joints, and reduction in disability of the upper limb. |
| Külcü and Gül, 2009 | Turkey | RCT | Knee osteoarthritis n=45 Female, 77.8% Age: 63.5±10.2 years | Pain and dysfunction | Knee | PEMF 2, 100, and 25 Hz frequency consecutively Intensity: 2–10 mT 35 min/session 5 sessions/week 15 sessions 3 weeks | ∙ WOMAC | WOMAC functional level score (P=0.003) significantly improved in the PEMF group. There were differences between groups regarding the WOMAC functional level scores (P<0.001) after the treatments. |
| Laufer et al., 2005 | Israel | RCT | Knee osteoarthritis n=103 Female, 60.2% Age: 73.7±6.6 years | Pain and dysfunction | Knee | Pulsed short wave 110 or 300 Hz frequency Intensity: 1.8 or 18 W 20 min/session Three sessions/week 3 weeks | ∙ WOMAC ∙ TUG ∙ Timed stair-climbing ∙ Timed stair-descending ∙ 3MWT | No significant differences across time or between groups were observed in any of the other measures. |
| Lee and Nam, 2021 | Korea | RCT | Knee osteoarthritis n=17 Female, rPMS: 88.9% Control: 100.0% Age: rPMS: 71.3±4.78 years Control: 71.2±3.55 years | Pain and dysfunction | Knee | rPMS | ∙ 5TST ∙ WOMAC | In both the rPMS group and control groups, significant decrease was observed in the 5TST and WOMAC test after treatment, and there was no significant difference in the 5TST and WOMAC test compared to the control group. Results suggest that rPMS and exercises provides pain relief and improves knee joint function in knee osteoarthritis patients. |
| Lee et al., 2006 | Korea | RCT | Low back pain n=36 Female, 47.2% Age: PEMT: 75±5 years Placebo: 74±4 years | Low back pain | Low back | PEMT 5 and 50 Hz frequency Intensity: 1.3–2.1T 15 min/session Three times/week 3 weeks | ∙ Revised ODI | The mean revised Oswestry disability percentage after 4 weeks was significantly improved from the baseline value in the PEMT group, whereas there were no significant differences in the placebo group. |
| Lim et al., 2018 | Korea | RCT | Acute low back pain n=26 Female, 53.8% Age: rPMS: 52.50±21.45 years Sham: 51.21±17.98 years | Low back pain | Most painful lumbar region | rPMS 20 Hz (on: 5 s, off: 25 s) frequency Intensity: 20% of maximal stimulator output 20 min Ten sessions 2 weeks | ∙ ODI ∙ RMDQ | Significant functional improvement was observed in the real rPMS group compared to that in the sham rPMS group after sessions 5 and 10 based on ODI and after session 5 based on RMDQ. |
| Lin et al., 2001 | USA | Prospective, pre–post, single-arm study | Spinal cord injury n=8 Female, 0.0% Age: 51±8 years | Pulmonary dysfunction caused by tetraplegia | Lower thoracic spine | FMS 20 Hz frequency Intensity: 50%–70% 20 min/session Twice a day Five times/week 4 weeks | ∙ Maximum expiratory pressure at total lung capacity ∙ Expiratory reserve volume ∙ Forced expiratory flow rate at total lung capacity ∙ Maximum expiratory pressure at functional residual capacity ∙ Forced expiratory flow rate at functional residual capacity ∙ Forced vital capacity ∙ Forced expiratory volume | A 4-week protocol of FMS of the expiratory muscles significantly improves voluntary expiratory muscle strength, indicating that FMS can be a noninvasive therapeutic technology in respiratory muscle training for persons with tetraplegia. |
| Lisi et al., 2019 | USA | RCT | Low back pain n=42 Female, PEMF: 52.6% Sham: 60.8% Age: PEMF: 34±13 years Control: 37±15 years | Low back pain | Low back | PEMF Low frequency (range 1–100 Hz) Intensity: low intensity (nT; 10 −9 ) 30 min/session, Two times/day, every day (first 6 weeks) Once daily, 2–3 days/week (next 6 weeks) 12 weeks | ∙ ODI | PEMF provides preliminary evidence of effectiveness in improving function in patients with non-specific low back pain. |
| Liu et al., 2013 | China | RCT | Postmenopausal osteoporosis n=44 Female, 100% Age: PEMF: 61.7±1.3 Alendronate: 63.1±4.3 | Reduced mobility | Lumber supine | PEMF 8 Hz frequency Intensity: 3.82mT (peak) 40 min Six times/week 5 weeks | ∙ Lower-extremity manual muscle test ∙ BBS | There was no significant treatment difference between the PEMF and alendronate groups in the total lower-extremity manual muscle test and BBS score. These results suggested that a course of PEMF treatment with specific parameters was as effective as alendronate in treating postmenopausal osteoporosis. |
| Massé-Alarie et al., 2013 | Canada | RCT | Low back pain n=13 Female, 61.5% Age: rPMS: 53.6±5.5 years Sham: 53.8±9.8 years | Postural adjustment disability | Transversus abdominis/internal oblique muscle | rPMS 50 Hz frequency Intensity: 33% of maximal stimulator output 10 min One session | ∙ Quebec Back Pain Disability Scale | Two weeks after experiment, Quebec Back Pain Disability Scale scores (functional disability) was improved in rPMS group, whereas it was unchanged in sham group. |
| Massé-Alarie et al., 2017 | Canada | RCT | Chronic low back pain n=21 Female, 47.6% Age: rPMS: 33.2±10.8 years Sham: 42.1±17.2 years | Low back pain | Superficial multifidus muscle (L4–L5 level) | rPMS 20 Hz (30 contractions of 10 s with 30 s off) frequency Intensity: 35% and 40% of maximal stimulator output 20 min Three times/week 1 week | ∙ ODI ∙ PSFS | rPMS significantly improved the ODI and PSFS. |
| Moldovan et al., 2012 | Romania | RCT | Knee osteoarthritis n=65 Female, 72.3% Age: PEMF: 57.7±8.67 years Placebo: 57.8±8.67 years | Pain and dysfunction | Knee | PEMF 1.5 Hz frequency Intensity: 30 mT 15 min/session 10 days | ∙ WOMAC | There was a significant improvement in WOMAC score in both groups. There was no overall statistically significant difference in the active versus placebo group. In a subgroup analysis, after having excluded the advanced knee osteoarthritis patients with Kellgren-Lawrence scores of 3 and 4, the patients treated with PEMF had superior improvement in WOMAC score. |
| Momosaki et al., 2014 | Japan | RCT | Stroke n=20 Female, 30% Age: FMS: 61±22 years Sham: 66±9 years | Post-stroke dysphagia | Suprahyoid muscles | FMS 30 Hz frequency (on: 2 s, off: 28 s) Intensity: 90% of minimal intensity at which patient subjectively feels local pain 10 min One session Single day | ∙ Timed water swallow test ∙ Interswallow interval ∙ Swallowing volume velocity ∙ Volume per swallow | The improvement of speed and capacity of swallowing after stimulation was significantly larger in the real group than in the sham group. However, no significant difference in the interswallow interval was found between the groups. |
| Momosaki et al., 2015 | Japan | Case series | Post-stroke n=8 Female, 25.0% Age: 62–27 years | Dysphagia | Suprahyoid muscles | rPMS 20 Hz (on: 3 s, off: 27 s) frequency Intensity: 90% of maximal intensity 10 min Twice daily Six consecutive days | ∙ Laryngeal elevation delay time ∙ Penetration aspiration scale ∙ Functional Oral Intake Scale ∙ Mann Assessment of Swallowing Ability | rPMS induced significant improvement in swallowing ability, laryngeal elevation delay time, and penetration aspiration scale, but had no significant effect on the functional oral intake scale. |
| Moretti et al., 2012 | Italy | RCT | Total knee arthroplasty n=30 Female, NA Age: PEMF: 70.0±10.6 years Control: 70.5±8.1 years | Pain, joint swelling, and physical dysfunction | Knee | PEMF 75 Hz frequency Intensity: 1.5mT 4 h/day 60 days | ∙ Knee Society Score | The Knee Score demonstrated significantly positive outcomes in the PEMF group compared with the controls at follow-ups. The effect of PEMF therapy was maintained after use of the device was discontinued. |
| Musarò et al., 2019 | Italy | RCT | ALS n=22 Female, 13.6% Age: 61.27±13.44 years | Muscle dysfunction | Arm | Neuromuscular magnetic stimulation 5 Hz frequency Intensity: 100% 5 days/week 2 weeks | ∙ MRC score ∙ Handgrip strength ∙ Muscle fiber type composition, muscle atrophy and wasting | A significant effect of neuromuscular magnetic stimulation was observed on MRC scale at the flexor carpi radialis muscle. The improvement observed in neuromuscular magnetic stimulation-treated muscles was associated with counteracting muscle atrophy and down-modulating the proteolysis. |
| Nagashima et al., 2021 | Japan | Pre–post, single-arm study | Healthy adults n=20 Female, 25.0% Age: 32±9 years | NA | Suprahyoid muscles | Electromyography (EMG)-triggered peripheral magnetic stimulation 30 Hz frequency 2 s when EMG level in sternohyoid muscle exceeded threshold | ∙ Movement time of hyoid bone ∙ Anterior maximum movement distance of hyoid bone ∙ Opening width of UES ∙ Anterior movement distance of hyoid bone at maximum UES opening ∙ Maximum pressure immediately after UES closure | Magnetic stimulation significantly extended the movement time of the hyoid bone. During liquid deglutition, significant increases were observed in the anterior maximum movement distance of the hyoid bone, opening width of the UES, and anterior movement distance of the hyoid bone at the maximum UES opening. In pressure topography, the maximum pressure immediately after UES closure significantly decreased with magnetic stimulation. EMG-triggered peripheral magnetic stimulation made it possible to apply magnetic stimulation during voluntary swallowing. |
| Nicolakis et al., 2002 | Austria | RCT | Knee osteoarthritis n=32 Female, 59.4% Age: PMF: 69±5 years Sham: 67±7 years | Disability | Whole body | PMF 1–3000 Hz frequency Intensity: 40µT 30 min/session Two times/day 6 weeks | ∙ WOMAC ∙ Gait speed ∙ Knee extension muscle strength | After 6 weeks of treatment, the WOMAC Osteoarthritis Index was more reduced in the pulsed magnetic field group than the sham group. The following secondary parameters improved in the pulsed magnetic field group more than they did in the sham group: gait speed at fast walking, acceleration time in the isokinetic dynamometry strength tests. |
| Obayashi and Takahashi, 2020 | Japan | NRCT | Stroke n=19 Female, 31.6% Age: rPMS: 64.3±13.1 years Standard care: 72.3±10.7 years | Severe upper-limb paresis | Upper limb (extensor digitorum communis, extensor carpi radialis, flexor digitorum superficialis, triceps brachii, biceps brachii, and anterior or middle head of deltoid) | rPMS 30 Hz (on: 2 s, off: 2 s) frequency Intensity: 70% maximal stimulator output, corresponding to 0.65 T 15–20 min/day 3 days/week | ∙ UE-FMA ∙ WFMT ∙ BBT | Significant improvement in FMA-UE and WMFT, but not in BBT. |
| Ogawa et al., 2020 | Japan | RCT | Healthy adults n=24 Female, NA Age: Magnetic stimulation: 30±6 years Head lift: 29±5 years | Dysphagia | Suprahyoid muscles | rPMS 30 Hz (on: 2 s, off: 8 s) frequency Intensity: 70% of maximum (approximately 0.7 T) 90 times daily 2 weeks | ∙ Cervical flexor strength ∙ Jaw-opening force ∙ Tongue pressure ∙ Muscle fatigue of the hyoid and laryngeal muscles ∙ Displacement of hyoid bone ∙ Opening width of UES | Cervical flexor strength significantly increased solely in the magnetic stimulation. Tongue pressure significantly improved in both groups. There were no significant differences in the jaw-opening force, median frequency rate of the anterior belly of the digastric muscle, sternohyoid muscle, sternocleidomastoid muscle, anterior and superior hyoid bone displacement, and UES opening width in both groups. |
| Oke and Umebese, 2013 | Nigeria | RCT | Back pain n=16 Female, 43.8% Age: 42.82±8.63 years | Back pain | Back | PEMF Four times/day 2 h (total) During admission (8.25±1.83 times) | ∙ Functional activity scores | There was a statistically significant faster resumption of active functions in patients treated with PEMF plus analgesic compared with the rates exhibited by patients treated with standard analgesics alone. |
| Omar et al., 2012 | Egypt | RCT | Discogenic lumbar radiculopathy n=40 Female, 72.5% Age: PEMF: 37.5±8.5 years Sham: 40.0±8.3 years | Low back pain with radicular symptoms | Low back | PEMF 7 Hz–4kHz frequency Intensity: 5–15G 20 min daily 3 weeks | ∙ ODI | Significant differences were observed between both groups before and after application of PEMF therapy relative to total ODI (P<0.001), and other domains of ODI. |
| Özgüçlü et al., 2010 | Turkey | RCT | Knee osteoarthritis n=40 Female, 72.5% Age: PEMF: 60.55±7.7 years Sham: 62.15±8.15 years | Pain and dysfunction | Knee | PEMF 50 Hz frequency Intensity: 30 G 30 min/session Ten sessions 2 weeks | ∙ WOMAC | Both PEMF and sham PEMF treatment groups showed statistically significant improvement in WOMAC pain and functional scores at the end of treatment. There were no statistically significant differences between groups in WOMAC pain, stiffness, and physical function scores after treatment. |
| Paolucci et al., 2016 | Italy | RCT | Fibromyalgia n=33 Female, 100.0% Age: 50.33±10.94 years | Pain | Dorsal body | Low-frequency magnetic field 1–80 Hz frequency Intensity: 100 μT 30 min/session Three times/week 4 weeks | ∙ FIQ ∙ HAQ | Short-term benefits of low-frequency magnetic field were observed in FIQ and HAQ scores, with less significant effects seen in the medium term. |
| Park et al., 2014 | Korea | RCT | Lumbar myalgia n=38 Female, 71.1% Age: 31.95±12.3 years | Pain and dysfunction | Low back | PEMF 8.56 kHz frequency Intensity: 820 mT 10 min/session Three sessions/week 2 weeks | ∙ ODI ∙ RMDQ | PEMF and sham group showed significant improvements in ODI and RMDQ scores. However, RMDQ scores of the PEMF group were much lower than those of the sham group. The two groups showed no significant difference in ODI. |
| Piatkowski et al., 2009 | Germany | RCT | Multiple sclerosis n=37 Female, Treatment: 89.5% Placebo: 72% Age: Treatment: 44±8.3 years Placebo: 61±8 years | Fatigue-associated physical dysfunction | Whole body | Bio-electro-magnetic-energy-regulation Low frequency Intensity: 14µT 8 min/session Twice everyday 12 weeks | ∙ Multiple Sclerosis Functional Scale ∙ Expanded Disability Status Scale | There was a significant difference of Multiple Sclerosis Functional Scale value after 12 weeks in favor of the treatment group. |
| Pipitone and Scott, 2001 | UK | RCT | Knee osteoarthritis n=69 Female, PEMF: 35.3% Control: 20.0% Age: PEMF: 62 (40–84) years Control: 64 (48–84) years | Pain and dysfunction | Knee | PEMF 3 and 7.8 Hz frequency Intensity: <0.5 G 10 min/session Three times/day 6 weeks | ∙ WOMAC | PEMF is beneficial for disability in patients with knee OA resistant to conventional treatment. |
| Provencher et al., 2022 | Canada | Case study | Cerebral palsy n=1 Female Age: 30 years | Balance dysfunction, inadequate protective reactions and postural adjustments, inadequate motor control and trunk stabilization | Tibialis anterior, deep trunk muscles, hamstring | rPMS Four sessions One session/week Tibialis anterior and deep trunk muscles: 2 s on, 8 s off, total of 600 pulses over 200 s Hamstring: 42% maximal stimulator output, total of 600 pulses over 40 s | ∙ Active ROM (ankle dorsiflexion) ∙ Gait pattern | Active ankle dorsiflexion was significantly increased. The improvement of ankle function was carried over to the quality of locomotor patterns. |
| Richards et al., 1997 | USA | RCT | Multiple sclerosis n=30 Female, 70.0% Age: NA | Physical dysfunction | Shoulder, back, or hip | PEMF 4–13 Hz frequency Intensity: 50–100mG 10–24 h/day 2 months | ∙ Extended Disability Status Scale | No change on the Extended Disability Status Scale, but a significant improvement on the combined mobility performance scale. |
| Silantyeva et al., 2021 | Russia | Retrospective, comparative study | Parous women n=95 Female, 100.0% Age: HIFEM: 31.1±5.4 years Electrostimulation: 32.0±7.7 years Control: 27.2±4.3 years | Weakened pelvic floor muscles accompanied by urinary incontinence | Pelvic area | HIFEM 2.5 T Two or three times/week Ten sessions | ∙ Pelvic floor integrity (anteroposterior diameter and laterolateral diameter of levator hiatus and hiatal area, and levator–urethra gap) ∙ PFDI-20 | Three-dimensional ultrasound showed positive changes in pelvic floor dynamics after treatment (decreased anteroposterior diameter, laterolateral diameter, and hiatal area). Significant changes in pelvic floor integrity were observed. A greater degree of improvement in the Pelvic Floor Disability Index questionnaire 20 was observed compared to electrostimulation. Significantly fewer patients in the HIFEM group reported urinary leakage after treatment. |
| Sorrell et al., 2018 | USA | RCT | Lumbar surgery n=36 Female, 42-μs: 38.4% 38-μs: 50.0% Sham: 64.2% Age: 42-μs: 56.0±14.3 years 38-μs: 51.2±12.3 years Sham: 50.6±12.2 years | Chronic postoperative pain | Back | PEMF 27.12 MHz frequency Intensity: 591±44 V/m 30 min/session Twice daily 60 days | ∙ ODI | ODI results were consistent with an overall beneficial effect of the PEMF 42-μs pulse width device. |
| Sutbeyaz et al., 2006 | Turkey | RCT | Cervical osteoarthritis n=32 Female, 65.6% Age: PEMF: 43.15±10.31 years Sham: 42.10±10.12 years | Pain and dysfunction | Whole body | PEMF 0.1–64 Hz frequency Intensity: 40 µT 30 min/session Two times/day 3 weeks | ∙ NPDS ∙ Active ROM | The active ROM, paravertebral and neck pain and disability scale scores improved significantly after PEMF therapy, but no change was observed in the sham group. |
| Taradaj et al., 2018 | Poland | RCT | Low back pain n=106 Female, 66.0% Age: Group A (magnetic therapy): 50.45±10.11 years Group B (magnetic therapy): 55.20±11.40 years Group C (placebo magnetic therapy): 52.30±8.22 years Group D (magnetic stimulation): 51.80±11.50 years Group E (placebo magnetic stimulation): 55.75±9.28 years | Low back pain | Lumbosacral region | Magnetic therapy (Group A) 50 Hz frequency 10 mT 20 min 3 weeks Magnetic therapy (Group B) 50 Hz frequency 5 mT 20 min 3 weeks Magnetic stimulation 195 Hz frequency 49.2 μT 20 min 3 weeks | ∙ Hip ROM ∙ ODI ∙ RMDQ | All comparison groups demonstrated statistically significant improvements in ROM and functional ability. Application of magnetic therapy (Group A: 10 mT, 50 Hz, 20 min) leads to an improvement of functional ability in patients with low back pain. |
| Thamsborg et al., 2005 | Denmark | RCT | Knee osteoarthritis n=83 Female, 54.2% Age: PEMF: 60.4±8.7 years Sham: 59.6±8.6 years | Pain and dysfunction | Knee | PEMF 50 Hz frequency Intensity: 50 V 120 min/session 5 days/week 6 weeks | ∙ WOMAC | Within group analysis revealed a significant improvement in ADL, stiffness, and pain in the PEMF-treated group at all evaluations. In the control group, there was no effect on ADL after 2 weeks and a weak significance was seen after 6 and 12 weeks. Significant effects were seen on pain at all evaluations and on stiffness after 6 and 12 weeks. Between group analysis did not reveal significant improvements over time. |
| Trock et al., 1993 | USA | RCT | Osteoarthritis (knee, hand, ankle) n=27 Female, NA Age: NA | Pain and dysfunction | Symptomatic joints (knee, hand, ankle) | PEMF 30 Hz frequency Intensity: 10–20 G 30 min/session 3–5 sessions/week 18 sessions 1 month | ∙ ADL (scale of 1 to 5) | An average improvement of 23%–61% occurred in the clinical variables observed with active treatment. |
| Vadalà et al., 2018 | Italy | Retrospective, observational, single-arm study | Urinary incontinence n=20 Female, 50.0% Age: 64.14±13.61 years | Urinary incontinence | Pelvic floor | FMS 10, 35 Hz frequency Intensity: 15%–30% of maximum 20 min/session Two sessions/week 3 weeks | ∙ Maximum urethral closure pressure | Urodynamic tests recorded a significant increase in maximum urethral closure pressure compared with the baseline values. |
| Venugobal et al., 2023 | Singapore | Retrospective, single-arm study | Older adults (voluntary subjects) n=101 Female, 62% Age: 38–91 years | NA | Quadriceps | PEMF 1 mT 10 min/day One session/week 12 weeks | ∙ TUG ∙ 5TST ∙ 4-m normal gait speed ∙ Body composition (weight, skeletal muscle mass, body fat mass, and visceral fat area) | Weekly PEMF exposure was associated with significant improvements in mobility (TUG, 5TST, 4-m normal gait speed) and body composition (increased skeletal muscle mass and reduced total and visceral fat mass), particularly in the older participants. |
| Werner et al., 2016 | Germany | Crossover design | Stroke or traumatic brain injury n=40 Female, 40.0% Age: rPMS→Sham: 47.9±8.5 years Sham→rPMS: 55.4±8.6 years | Hemiparesis- or tetraparesis-related dysfunction | Forearm | rPMS 5 Hz frequency Intensity: not reported 5 min Single session | ∙ Passive ROM | The mean relative extension deficit of the wrist and MCP joints to neutral showed larger decrease of the relative extension deficit following rPMS as compared to sham. |
| Wuschech et al., 2015 | Germany | RCT | Knee osteoarthritis n=57 Female, 35.1% Age: 61.1±12.0 years | Knee pain | Knee | PEMF 4–12 Hz frequency Intensity: 105 mT 5 min Two times/day 18 days | ∙ WOMAC | Treatment with PEMF showed a highly significant reduction in disability in daily activities according to the WOMAC scales. |
| Xu et al., 2023 | China | RCT | Postpartum pelvic floor dysfunction n=100 Female, 100.0% Age: Intervention: 29.52±3.35 years Control: 29.61±3.43 years | Postpartum pelvic floor dysfunction | Perineum | Magnetic wave 15–50 Hz frequency Intensity: patient’s tolerance and bellows movement of both legs 20 min/session Once every 2 days 8 weeks | ∙ Pelvic floor muscle strength ∙ PFDI-20 | Extracorporeal magnetic wave pelvic floor therapy combined with pelvic floor muscle training can effectively improve the clinical efficacy of postpartum pelvic floor dysfunction patients, and improve pelvic floor muscle strength, which has a high clinical reference value. |
| de Carvalho et al., 2012 | Italy | Crossover RCT | Multiple sclerosis n=50 Female, 70.0% Age: 52.3±10.7 years | Fatigue-associated physical dysfunction | Whole body | PEMF 4–7 Hz frequency Intensity: 37.5µT 24 min/session Three times/week 8 weeks | ∙ 10MWT | Statistical analysis did not show any significant differences for 10MWT. |
| Özdemir et al., 2021 | Turkey | RCT | Supraspinatus tendon tear n=40 Female, 67.5% Age: PEMF: 65.6±6.6 years Sham: 64.6±11.5 years | Supraspinatus tendon tear | Shoulder | PEMF 50 Hz frequency 25 G intensity 25 min/session | ∙ UCLA Shoulder Scale ∙ SPADI | No significant difference was found between PEMF and sham groups according to the UCLA Shoulder Scale and SPADI scores. |
| Üzelpasaci et al., 2023 | Turkey | Case report | Anal canal injury n=1 Male Age: 23 years | Fecal incontinence | Perianal region | Extracorporeal magnetic innervation 10, 50 Hz frequency Intensity: maximum level 20 min/session Three times/week 10 weeks | ∙ Pelvic floor muscle strength and endurance | Pelvic floor muscle exercises and extracorporeal magnetic innervation are effective treatments for increasing the pelvic floor muscle strength and endurance in a patient with colostomy during the preclosure and postclosure periods. |
Diseases or Populations and Functional Impairments Treated with PMS
The most common musculoskeletal disease treated with PMS was knee osteoarthritis-related dysfunction (18 studies), 23 , 38 , 39 , 41 , 42 , 46 , 52 , 54 , 68 , 102 , 103 , 105 , 106 , 107 , 108 , 110 , 113 , 116 ) followed by low back pain-related dysfunction (16 studies), 17 , 47 , 48 , 74 , 77 , 80 , 81 , 82 , 83 , 90 , 94 , 96 , 98 , 99 , 101 , 112 ) shoulder impingement syndrome-related dysfunction (3 studies), 29 , 104 , 109 ) and complex regional pain syndrome (2 studies). 35 , 58 ) Other diseases are detailed in Figs. 3 and 4 and Table 5 . 18 , 30 , 31 , 32 , 33 , 37 , 40 , 51 , 59 , 60 , 88 , 92 ) The most common neurological disease treated with PMS was stroke-related dysfunction, including paralysis and dysphagia (16 studies), 22 , 63 , 64 , 65 , 67 , 72 , 73 , 76 , 78 , 84 , 85 , 87 , 89 , 91 , 93 , 95 ) followed by motor impairment caused by cerebral palsy (4 studies), 70 , 71 , 75 , 79 ) multiple sclerosis-related physical dysfunction (3 studies), 50 , 57 , 69 ) spinal cord injury (1 study), 49 ) and amyotrophic lateral sclerosis (1 study). 19 ) In addition, two studies showed that PMS effectively treated COPD-related muscle dysfunction. 15 , 16 ) Incontinence-related diseases treated with PMS included urinary incontinence (6 studies), 36 , 43 , 61 , 97 , 100 , 111 ) antepartum and postpartum incontinence (3 studies), 20 , 53 , 114 ) and anal canal injury (1 study). 34 ) Other applications of PMS included treatment of limb and suprahyoid muscle groups in healthy individuals, 21 , 55 , 62 , 66 , 115 ) skeletal muscles in the elderly, 44 , 45 ) and conditions associated with low bone mineral density and osteoporosis ( Figs. 3 and 4 and Table 5 ). 56 , 86 )
Treatment Site for PMS
The treatment sites for PMS in musculoskeletal diseases included the knee (17 studies), 23 , 38 , 39 , 41 , 42 , 46 , 52 , 54 , 68 , 102 , 103 , 105 , 106 , 108 , 110 , 113 , 116 ) lower back (16 studies), 17 , 47 , 48 , 74 , 77 , 80 , 81 , 82 , 83 , 90 , 94 , 96 , 98 , 99 , 101 , 112 ) shoulder (4 studies), 29 , 30 , 104 , 109 ) and other sites throughout the body (12 studies). 18 , 31 , 32 , 33 , 37 , 40 , 51 , 59 , 60 , 88 , 92 , 107 ) In neurological diseases, PMS was applied to the upper limb in five studies 19 , 65 , 72 , 87 , 89 ) ; the whole body, 57 , 69 ) suprahyoid muscles, 22 , 67 ) shoulder, 63 , 91 ) gluteal muscles, 70 , 71 ) and pelvic girdle 93 , 95 ) in two studies each; and other parts of the body. 49 , 50 , 64 , 73 , 75 , 76 , 78 , 79 , 84 , 85 ) PMS was applied to the quadriceps muscle (2 studies) for respiratory diseases, 15 , 16 ) and pelvic floor muscle (10 studies) for incontinence-related diseases. 20 , 34 , 36 , 43 , 53 , 61 , 97 , 100 , 111 , 114 ) In addition, PMS was applied to the suprahyoid muscle, whole body, and the arms and calves in several other studies ( Fig. 5 and Table 5 ). 21 , 44 , 45 , 55 , 56 , 62 , 66 , 86 , 115 )
Treatment Outcomes with PMS
For musculoskeletal diseases, the primary outcome measures for PMS were the Oswestry Disability Index (ODI) 17 , 33 , 47 , 48 , 74 , 77 , 81 , 82 , 83 , 90 , 94 , 96 , 99 , 101 ) and the Western Ontario MacMaster University Osteoarthritis Index (WOMAC), 23 , 39 , 41 , 42 , 46 , 52 , 54 , 68 , 102 , 106 , 107 , 108 , 110 , 113 ) each reported in 14 studies. Range of motion (ROM) was assessed in nine studies 29 , 38 , 40 , 90 , 92 , 94 , 103 , 109 , 116 ) and muscle strength in five. 18 , 29 , 103 , 104 , 107 ) For neurological diseases, the upper-extremity Fugl–Meyer Assessment (UE-FMA) was used in eight studies, 63 , 65 , 72 , 84 , 85 , 87 , 89 , 91 ) ROM in seven, 63 , 73 , 75 , 76 , 78 , 79 , 89 ) gait speed 57 , 64 , 70 ) and Barthel Index 72 , 93 , 95 ) in three each, and muscle strength in two studies. 76 , 78 ) For respiratory disease, the 6-min walk test (6MWT) and fat-free mass index were used to evaluate PMS effects across two studies. 15 , 16 ) For incontinence-related disease, pelvic floor muscle strength was commonly measured. 20 , 34 , 36 , 43 , 53 , 61 , 97 , 100 , 111 , 114 ) Detailed outcome measures for the various diseases and conditions are presented in Fig. 6 and Table 5 .
Treatment Characteristics for PMS
Study settings are detailed in Table 5 . Treatment intensities varied based on the devices used. Frequencies ranged from 0.06 Hz to 27.12 MHz, session durations spanned 5 min to 12 h, and session frequencies ranged from weekly to daily, with follow-ups extending to 1 year.
Summary and Synthesis of the Impact of PMS on Commonly Treated Diseases
For knee osteoarthritis, improvements were observed in the WOMAC and ROM. For low back pain, improvements were noted in the ODI and Roland–Morris Disability Questionnaire (RMDQ). For stroke, improvements were observed in UE-FMA, ROM, muscle strength, gait parameters, and ADL. For COPD, improvements were observed in 6MWT, and increased pelvic floor muscle strength was reported for incontinence-related conditions. PMS improved pain-related impairments in musculoskeletal disorders and upper limb function following stroke. Studies on respiratory and incontinence-related disorders were limited and heterogeneous, although some demonstrated improvements in exercise capacity and pelvic floor muscle strength ( Table 6 ).
Table 6.
Summary of the impact of PMS on commonly treated diseases
| Disease | Main treatment site | Summary of PMS settings | Major evaluation outcomes | Summary of results |
| Knee osteoarthritis | Knee | Frequency: 0.06–3000 Hz Stimulation session: 10 min–12 h Duration: 9 days–26 weeks | WOMAC | Improvement (no significant difference between groups, superior improvement in subgroup analysis) |
| ROM | Improvement (no significant difference between groups) | |||
| Low back pain | Low back | Frequency: 3 Hz–27.12 MHz Stimulation session: one session–20 min Duration: 1 day–12 weeks | ODI | Improvement (no significant difference between groups) |
| RMDQ | Improvement (possibly superior to placebo) | |||
| Stroke | Various sites | Frequency: 5–40 Hz Stimulation session: one session–40 min Duration: 1 day–8 weeks | UE-FMA | Improvement (significant improvement compared to controls) |
| ROM | Improvement (significant improvement compared to placebo) | |||
| Muscle strength | Improvement (significant improvement compared to placebo) | |||
| Gait | Improvement (significant improvement in gait speed, gait ability, and balance ability. No significant effects on endurance capacity or step length) | |||
| ADL | Improvement (possibly superior to controls) | |||
| COPD | Quadriceps muscle | Frequency: 8–15 Hz Stimulation session: 15 min Duration: 3–8 weeks | 6MWT | Improvement (no group comparison) |
| Incontinence-related disease | Pelvic floor muscle | Frequency: 5–50 Hz Stimulation session: 20–30 min Duration: 3–8 weeks | Pelvic floor muscle strength | Improvement (no significant difference between groups) |
DISCUSSION
In this scoping review, we aimed to identify, summarize, and map the relevant literature on the current use of PMS for various diseases and related dysfunctions, while also highlighting areas for future research. Notably, no previous studies have explored the application of PMS across domains with a specific focus on functional impairment, making this review both novel and original.
Our findings indicate an increasing use of PMS for various conditions. Many studies using PMS were conducted in Turkey, the United States, Italy, and Japan. Based on disease types and associated functional impairments, we categorized the studies into five areas, including musculoskeletal diseases, neurological diseases, respiratory diseases, incontinence-related diseases, and others. Musculoskeletal diseases accounted for the highest number of studies, especially knee osteoarthritis and low back pain. Interventions targeting pain-related dysfunctions were applied to the affected area, and outcomes were commonly assessed using disease-specific measures (such as WOMAC, ODI, and RMDQ), along with evaluations of ROM and muscle strength. Neurological diseases were the second most frequently studied category, with stroke being the most common. In particular, PMS was often applied to upper-limb paralysis, with UE-FMA, ROM, muscle strength, gait parameters, and ADL serving as key outcome measures.
The mechanisms of action for PMS treatment can be broadly categorized as neuromodulation of central and peripheral pathways, alteration of cortical excitability and plasticity, and direct muscular and neural activation. 117 , 118 , 119 ) In addition, growing preclinical and in vitro evidence suggests that PMS modulates inflammatory cytokines and promotes the release of growth factors, 120 , 121 ) thereby facilitating neural repair, muscle regeneration, and anti-inflammatory effect. Musculoskeletal diseases are most commonly associated with pain and pain-related disabilities. 122 ) The aforementioned neuromodulation of central and peripheral pathways, alterations in cortical excitability and plasticity, direct muscle and nerve activation, and suppression of inflammatory cytokines potentially reduce pain, 117 , 118 , 119 , 120 , 121 ) which in turn is associated with improved physical function. 10 , 11 ) Furthermore, although the detailed mechanism remains unclear, PMS reportedly affects physical function in knee osteoarthritis without improvement in pain, 123 ) thus supporting its effect on physical function. In stroke survivors, PMS may optimize neuromuscular activity at the treatment site, strengthen synaptic connections within the spinal cord, activate the cerebral cortex via afferent input, and regulate corticospinal motor excitability. 85 , 124 ) In the early post-stroke stage, spontaneous recovery comprises synaptogenesis, dendritic and axonal sprouting, and migration of neural stem cells. 125 , 126 ) PMS application during this period may facilitate a coupling effect between cortical reorganization and neural regeneration, potentially improving upper limb function, physical function, and ADLs. PMS has also been applied to strengthen pelvic floor muscles and prevent incontinence-related diseases. This review confirmed that improvements in pelvic floor muscle function are attributable to an underlying mechanism where changing magnetic fields stimulate pelvic floor nerves, causing repetitive contractions. 127 ) PMS offers advantages over electrical stimulation therapy because it is non-invasive and allows treatment while individuals remain fully clothed. 123 ) In COPD, PMS has been applied to the quadricep muscles, with exercise capacity serving as the main outcome measure. Although limited in number, studies suggest that PMS may improve exercise capacity, potentially by improving muscle function. 15 , 16 )
Regarding representative musculoskeletal diseases of knee osteoarthritis and low back pain, although significant differences between the intervention and control groups were not always confirmed, our findings revealed that PMS improves functional aspects ( Table 6 ). Regarding neurological diseases, consistent benefits were identified in post-stroke upper limb paresis, ROM, muscle strength, gait, and ADLs. Regarding incontinence-related disease, significant differences observed between both groups were less consistent, and the number of studies was limited; however, a trend toward improvement with the intervention was noted. Regarding COPD, within-group comparisons showed improvements in exercise tolerance; however, no studies conducted between-group comparisons. Based on current evidence, PMS should be prioritized for treating neurological and musculoskeletal diseases, including knee osteoarthritis and low back pain, because multiple trials have demonstrated benefits in these conditions. Although clinically recommended practices exist for incontinence-related diseases, supporting evidence remains inconsistent. Conversely, evidence for its use in COPD, a common respiratory disease, remains limited. Furthermore, no reports exist on the use of PMS for other internal diseases, such as cardiovascular disease, cancer, or diabetes mellitus. In other words, the impacts of PMS on these conditions remain unclear, and efforts to address the functional impairments associated with these conditions 124 , 125 , 126 , 127 ) must begin with the verification of safety and mechanisms of action. The characteristics of PMS treatment varied across diseases and dysfunctions; PMS was also provided in various settings, even for the same conditions. These variations are likely attributable to differences in the intensity and frequency of PMS in different settings. In the future, identifying effective applications of using PMS for specific diseases and dysfunctions and establishing standard PMS prescriptions are essential.
This review had some limitations. First, despite the acquisition of a substantial amount of information, the risk of bias was not evaluated. Although risk-of-bias assessments are not mandatory for scoping reviews, evaluating the quality of the included studies could reveal new issues and lead to different conclusions. Second, because this was a scoping review without a quantitative synthesis, publication bias was not formally assessed. However, given that grey literature was excluded, the findings may be influenced by the selective publication of positive results. Third, this study focused exclusively on English-language articles, and studies published in other languages were not included; therefore, some relevant studies may have been missed. Fourth, owing to the variability in PMS device settings across studies, we could not examine the effects of stimulation parameters. Fifth, because the intervention duration varied among studies, we could not verify the optimal duration of the effect. These issues need to be addressed in the future.
CONCLUSION
This scoping review clarifies the current applications of PMS across various diseases and related dysfunctions. Based on current evidence, PMS should be prioritized for treating neurological and musculoskeletal diseases, including knee osteoarthritis and low back pain. Although the evidence is inconsistent, there are clinically recommended practices for treating incontinence-related diseases. Conversely, evidence for its use in COPD, a common respiratory disease, remains limited. Furthermore, no studies to date have reported the use of PMS for other internal diseases, such as cardiovascular disease, cancer, or diabetes mellitus. Because the impacts of PMS on these conditions are unclear, efforts to address the associated functional impairments must begin with the verification of its safety and mechanisms of action. In addition, standardized PMS prescriptions have not yet been established. Future studies are warranted to clarify the safety and efficacy mechanisms in areas where PMS has not been implemented and to determine effective PMS settings for each disease.
ACKNOWLEDGMENTS
The authors thank the members of the Faculty of Rehabilitation and Department of Physical Medicine and Rehabilitation, Kansai Medical University, for their support, guidance, and cooperation. This work was supported in part by the Japan Society for the Promotion of Science (grant number 25K00126).
CONFLICTS OF INTEREST: The authors declare no conflict of interest.
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