PEMF therapy for Amputees in South Africa

PEMF Therapy for Amputees in South Africa- A Multifaceted Therapy Approach for Patients and Medical Practitioners

PEMF therapy for Amputees in South AfricaIntroducing PEMF therapy for Amputees in South Africa: Rife has brought a new dimension to medical practice with non-invasive therapy techniques that have shown to be valuable adjuncts to conventional therapy. With more and more studies available on the therapeutic benefits of PEMF, we are proud to offer the first South African PEMF device specifically designed for practitioners with amputees in mind.

The Rife PEMF Model MA is designed to help amputees deal with some of the major issues that they are faced with, including:

  • Phantom Limb pain
  • Wound healing
  • Depression

PEMF therapy for Amputees in South Africa and Phantom Limb Pain

Stump or phantom limb pain is often one of the biggest issues facing an amputee. Pain ranges from mild to debilitating, and although analgesics, opioids, and even antidepressants are often used to manage these symptoms, they are not without side-effects, and long term use of some of these therapies can be detrimental to other aspects of health.

PEMF therapy has been shown to be a useful adjunct to medication and in some cases has been found to be primary therapeutic option for the management of phantom limb pain. PEMF is safe for long term use in the management of pain and even offers other benefits in terms of supporting circulation, wound healing, and other aspects of health.

Below is a summary of some of the PEMF and electrical stimulation in the management of phantom limb pain in amputees:

  1. PEMF/TENS is effective at reducing pain on short term basis: In a comparison between Mirror Therapy and TENS therapy, both Mirror Therapy and TENS were found to be effective in pain reduction on a short-term basis and both groups had a significant decrease in pain using the visual analogue scale (VAS) and universal pain score (UPS)[1]
  2. PEMF/TENS effectively reduces phantom limb pain at rest and on movement: A study on ten individuals with a transtibial amputation and persistent moderate-to-severe phantom and/or stump pain demonstrated that TENS has potential for reducing phantom pain and stump pain at rest and on movement.[2]
  3. PEMF/Electrical Stimulation increased >75% paresthesia coverage, reduced pain by >60% and increased quality of life outcomes: This study investigated a novel approach to peripheral nerve stimulation in which a lead was placed percutaneously a remote distance (> 1 cm) away from the femoral nerve in a patient with severe residual limb pain 33 years following a below-knee amputation. Electrical stimulation generated ≥ 75% paresthesia coverage, reduced residual limb pain by > 60%, and improved quality of life outcomes as measured by the pain interference scale of the Brief Pain Inventory-Short Form (100% reduction in pain interference), Pain Disability Index (74% reduction in disability), and the Patient Global Impression of Change (very much improved) during a 2-week home trial[3]
  4. PEMF treated Phantom Limb pain, and reduced re-amputations: A total of 51 patients were randomized to one of three postoperative treatment regimens: sham TENS and chlorpromazine medication, sham TENS only, and active low frequency TENS. There were fewer re-amputations and more rapid stump healing among below-knee amputees who had received active TENS. Sham TENS had a considerable placebo effect on pain. There were, however, no significant differences in the analgesic requirements or reported prevalence of phantom pain between the groups during the first four weeks. The prevalence of phantom pain after active TENS was significantly lower after four months but not after more than one year[4]
  5. PEMF was successful at treating Phantom Limb Pain in three adults with no pain recurrence at six month follow-up. Three adult patients with below-knee amputation of various etiologies were treated at Norristown's Sacred Heart Hospital and Rehabilitation Center in the fall of 1983. The patients ranged in age from 48 to 64 years and two were men. All three had complaints of phantom limb pain originating from various anatomic sites of the amputated extremity. In all three cases the phantom limb pain was severe and hampered prosthetic training. The patients were treated solely by application of the TENS unit to the contralateral extremity at the sites where the phantom pain originated on the amputated limb. All three patients responded to treatment and were able to continue their prosthetic training. A six-month follow-up showed no pain recurrence of phantom limb pain in all three cases[5]

PEMF therapy for Amputees in South Africa - Wound Healing

PEMF therapy for Amputees South Africa

PEMF therapy for Amputees South Africa

Wounds are a common issue amongst amputees with wound infection being a primary concern. In a study conducted on stump infections after major lower limb amputations[6], Staphylococcus was the most frequently isolated bacterium that was responsible for wound infections. The speed of wound healing also influences subsequent prosthetic training.[7]

Certain PEMF frequencies have been shown to be effective at reducing both Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) - bacterial cultures exposed to ELF PEMF showed a decrease in their growth rate – 68% and 76% decrease - when compared to control samples.[8]

PEMF has also been shown to increase wound healing and wound healing rates. A summary of some of the studies conducted on wound healing include:

  • PEMF increases wound healing, increases circulation: A randomized, double-blind, placebo-controlled clinical trial on a homogenous subset of chronic diabetic foot ulcers. By the end of the treatment period, there was an 18% decrease inwound size in the active PEMF group as compared with a 10% decrease in the control group. The PEMF group demonstrated significant cumulative increase in cutaneous capillary blood velocity (by 28%) and 14% increase in capillary diameter. In contrast, the control group showed a decrease in both capillary blood velocity and diameter.[9]
  • PEMF accelerates wound healing, increases percentage of healing and increases tensile strength of wound tissue: Delayedwound healing is a common complication in diabetes mellitus. From this point of view, the main purpose of the present study is to investigate the effect of extremely low frequency pulsed electromagnetic fields on skin wound healing in diabetic rats. In this study, diabetes was induced in male Wistar rats One month after the induction of diabetes, a full-thickness dermal incision (35 mm length) was made on the right side of the paravertebral region. The wound was exposed to ELF PEMF for 1 h per day. Wound healing was evaluated by measuring surface area, percentage of healing, duration of healing, and wound tensile strength. Obtained results showed that the duration of wound healing in diabetic rats in comparison with the control group was significantly increased. In contrast, the rate of healing in diabetic rats receiving PEMF was significantly greater than in the diabetic control group. The wound tensile strength also was significantly greater than the control animals. In addition, the duration of wound healing in the control group receiving PEMF was less than the sham group. Based on the above-mentioned results we concluded that this study provides some evidence to support the use of ELF PEMFs to accelerate diabetic wound healing. Further research is needed to determine the PEMF mechanisms in acceleration of wound healing in diabetic rats.[10]
  • We hypothesized that PEMF would increase the myofibroblast population, contributing to wound closure during diabetic wound healing: Reduced collagen deposition possibly leads to slow recovery of tensile strength in the healing process of diabetic cutaneous wounds. Myofibroblasts are transiently present during wound healing and play a key role in wound closure and collagen synthesis. A full-thickness square-shaped dermal wound (2 cm × 2 cm) was excised aseptically on the shaved dorsum. The rats were randomly divided into PEMF-treated (5 mT, 25 Hz, 1 h daily) and control groups. The results indicated that there were no significant differences between the groups in blood glucose level and body weight. However, PEMFtreatment significantly enhanced wound closure (days 10 and 14 post-wounding) and re-epithelialization (day 10 post-wounding), although these improvements were no longer observed at later stages of the wound healing  Using immunohistochemistry against α-smooth muscle actin (α-SMA), we demonstrated that significantly more myofibroblasts were detected on days 7 and 10 post-wounding in the PEMF group when compared to the control group.[11]
  • PEMFtherapy has been used successfully in the management of postsurgical pain and edema, the treatment of chronic wounds, and in facilitating vasodilatation and angiogenesis. Using scientific support, the authors present the currently accepted mechanism of action of PEMF therapy[12].
  • Elimination of pressure ulcers with electrical stimulation--a case study: Pressure ulcers, also called decubitus ulcers, are a common challenge of humanity and are exceptionally difficult to heal. They are wounds that are initiated by relatively short periods of pressure on the skin that blocks blood circulation causing the skin and underlying tissues to die, leading to an openwound. Pressure release can prevent further tissue degeneration, and some ulcers heal and disappear by themselves. However, many pressure ulcers never heal and continue to grow in diameter and depth. By one year, such unhealing ulcers are referred to as chronic ulcers. Chronic ulcers frequently jeopardize the life of the patient due to infections that become increasingly deep until they invade bones and the circulatory system. We report on a patient with a chronic pressure ulcer at his coccyx prominence. Fourteen months after the ulcer had appeared, a surface pulse electromagnetic force (PEMF) stimulator was applied over T7-T8, 45 cm cephalic to the ulcer, as part of a nerve stimulation study. Although the ulcer had continued to grow both in diameter and depth for 14 months and showed no signs of healing, within 6 days of applying the PEMFstimulator, the ulcer began to heal and was fully eliminated after 3 months. We concluded that the electrical stimulation induced the healing of the pressure ulcer.[13]
  • The effect of pulsed electromagnetic fields on secondary skinwound healing: an experimental study: A variety of pulsed electromagnetic fields (PEMFs) have already been experimentally used, in an effort to promote wound healing. The aim of the present study was to investigate the effects of short duration PEMF on secondary healing of full thickness skin wounds in a rat model. Full thickness skin wounds, 2 by 2 cm, were surgically inflicted in two groups of male Wistar rats, 24 animals each. In the first group (experimental group - EG), the animals were placed and immobilized in a special constructed cage. Then the animals were exposed to a short duration PEMF for 20 min daily. In the second group (control group - CG), the animals were also placed and immobilized in the same cage for the same time, but not exposed to PEMF. On days 3, 6, 9, 12, 18, and 22, following the infliction of skin wounds, the size and healing progress of each wound were recorded and evaluated by means of planimetry and histological examination. According to our findings with the planimetry, there was a statistically significant acceleration of the healing rate for the first 9 days in EG, whereas a qualitative improvement of healing progress was identified by histological examination at all time points, compared to the control group.[14]
  • Electroacupuncture is as effective as Carprofen(NSAID) for pain: The objective of the present study was to compare the effect of electroacupuncture (EA) and carprofen (CP) on postoperative incisional pain using the plantar incision (PI) model in rats.We conclude that 100-Hz EA at the ST36 point, but not at non-acupoints, can reduce mechanical nociception in the rat model of incisional pain, and its effectiveness is comparable to that of carprofen.[15]

PEMF therapy for Amputees in South Africa - Depression

PEMF has been widely accepted as a valuable adjunct to for the treatment of depression and the FDA has approved a number of devices for use in medication resistant depression.[16] Studies suggest between 1 in 3 or 1 in 4 amputees suffer from major depressive disorder.[17] Risk factors linked to the development of depression include phantom limb pain; avoidance of the amputation and prosthesis; and lacking a social support system, particularly in the formative months directly following amputation.

PEMF therapy for Amputees South AfricaThe PEMF MA addresses two aspects of depression in amputees, namely the phantom limb pain directly, as well as potentially addressing depression. There are numerous studies that deal with PEMF as a potential therapy for depression.

Here are a brief summary of some of those studies:

  • In a double-blind controlled study on dose remission of PEMF in therapy resistant depression, T-PEMF therapy resulted in a 73.5% remission of therapy-resistant depression on one dose of treatment per day after 8 weeks of therapy: A self-treatment set-up of the T-PEMFdevice was used allowing self-administration by patients in own homes. All patients were treated for 30 min per T-PEMF  The antidepressant medication the patients were receiving at baseline remained unchanged during the trial. In total 34 patients received active T-PEMF once a day and 31 patients twice daily. After 5 weeks of therapy remission was obtained in 26.5% and 32.3% on one dose and two doses of T-PEMF, respectively. After 8 weeks the rate of remission was 73.5% and 67.7%, respectively. The side effects as measured by the Udvalget for Kliniske Undersøgelser scale showed a better toleration of the antidepresssive medication in both treatment groups, which was reflected by the WHO-5 well-being scale with increased scores in both groups of patients.The high remission rate obtained by the T-PEMF augmentation was not a dose effect (one versus two daily T-PEMF sessions) but was explained by the extension of the treatment period from 5 to 8 weeks.[18]
  • PEMF was successful at treating treatment resistant depression in patients and apathy scale could be used to determine dose: In patients without apathy, the remission rate after T-PEMFwas 83.9% versus 58.8% in patients with apathy (p≤0.05). In patients without apathy receiving one active dose daily 94.4% remitted versus 50% for patients with apathy (p≤0.05). In patients without apathy who received two active doses 69.9% remitted versus 66.7% for patients with apathy[19]
  • Low field magnetic stimulation resulted in rapid mood elevating effects in patients with bipolar disorder: We previously reported rapid mood elevation following an experimental magnetic resonance imaging procedure in depressed patients with bipolardisorder (BPD). This prompted the design, construction, and testing of a portable electromagnetic device that reproduces only the rapidly oscillating (1 kHz, <1 V/m) electromagnetic field of the experimental procedure, called low field magnetic stimulation (LFMS). Substantial improvement (>10% of baseline) in mood was observed following LFMS treatment relative to sham treatment for both diagnostic subgroups for our primary outcomes, the VAS and the HDRS-17. These differences were not statistically significant in primary analyses stratifying by diagnosis but were significant in secondary analyses combining data across the two diagnostic groups (p = .01 VAS, p = .02 HDRS-17). Rapid improvement in mood was also observed using the Positive and Negative Affect Schedule scales as secondary measures (positive affect scale p = .02 BPD, p = .002 combined group). A finite element method calculation indicates a broad penetration of the LFMS electric field throughout the cerebral cortex. Low field magnetic stimulation may produce rapid changes in mood using a previously unexplored range of electromagnetic [20]
  • rTMS has been approved for therapy by the FDA and is being considered for therapy in Japan Therapeutic applications of repetitive transcranial magnetic stimulation (rTMS) have long been awaited for not only neurological but also psychiatric disorders as a low-invasive transcranial brain stimulation. In 2008, the Food and Drug Administration (FDA) of the United States finally approved repetitive transcranial magnetic stimulation (rTMS) for medication-resistant patients with majordepression. More recently, at the beginning of 2013, a deep TMS device with the H-coil received FDA approval as the second TMS device for major depression. In this paper, recent progress in the clinical introduction of rTMS for major depression in Japan is reported, in order to facilitate future discussion about how rTMS should be introduced for patients with major depression in Japan.[21]

Introducing the Rife PEMF Model MA for Amputees

Rife PEMF is a leading manufacturer and supplier of medical Bio-Active Electro Frequency devices in South Africa. By complying with South African and International standards for our medical devices, the company is committed to manufacture and supply top quality, safe and affordable devices for use in medical practice.

Rife PEMF was founded in 1994 by Mr. W.G.E. Schuwlst and has been on the leading edge of frequency therapy since the inception of the company. The first to apply and register the device, Mr. Schwulst saw the necessity of bringing Rife and PEMF technology to the people who could use it to its greatest advantage.

We are committed to working with medical practitioners and therapists to bring this state of the art technology to patients in South Africa. The device was specifically designed to allow practitioners to apply PEMF in their practice.

The device offers up to 10 programs that are programmed based on the physicians requirements. The model MA is rented to the physician directly for use in their practice or for rental to patients. Alternatively we rent to your patients directly and pay over any referral fees for rentals to your practice on a monthly basis.

The Rife Model MA PEMF therapy for Amputees in South Africa provides the following basic programs:

  • Pain
  • Circulation
  • Inflammation
  • Wound healing & regeneration
  • Depression
  • Sleep, healing and rejuvenation

Practitioners can add up to four other conditions to the PL should they wish to do so.

The Model MA comes with a set of magnetic body pads for ease of use. These body pads can be slipped into the prosthetic sock for direct treatment of the area affected by pain and phantom limb pain. It also comes with two magnetic cylinders for treatment of the hands and upper body.

The device is extremely easy to use. Patients are given personalized instructions for use and programs are run by pressing “Select”, “Program No” and then “Run”. Programs can be paused and resumed at a later time if needs be.

PEMF therapy can be used as an adjunct to conventional therapy and medication without interaction or side-effects.

Click here for more information on how to rent or buy your Rife PEMF device.

Finally, MA devices can be sent back to head office for reprogramming should the patient or practitioner decide to change the programs available on the MA device. Reprogramming is done for a fee of R 450.00 per device.

Add PEMF therapy for Amputees in South Africa to Your Practice

Adding PEMF as a therapy option to your practice has never been easier. Contact us for more details about renting or adding the Rife PEMF for amputees today.

For a contract, please email us, or for more information, feel free to contact George Schwulst on 082 882 0640.

[1] http://www.ncbi.nlm.nih.gov/pubmed/25832306

[2] http://www.ncbi.nlm.nih.gov/pubmed/22935086

[3] http://www.ncbi.nlm.nih.gov/pubmed/22548686

[4] http://www.ncbi.nlm.nih.gov/pubmed/3257494

[5] http://www.ncbi.nlm.nih.gov/pubmed/3874615

[6] http://www.ncbi.nlm.nih.gov/pubmed/24210847

[7] http://www.ncbi.nlm.nih.gov/pubmed/3874615

[8] https://researchbank.rmit.edu.au/eserv/rmit:160679/Ahmed.pdf

[9] http://www.ncbi.nlm.nih.gov/pubmed/25882659

[10] http://www.ncbi.nlm.nih.gov/pubmed/20082338

[11] http://www.ncbi.nlm.nih.gov/pubmed/24395219

[12] http://www.ncbi.nlm.nih.gov/pubmed/19371845

[13] http://www.ncbi.nlm.nih.gov/pubmed/18616047

[14] http://www.ncbi.nlm.nih.gov/pubmed/17486634

[15] http://www.ncbi.nlm.nih.gov/pubmed/22911345

[16] http://www.ncbi.nlm.nih.gov/pubmed/26514048

[17] http://courses.washington.edu/rehab427/Winter%202009/Depression_review.pdf

[18] http://www.ncbi.nlm.nih.gov/pubmed/25241755

[19] http://www.ncbi.nlm.nih.gov/pubmed/25273893

[20] http://www.ncbi.nlm.nih.gov/pubmed/24331545

[21] http://www.ncbi.nlm.nih.gov/pubmed/26514048

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