Electromagnetic Induction for Treatment of Unspecific Back Pain: A Prospective Randomized Sham-Controlled Clinical Trial.

OBJECTIVE: To evaluate the effects of high-energy pulsed electromagnetic fields on unspecific back pain. METHODS: A prospective, randomized, sham-controlled clinical trial with repeated measurements was performed. The study included 5 visits (V0 to V4) with 3 interventions during V1, V2 and V3. Sixty-one patients aged between 18 and 80 years with unspecific back pain (acute inflammatory diseases and specific causes were reasons for exclusion) were included. The treatment group (n = 31) received 1-2 pulses/s, with an intensity of 50 mT, and an electric field strength of at least 20 V/m on 3 consecutive weekdays for 10 min each time. The control group (n = 30) received a comparable sham therapy. Pain intensity (visual analogue scale), local oxyhaemoglobin saturation, heart rate, blood pressure, and perfusion index were evaluated before (b) and after (a) V1 and V3 interventions. Change in visual analogue scale for V1 (ChangeV1a-b) and V3 (ChangeV3a-b), and ChangeData between V3a and V1b (ChangeV3a-V1b) for the remaining data were calculated (results were mean (standard deviation) (95% confidence interval; 95% CI)). RESULTS: Concerning the visual analogue scale: (i) compared with the control group, the treatment group had higher ChangeV1a-b (-1.25 (1.76) (95% CI -1.91 to -0.59) vs -2.69 (1.74) (95% CI -3.33 to -2.06), respectively), and comparable Change V3a-b (-0.86 (1.34) (95% CI -1.36 to -0.36) vs -1.37 (1.03) (95% CI -1.75 to 0.99), respectively); and (ii) there was a significant marked decrease in Change V3a-1b in the treatment group compared with the control group (-5.15 (1.56) (95% CI -5.72 to -4.57) vs -2.58 (1.68) (95% CI -3.21 to -1.96), p = 0.001, respectively). There was no significant ChangeV3a-V1b in local oxyhaemoglobin saturation, heart rate, blood pressure or perfusion index between the 2 groups and for the same group (before vs after). CONCLUSION: Non-thermal, non-invasive electromagnetic induction therapy had a significant and rapid influence on unspecific back pain in the treatment group.

Sex-specific response to whole-body vibration training: a randomized controlled trial.

A few studies have indicated that males and females respond differently to whole-body vibration (WBV) training. However, the existing insights are still insufficient and they cannot be transferred to sex-specific practice planning. To evaluate the effect of 5-week WBV training on neuromuscular [countermovement jump (CMJ), squat jump (SJ)] and cardiovascular [heart rate and blood pressure] data, taking into account sex-specific effects. This is a comparative experimental study including 96 healthy adults, divided into two groups: a WBV group (25 females and 24 males) and a control group (27 females and 20 males). The participants attended nine to ten training sessions (twice a week for 5 weeks), each lasting approximately 30 min. Both groups performed the same exercise routine on the vibration training device. For the WBV group, the training device was vibrating during the whole training session, including the breaks. For the control group, it was turned off. Maximum jump height (H, cm) and maximum relative power (MRP, kW/kg) were noted during CMJ and SJ performed on a force plate. Resting (sitting) heart rate (bpm) and blood pressure (mmHg) were measured twice, before and after the intervention. For each parameter, Δdata (= before - after) was calculated. Interactive effects of sex (2) vs group (2) vs session (2) were noted only in males and they only concerned ΔSJMPR and ΔCMJH: compared to the control group, the WBV group had better ΔSJMPR (1.39 ± 3.05 vs -2.69 ± 4.49 kW/kg, respectively) and ΔCMJH (0.50 ± 6.14 vs -4.42 ± 5.80 cm, respectively). No sex-specific effect of WBV on neuromuscular (CMJ and SJ) or cardiovascular (heart rate and blood pressure) data was found.

Detrimental effect of oral contraceptives on parameters of bone mass and geometry in a cohort of 248 young women.

The aim of this cross-sectional analysis was to examine the skeletal effects of low-dose monophasic oral contraceptive (OC) use in a cohort of 248 young Caucasian women aged 18-24 years. Areal bone mineral density (BMD) of the femoral neck and lumbar spine was evaluated by dual-energy X-ray absorptiometry. Volumetric BMD, bone mineral content (BMC), and bone geometry were assessed in the tibia by peripheral quantitative computed tomography (pQCT). The women were allocated into ever or never OC users, and also into 5 different OC groups according to duration and time of initiation of OC use. Women with >2 years of OC use and OC initiation within 3 years after menarche were characterized by 10% lower femoral neck areal BMD (P<0.001), 5% lower spine areal BMD (not significant, P=0.101), 7% lower distal tibial total BMC (P<0.05), and 6% lower total BMC at the tibial shaft (P<0.05) relative to never users. In addition, women who had ever used OCs had lower bone mass at the femoral neck and tibial shaft, despite similar age, height, weight, BMI, hours of exercise, and calcium intake compared with never users. At the tibial shaft, OC users showed reduced total cross-sectional area, and increased cortical BMD. In conclusion, our data suggest that OC use is associated with a detrimental effect on bone mass in young women, and provide further insight into the pathophysiological mechanisms involved.

Comparison of the skeletal effects of the progestogens desogestrel and levonorgestrel in oral contraceptive preparations in young women: controlled, open, partly randomized investigation over 13 cycles.

AIM: This 12-month study was conducted to evaluate the skeletal effects of two monophasic oral contraceptives containing 20 mug of ethinylestradiol and 100 mug of levonorgestrel (LEVO) or 150 mug of desogestrel (DESO). METHODS: Fifty-two women (18-24 years) were randomized into the DESO group or the LEVO group; 36 women served as controls. The areal bone mineral density (aBMD) of the femoral neck and the lumbar spine was evaluated by DXA, and parameters of bone geometry and volumetric bone mineral density (vBMD) were assessed by peripheral quantitative computed tomography at the distal radius and the tibia. RESULTS: The LEVO group did not lose vertebral aBMD, whereas women in the DESO group lost 1.5%. At the distal radius and the tibia (shank level, 14%), LEVO induced an increase in total cross-sectional area, indicating increased periosteal bone formation. Radial trabecular vBMD declined by 1.4+/-1.8% in the DESO group, while it remained unchanged in the LEVO group. CONCLUSION: Our study suggests that the skeletal effects of OC preparations may be influenced by progestogenic components in young women.

Age at first oral contraceptive use as a major determinant of vertebral bone mass in female endurance athletes.

It was the aim of this retrospective analysis to examine the influence of low-dose monophasic oral contraceptives (OCs) on bone mineral density (BMD) of the femoral neck and of the spine in young female endurance athletes. Data on training intensity, dietary intake, menarche, menstrual cycle disorders, years of OC use, and age at first OC use were determined by a self-report questionnaire. Only athletes performing regular endurance exercise for more than 3 years with more than 3 h of exercise per week were included in this study and underwent a clinical assessment including measurement of weight, height, spine, and hip BMD by dual-energy X-ray absorptiometry, and collection of a blood sample. The data from 75 regularly exercising endurance athletes aged 18-35 years (26.5 +/- 4.8 years) were initially included in this analysis. Six athletes were later excluded due to oligo-/amenorrhea. Subjects were allocated into the OC group when they reported OC use for more than 3 years in women younger than 22 years of age, or when they reported OC use for more than 50% of the time after menarche in women aged 22-35 years. There were no differences in age, weight, height, body mass index (BMI), body fat, menarche, training intensity, age at start of training, or any serum parameters between OC users (n = 31) and control subjects (n = 38). However, OC users had 7.9% lower spine BMD and 8.8% lower proximal femur BMD (P < 0.01 for both sites). When the relationship between BMD of the spine and OC use was further analyzed by a stepwise model of multiple regression analysis using OC years, age at OC initiation, BMI, and menarche as independent variables, age at first OC use was found to be the best predictor of vertebral BMD, while the only significant predictor of femoral neck BMD was BMI. We conclude that OC use is associated with decreased BMD of the spine and the femoral neck in female endurance athletes, and that early age at initiation of OC use may be an important risk factor for low peak bone mass in young women.