Laurie's Blogs.

I was looking up research on using these modalities in combination, however I ended up finding mostly comparison studies…  So, here we go, let’s dive into this topic!

I went into this search a bit biased, but genuinely curious.  There was less research on the topic than I thought I would find, but certainly a variety of subject matter that I wasn’t expecting to find!  

Here’s the run down!

Thabet AAE, Elsodany AM, Battecha KH, Alshehri MA, Refaat B. High-intensity laser therapy versus pulsed electromagnetic field in the treatment of primary dysmenorrhea. J Phys Ther Sci. 2017 Oct;29(10):1742-1748. 

Menstrual pain!  An interesting topic, perhaps not as much of canine rehab relevance, but likely relevant to at least half (if not more) of the audience reading this!

The Comparison:

•  A class 4 (3W) laser (Nd:YAG) delivering a total of 880J in a three phases per session, which is too random to both explaining.  Targeting above the suprapubic region and the L4-S3 paraspinal region which took approximately 15 minutes

•  The PEMF unit had a frequency of 50Hz and 60 Gauss with two ‘electrodes’ (?) – one above the suprapubic region and the other over the L4-S3 region for 30 minutes.

Both groups receive the therapeutic interventions in three sessions over three days.

Both groups found statistically significant improvements with each intervention.

Laser therapy reduced prostaglandin levels in the blood more than the PEMF.  As well, the laser group reported more relief on pain scoring than the PEMF group.  However the differences between the two interventions was not statistically significant.

Elboim-Gabyzon, Michal & Nahhas, Fouad. (2023). Laser therapy versus pulsed electromagnetic field therapy as treatment modalities for early knee osteoarthritis: a randomized controlled trial. BMC Geriatrics. 23. 10.1186/s12877-022-03568-5.

Here they looked at PEMF or low level laser therapy (LLLT) for knee osteoarthritis and their impact on pain and physical function

The Comparison:

Both groups received 6 treatment sessions over a 3-week period.

•  Laser – “Power, 100%; dose, 8 J/cm2; frequency, 2 Hz; duty factor, 75%; and treatment area,  20  cm2 applied over five points over the anterior part of the articular space for 3 min at each point for a total time of 15 min.”

•  PEMF – “Focused over the medial and lateral sides of the knee.  The parameters were as follows: rectangular field shape; frequency, 30 Hz; intensity, 10 mT; and treatment time, 15 min.”

Pain and physical function improved significantly in both groups. 

PEMF was significantly more effective in reducing pain at rest, and during functional activity testing. 

Fouda, Atef & Refai, Hamida & Mohammed, and. (2013). LOW LEVEL LASER THERAPY VERSUS PULSED ELECTROMAGNETIC FIELD FOR INACTIVATION OF MYOFASCIAL TRIGGER POINTS. American Journal of Research Communication.

This study looked at myofascial pain for temporomandibular dysfunction.

The Comparison:

•  Group 1 received laser therapy with a wavelength of 980 nanometers, power 0.2 watts, total energy 12 joules to “the trigger point”.  Laser was applied in three sessions per week for 2 weeks with exposure time 50 seconds for each session

•  Group 2 received PEMF stimulation using a PEMF probe device with a pulse duration of 200 nanoseconds, rise time of 8 nanoseconds, electromagnetic segment at 50 MHz and lower. PEMF was applied in three sessions per week for 2 weeks, with exposure time 15minutes for each session.

All patients of both groups showed improvement in mouth opening and pain.

There was statistically significant difference between patients exposed to PEMF applied to the superficial muscles (masseter) regarding pain and the group exposed to LASER therapy.

Afify Abdulrashid N, Ayoub HE, AbdelKader AM. Laser Therapy Versus Electromagnetic Field on Mucosal Membrane Thickening in Children With Chronic Rhinosinusitis. J Lasers Med Sci. 2019 Summer;10(3):230-234. 

Another unique study here!  They looked at PEMF or Laser for sinusitis in kids!

The Comparison:

•  Laser – A Ga-As (infrared red) class 1 laser device was used, delivering 1.5 J for all sinuses for 8 minutes and divided on the eight sinuses (9.12 Hz, 905 nm). This protocol was conducted 3 sessions/week, for 1 month.

•  PEMF - The device delivered 20 gauss for 10 minutes, at 7 Hz.  This protocol was conducted 3 sessions/week, for 1 month.

The study showed that there were statistically significant improvements in mucosal membrane thickness in both groups, while there was no statistically significant difference between groups.

CONCULSION:

Both can help!  The information on the PEMF and Laser Therapy parameters and dosages was all over the map and a bit difficult to parse out, however, I think we can say that it’s a bit of a tie when it comes to the comparisons that can be made. 

So, why not use both in clinical practice?!