Effectiveness of magnetic therapy versus exercise in elderly patients with chronic mechanical neck pain: A randomized clinical trial
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King Fahd General Hospital, Ministry of Health, Jeddah, SAUDI ARABIA
Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
Online publication date: 2023-12-14
Publication date: 2024-01-01
Electron J Gen Med 2024;21(1):em558
Mechanical neck pain (MNP) affects all age groups, it has a substantial physical, psychological, and economic impact, especially in elderly. This study aimed to evaluate effect of addition of magnetic therapy (MT) to exercise versus exercise therapy alone on neck pain (NP), proprioception, and balance in elderly patients with chronic MNP.

Materials & Methods:
50 elderly patients with chronic MNP were assigned to magnetic group (25 patients who practiced exercise program for 35-40 minutes/session three sessions per week for four weeks in addition exposure to MT for 20 minutes each session three sessions per week for four weeks) and control group (25 patients who practiced only the exercise program). The severity of pain, cervical joint position sense (JPS) and balance performance were measured by using the visual analogue scale (VAS) goniometer and the both single-leg stance time (SLST), and timed up and go (TUG) tests, respectively. ANOVA and Independent t-tests were used to determine significant differences within and between two groups for normal variables, whereas the Mann-Whitney and Kruskal-Wallis tests were used for not normal variables.

The results show significant improvements in VAS, SLST (with open and closed eyes), TUG, and JPS after interventions in both groups, p-value <0.05, while addition of MT to exercise program induced only significant differences in VAS, SLST (with open & closed eyes), TUG, except JPS, p-value = 0.002, 0.047 & 0.037, 0.001, and 0.928 respectively, in favor to the magnetic group.

Multi-dimensional exercise program is effective in relieving NP and improving balance in elderly with MNP, addition of MT to exercise program could induce superior effects only on pain and balance for elderly patients with MNP.

Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: A review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010;9(2):49-59. https://doi.org/10.1016/j.jcm.... PMid:21629550 PMCid:PMC2943658.
Vijiaratnam N, Williams DR, Bertram KL. Neck pain: What if it is not musculoskeletal? Aust J Gen Pract. 2018;47(5):279-82. https://doi.org/10.31128/AFP-1... PMid:29779295.
Binder A. The diagnosis and treatment of nonspecific neck pain and whiplash. Eura Medicophys. 2007;43(1):79-89.
Masaracchio M, Kirker K, States R, Hanney WJ, Liu X, Kolber M. Thoracic spine manipulation for the management of mechanical neck pain: A systematic review and meta-analysis. PLoS One. 2019 13;14(2):e0211877. https://doi.org/10.1371/journa... PMid:30759118 PMCid:PMC6373960.
Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015;90(2):284-99. https://doi.org/10.1016/j.mayo... PMid:25659245.
Safiri S, Kolahi AA, Hoy D, et al. Global, regional, and national burden of neck pain in the general population, 1990-2017: Systematic analysis of the global burden of disease study 2017. BMJ. 2020;26(368):m791. https://doi.org/10.1136/bmj.m7... PMid:32217608 PMCid:PMC7249252.
Khired Z. The prevalence of and factors associated with neck pain among Jazan adult population. Cureus. 2022;14(8):e28008. https://doi.org/10.7759/cureus....
Alhakami AM, Madkhli A, Ghareeb M, et al. The prevalence and associated factors of neck pain among Ministry of Health office workers in Saudi Arabia: A cross sectional study. Healthcare (Basel). 2022;16;10(7):1320. https://doi.org/10.3390/health... PMid:35885845 PMCid:PMC9324368.
Childs JD, Fritz JM, Piva SR, Whitman JM. Proposal of a classification system for patients with neck pain. J Orthop Sports Phys Ther. 2004;34(11):686-96. https://doi.org/10.2519/jospt.... PMid:15609489.
Stanton TR, Leake HB, Chalmers KJ, Moseley GL. Evidence of impaired proprioception in chronic, idiopathic neck pain: Systematic review and meta-analysis. Phys Ther. 2016;96(6):876-87. https://doi.org/10.2522/ptj.20... PMid:26472296 PMCid:PMC4897597.
Poitras V, Khangura S, Ford C. CADTH rapid response reports. Physiotherapy interventions for the management of neck and/or back pain: A review of clinical and cost-effectiveness. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017.
Hartvigsen J, Frederiksen H, Christensen K. Back and neck pain in seniors-prevalence and impact. Eur Spine J. 2006; 15(6):802-6. https://doi.org/10.1007/s00586... PMid:16235099 PMCid:PMC3489453.
Son KM, Cho NH, Lim SH, Kim HA. Prevalence and risk factor of neck pain in elderly Korean community residents. J Korean Med Sci. 2013;28(5):680-6. https://doi.org/10.3346/jkms.2... PMid:23678258 PMCid:PMC3653079.
Hidalgo JL, Sotos JR. Effectiveness of physical exercise in older adults with mild to moderate depression. Ann Fam Med. 2021;19(4):302-9. https://doi.org/10.1370/afm.26... PMid:34264835 PMCid:PMC8282290.
Theodore N. Degenerative cervical spondylosis. N Engl J Med. 2020; 383(2):159-68. https://doi.org/10.1056/NEJMra... PMid:32640134.
Kocur P, Tomczak M, Wiernicka M, Goliwąs M, Lewandowski J, Łochyński D. Relationship between age, BMI, head posture and superficial neck muscle stiffness and elasticity in adult women. Sci Rep. 2019;9:8515. https://doi.org/10.1038/s41598... PMid:31186509 PMCid:PMC6559965.
Collins BC, Laakkonen EK, Lowe DA. Aging of the musculoskeletal system: How the loss of estrogen impacts muscle strength. Bone. 2019;123:137-44. https://doi.org/10.1016/j.bone... PMid:30930293 PMCid:PMC6491229.
Kobayashi T, Miyakoshi N, Konno N, Abe E, Ishikawa Y, Shimada Y. Acute neck pain caused by arthritis of the lateral atlantoaxial joint. Spine J. 2014;1;14(9):1909-13. https://doi.org/10.1016/j.spin... PMid:24262860.
Keown GA, Tuchin PA. Workplace factors associated with neck pain experienced by computer users: A systematic review. J Manipulative Physiol Ther. 2018;41(6):508-29. https://doi.org/10.1016/j.jmpt... PMid:30025880.
Akay T, Murray AJ. Relative contribution of proprioceptive and vestibular sensory systems to locomotion: Opportunities for discovery in the age of molecular science. Int J Mol Sci. 2021;22(3):1467. https://doi.org/10.3390/ijms22... PMid:33540567 PMCid:PMC7867206.
Bove M, Fenoggio C, Tacchino A, Pelosin E, Schieppati M. Interaction between vision and neck proprioception in the control of stance. Neuroscience. 2009;164(4):1601-8. https://doi.org/10.1016/j.neur... PMid:19782723.
Ferlinc A, Fabiani E, Velnar T, Gradisnik L. The importance and role of proprioception in the elderly: A short review. Mater Sociomed. 2019;31(3):219-21. https://doi.org/10.5455/msm.20... PMid:31762707 PMCid:PMC6853739.
Uthaikhup S, Jull G, Sungkarat S, Treleaven J. The influence of neck pain on sensorimotor function in the elderly. Arch Gerontol Geriatr. 2012;55(3):667-72. https://doi.org/10.1016/j.arch... PMid:22349008.
Vuillerme N, Pinsault N, Bouvier B. Cervical joint position sense is impaired in older adults. Aging Clin Exp Res. 2008;20(4):355-8. https://doi.org/10.1007/BF0332... PMid:18852550.
Almegbel FY, Alotaibi IM, Alhusain FA, et al. Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: A cross-sectional study. BMJ Open. 2018;8(1):e019063. https://doi.org/10.1136/bmjope... PMid:29326189 PMCid:PMC5781015.
Mccaskey MA, Schuster-Amft C, Wirth B, Suica Z, De Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review. BMC Musculoskelet Disord. 2014;15:382. https://doi.org/10.1186/1471-2... PMid:25409985 PMCid:PMC4247630.
Vincent W, Andrasik F, Sherman R. Headache treatment with pulsing electromagnetic fields: A literature review. Appl Psychophysiol Biofeedback. 2007;32(3-4):191-207. https://doi.org/10.1007/s10484... PMid:17975726.
Alayat MS, Salem MM, El Fiky AA, Alshehri MA. Efficacy of pulsed electromagnetic field on pain and function in chronic mechanical neck pain: A randomized controlled trial. Int J Physiother Res. 2017;5(2):1930-6. https://doi.org/10.16965/ijpr.....
Saleh AM, Gad MK, Eldein MS, Mohamed M. Pulsed electromagnetic field versus pulsed ultrasound in treatment of mechanical neck pain: RCT. Int J Adv Multidiscip Res. 2021;8:7285-90.
Mahmoud L, Habib K, Nagy M, Badawy M. Effect of electromagnetic field therapy on neck pain and proprioception in cervical radiculopathy patients: A randomized controlled trial. NeuroQuantology. 2022;20:824-31.
Fortina M, Vittoria A, Giannotti S, Biandolino P, Cevenini G, Carta S. Short time effects of a low-frequency, high intensity magnetic field in the treatment of chronic neck and low back pain. AIMS Public Health. 2022;9(2):307-15. https://doi.org/10.3934/public... PMid:35634032 PMCid:PMC9114779.
Sutbeyaz ST, Sezer N, Koseoglu BF. The effect of pulsed electromagnetic fields in the treatment of cervical osteoarthritis: A randomized, double-blind, sham-controlled trial. Rheumatol Int. 2006;26(4):320-4. https://doi.org/10.1007/s00296... PMid:15986086.
Hattapoglu E, Batmaz I, Dilek B, Karakoc M, Em S, Cevik R. Efficiency of pulsed electromagnetic fields on pain, disability, anxiety, depression, and quality of life in patients with cervical disc herniation: A randomized controlled study. Turk J Med Sci. 2019;49(4):1095-101. https://doi.org/10.3906/sag-19... PMid:31385489 PMCid:PMC7018371.
Karakas M, Gok H. Effectiveness of pulsed electromagnetic field therapy on pain, functional status, and quality of life in patients with chronic non-specific neck pain: A prospective, randomized-controlled study. Turk J Phys Med Rehabil. 2020;66(2):140-6. https://doi.org/10.5606/tftrd.... PMid:32760890 PMCid:PMC7401674.
Kocic MN, Stankovic A, Krstovic A, Zivkovic V, Spalevic M, Dimitrijevic L. Low-frequency pulsed electromagnetic field therapy for non-specific neck pain. Ann Rheum Dis. 2013;72(Suppl 3):A352-3. https://doi.org/10.1136/annrhe....
Giombini A, Di Cesare A, Quaranta F, et al. Neck balance system in the treatment of chronic mechanical neck pain: A prospective randomized controlled study. Eur J Phys Rehabil Med. 2013;49(3):283-90.
Letafatkar A, Rabiei P, Alamooti G, Bertozzi L, Farivar N, Afshari M. Effect of therapeutic exercise routine on pain, disability, posture, and health status in dentists with chronic neck pain: A randomized controlled trial. Int Arch Occup Environ Health. 2020;93(3):281-90. https://doi.org/10.1007/s00420... PMid:31654125.
Kanai S, Taniguchi N, Okano H. Effect of magnetotherapeutic device on pain associated with neck and shoulder stiffness. Altern Ther Health Med. 2011;17(6):44-8.
Lee PB, Kim YC, Lim YJ, et al. Efficacy of pulsed electromagnetic therapy for chronic lower back pain: A randomized, double-blind, placebo-controlled study. J Int Med Res. 2006;34(2):160-7. https://doi.org/10.1177/147323... PMid:16749411.
Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165-9. https://doi.org/10.1097/MRR.0b....
Alahmari KA, Reddy RS, Silvian PS, Ahmad I, Kakaraparthi VN, Alam MM. Association of age on cervical joint position error. J Adv Res. 2017;8(3):201-7. https://doi.org/10.1016/j.jare... PMid:28203459 PMCid:PMC5292654.
Burke S, Lynch K, Moghul Z, Young C, Saviola K, Schenk R. The reliability of the cervical relocation test on people with and without a history of neck pain. J Man Manip Ther. 2016;24(4):210-4. https://doi.org/10.1179/204261... PMid:27582620 PMCid:PMC4987149.
Goldberg A, Casby A, Wasielewski M. Minimum detectable change for single-leg-stance-time in older adults. Gait Posture. 2011;33(4):737-9. https://doi.org/10.1016/j.gait... PMid:21444208.
Hurvitz EA, Richardson JK, Werner RA, Ruhl AM, Dixon MR. Unipedal stance testing as an indicator of fall risk among older outpatients. Arch Phys Med Rehabil. 2000;81(5):587-91. https://doi.org/10.1016/S0003-... PMid:10807096.
Mkacher W, Tabka Z, Trabelsi Y. Minimal detectable change for balance measurements in patients with COPD. J Cardiopulm Rehabil Prev. 2017;37(3):223-8. https://doi.org/10.1097/HCR.00... PMid:28449004.
Takacs J, Garland SJ, Carpenter MG, Hunt MA. Validity and reliability of the community balance and mobility scale in individuals with knee osteoarthritis. Phys Ther. 2014;94(6):866-74. https://doi.org/10.2522/ptj.20... PMid:24557649 PMCid:PMC4040425.
Kristensen MT, Bloch ML, Jønsson LR, Jakobsen TL. Interrater reliability of the standardized timed up and go test when used in hospitalized and community-dwelling older individuals. Physiother Res Int. 2019;24(2):e1769. https://doi.org/10.1002/pri.17... PMid:30657232.
Podsiadlo D, Richardson S. The timed “up & go”: A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532... PMid:1991946.
Bohannon RW. Reference values for the timed up and go test: A descriptive meta-analysis. J Geriatr Phys Ther. 2006; 29(2):64-8. https://doi.org/10.1519/001391... PMid:16914068.
Harrison AL, Barry-Greb T, Wojtowicz G. Clinical measurement of head and shoulder posture variables. J Orthop Sports Phys Ther. 1996;23(6):353-61. https://doi.org/10.2519/jospt.... PMid:8727015.
Saadat M, Salehi R, Negahban H, Shaterzadeh MJ, Mehravar M, Hessam M. Traditional physical therapy exercises combined with sensorimotor training: The effects on clinical outcomes for chronic neck pain in a double-blind, randomized controlled trial. J Bodyw Mov Ther. 2019; 23(4):901-7. https://doi.org/10.1016/j.jbmt... PMid:31733780.
Alzayed KA, Alsaadi SM. Efficacy of pulsed low-frequency magnetic field therapy on patients with chronic low back pain: A randomized double-blind placebo-controlled trial. Asian Spine J. 2020;14(1):33-42. https://doi.org/10.31616/asj.2... PMid:31575112 PMCid:PMC7010518.
Aydin E. Efficacy of pulsed electromagnetic field therapy in patients with lumbar spinal stenosis: A randomised controlled study. Turk J Geriatr. 2018;21(4):557-64. https://doi.org/10.31086/tjger....
Abdelaal A, El-Fiky A, Alayat M. Effects of pulsed electromagnetic field therapy versus extra corporeal shock wave therapy on peripheral circulation and functional balance in patients with diabetic peripheral neuropathy: RCT. Int J Physiother. 2016;3(6):711-20. https://doi.org/10.15621/ijphy....
Al-Shenqiti A. Effect of pulsed magnetic field on peak torque of quadriceps/hamstring muscles and knee proprioception in athletic subjects: A randomized controlled study. Int J Physiother. 2017;4(6):371-6. https://doi.org/10.15621/ijphy....
Markov MS. Pulsed electromagnetic field therapy history, state of the art and future. Environment. 2007;27:465-75. https://doi.org/10.1007/s10669....
Mansourian M, Shanei A. Evaluation of pulsed electromagnetic field effects: A systematic review and meta-analysis on highlights of two decades of research in vitro studies. Biomed Res Int. 2021;2021:6647497. https://doi.org/10.1155/2021/6... PMid:34368353 PMCid:PMC8342182.
Lee HM, Kwon UH, Kim H, et al. Pulsed electromagnetic field stimulates cellular proliferation in human intervertebral disc cells. Yonsei Med J. 2010;51(6):954-9. https://doi.org/10.3349/ymj.20... PMid:20879066 PMCid:PMC2995961.
Aaron RK, Boyan BD, Ciombor DM, Schwartz Z, Simon BJ. Stimulation of growth factor synthesis by electric and electromagnetic fields. Clin Orthop Relat Res. 2004;419:30-7. https://doi.org/10.1097/000030... PMid:15021128.
Filimban W, El-Fiky A, Helal O, Abdelaal A. Effect of magnetic therapy on balance deficits in patients with diabetic polyneuropathy: Randomized controlled trial. JOKULL. 2015;65(3):187-96.
Espí-López GV, Aguilar-Rodríguez M, Zarzoso M, et al. Efficacy of a proprioceptive exercise program in patients with nonspecific neck pain: A randomized controlled trial. Eur J Phys Rehabil Med. 2021;57(3):397-405. https://doi.org/10.23736/S1973... PMid:33047944.
Liu JX, Thornell LE, Pedrosa-Domellöf F. Muscle spindles in the deep muscles of the human neck: A morphological and immunocytochemical study. J Histochem Cytochem. 2003;51(2):175-86. https://doi.org/10.1177/002215... PMid:12533526.
Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: The effect of two exercise regimes. J Orthop Res. 2007;25(3):404-12. https://doi.org/10.1002/jor.20... PMid:17143898.
Graham ZA, Lavin KM, O’bryan SM, Thalacker-Mercer AE, Buford TW, Ford KM. Mechanisms of exercise as a preventative measure to muscle wasting. Am J Physiol Cell Physiol. 2021;321(1):C40-57. https://doi.org/10.1152/ajpcel... PMid:33950699 PMCid:PMC8424676.
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