Effects of Magnetic Field Therapy on Edema, Range of Joint Motion, Depression, and Life Quality in Patients with Chronic Venous Insufficiency

Year 2017, Volume: 22 Issue: 3, 183 - 192, 19.04.2017

Özlem Çinar Özdemir Ramazan Kurul Elif Duygu M. Fatih Uysal Yeşim Bakar Ömer Osman Pala Kemalettin Erdem Handan Ankaralı

https://doi.org/10.21673/anadoluklin.303034

Abstract

Objective: The aim of this study is to investigate the effect of
low-frequency alternating magnetic field (LFAM) therapy on edema, quality of
life, depression and range of motion in patients with chronic venous
insufficiency.

Material and Methods: Fifty-five
patients with chronic venous insufficiency who were C3-C6 according to CEAP
(Clinical, Ethiological, Anatomic, Pathophysiological) classification were
included the study. The demographic information of the patients was obtained
and analyzed before the study. Clinical evaluations included the Venous
Insufficiency Epidemiological and Economic Study-Quality of Life Questionnaire
(VEINES-QOL), Beck Depression Inventory (BDI), range of motion and
circumferential measurements. Patients were divided into two groups using
random number generator as treatment (n = 21) and control group (n = 24). All
tests were performed twice at the beginning and at the end of the study.
Following the initial assessment, low-frequency electromagnetic field therapy
was administered to the treatment group for 5 days a week for 6 weeks.
Individuals were asked to use compression socks for 6 weeks at the same time.
The control group used only compression socks for 6 weeks.

Results: When the first and last measurements of both groups were compared,
there was a significant difference in the ankle dorsiflexion and plantar
flexion and depression measurements. (p = 0.000, p = 0.007, p = 0.000). When
the groups were compared in terms of circumferential measurements, depression
and quality of life, a significant difference was found  in depression evaluation and circumferential
measurements of the ankle (CB) and the area above the ankle (CB1) (p <0.05)

Discussion and conclusion: This study showed that low frequency low dose
alternating electromagnetic field therapy increases joint range of motion,
decreases edema and depression in individuals with chronic venous
insufficiency. This is the first study in our country where magnetic field
therapy has been used in other stages of Chronic Venous Insufficiency. We
consider that the repetition of the study with larger-sampled and long-term
follow-up will contribute the literature.

Keywords

: Magnetic Field, Edema, Quality of Life

Kronik Venöz Yetmezliği Olan Bireylerde Manyetik Alan Tedavisinin Ödem, Eklem Hareket Açıklığı, Depresyon ve Yaşam Kalitesine Etkisi

Abstract

Amaç:
Bu
çalışmanın amacı düşük frekanslı kesikli manyetik alan (KEMA) tedavisinin
kronik venöz yetmezliği olan hastalarda ödem, yaşam kalitesi, depresyon ve
eklem hareket açıklığı üzerine etkisini incelemektir.

Gereç ve Yöntemler: Bu çalışmaya kronik venöz yetmezlik tanısı
almış, CEAP (Klinik, Etyolojik, Anatomik,
Patofizyolojik) sınıflamasına göre C3-C6 olan 44 hasta dahil edildi.  Hastaların demografik bilgileri
çalışma öncesinde toplandı ve analiz edildi. Klinik değerlendirmelerde ise Venöz
Yetmezlikte Epidemiyolojik ve Ekonomik Çalışma-Yaşam Kalitesi Anketi (VEINES-QOL), Beck Depresyon Ölçeği
(BDÖ), eklem hareket açıklığı ve çevre ölçümleri kullanıldı. Hastalar
tedavi (n=21)  ve kontrol grubu (n=24)
olarak rastgele sayı oluşturucu kullanılarak iki gruba ayrıldı. Tüm testler
çalışmanın başlangıcında ve bitişinde olmak üzere iki kez uygulandı. İlk değerlendirmenin ardından düşük frekanslı
elektromanyetik alan terapisi haftanın 5 günü 6 hafta boyunca uygulama grubuna
uygulandı. Bireylere aynı zamanda kompresyon çorabı
verilerek 6 hafta kullanmaları istendi. Kontrol grubu ise 6 hafta boyunca
sadece kompresyon çorabı kullandı.

Bulgular:
Her
bir grubun ilk ölçüm, son ölçüm değerleri karşılaştırıldığında, tedavi grubunda
etkilenen ekstremitede ayak bileği dorsi fleksiyon ve plantar felksiyon
hareketlerinde ve depresyon ölçümlerinde anlamlı fark bulundu (p=0.000,
p=0.007, p=0.000). Çevre ölçümleri, depresyon ve yaşam kaliteleri bakımından
gruplar karşılaştırıldığında depresyon değerlendirmesi ve ayak bileği (CB) ve ayak
bileği üstündeki bölgenin (CB1) çevre ölçümlerinde anlamlı fark olduğu saptandı
(p<0.05).

Tartışma
ve sonuç:  Bu çalışma
düşük seviye düşük doz kesikli Elektromanyetik alan tedavisi uygulamasının
Kronik Venöz Yetmezliği olan bireylerde eklem hareket açıklığını arttırdığını,
ödem ve depresyonu azalttığını gösterdi. Bu çalışma ülkemizde manyetik
alan tedavisinin Kronik Venöz Yetmezliğin diğer evrelerinde de kullanıldığı ilk
çalışmadır. Uzun dönem
takip yapılan daha büyük bir örneklemle çalışma tekrarlanmasının literatüre
katkı sağlayacağı düşüncesindeyiz.

Keywords

Manyetik alan, ödem, yaşam kalitesi

References

• 1. Bergan JJ, Schmid-Schönbein GW, Smith PDC, Nicolaides AN, Boisseau MR, Eklof B. Chronic venous disease. New England Journal of Medicine. 2006;355(5):488-98.
• 2. Callam M. Epidemiology of varicose veins. British Journal of Surgery. 1994;81(2):167-73.
• 3. van Uden CJ, van der Vleuten CJ, Kooloos JG, Haenen J, Wollersheim H. Gait and calf muscle endurance in patients with chronic venous insufficiency. Clinical rehabilitation. 2005;19(3):339-44.
• 4. Kunimoto B, Cooling M, Gulliver W, Houghton P, Orsted H, Sibbald RG. Best practices for the prevention and treatment of venous leg ulcers. Ostomy Wound Management. 2001;47(2):34-51.
• 5. McKay JC, Prato FS, Thomas AW. A literature review: the effects of magnetic field exposure on blood flow and blood vessels in the microvasculature. Bioelectromagnetics. 2007;28(2):81-98.
• 6. Bohn W, Hess L, Burger R. The effects of the “physical BEMER® vascular therapy”, a method for the physical stimulation of the vasomotion of precapillary microvessels in case of impaired microcirculation, on sleep, pain and quality of life of patients with different clinical pictures on the basis of three scientifically validated scales. Journal of Complementary and Integrative Medicine. 2013;10(Suppl):S5-S12.
• 7. Weiss RA, Munavalli G, editors. Endovenous ablation of truncal veins. Seminars in cutaneous medicine and surgery; 2005: Elsevier.
• 8. Mariani F. Compression. Consensus document based on scientific evidence and clinical experiences. Minerva Medica, Torino. 2009.
• 9. Topal O. Ağız diş ve çene cerrahisinde darbeli elektromanyetik alan uygulamasının kemik iyileşmesi üzerine etkileri. SDÜ Sağlık Bilimleri Dergisi. 2016;7(3):51-4.
• 10. YALÇIN A, SAYGIN M. ELEKTROMANYETİK ALANLARIN ÜREME SİSTEMİ ÜZERİNE ETKİLERİ. Mühendislik Bilimleri ve Tasarım Dergisi. 2016;4(2):105-24.
• 11. GÜMÜŞAY M, KAYA A. Düşük Enerjili Darbeli Elektromagnetik Alanların Yara İyileştirmesine Etkileri Effects of Low Energy Pulsed Electromagnetic Fields on Wound Healing.
• 12. Houghton P. Effects of therapeutic modalities on wound healing: a conservative approach to the management of chronic wounds. Physical therapy reviews. 1999;4(3):167-82.
• 13. Mayrovitz HN, Larsen PB. Effects of pulsed electromagnetic fields on skin microvascular blood perfusion. Wounds. 1992;4(5):197-202.
• 14. McMeeken JM. Magnetic fields: effects on blood flow in human subjects. Physiotherapy theory and practice. 1992;8(1):3-9.
• 15. Santoro D, Ostrander L, Lee B, Cagir B, editors. Inductive 27.12 MHz diathermy in arterial peripheral vascular disease. Engineering in Medicine and Biology Society, 1994 Engineering Advances: New Opportunities for Biomedical Engineers Proceedings of the 16th Annual International Conference of the IEEE; 1994: IEEE.
• 16. Keith SL, McLaughlin DJ, Anderson FA, Cardullo PA, Jones CE, Rohrer MJ, et al. Do graduated compression stockings and pneumatic boots have an additive effect on the peak velocity of venous blood flow? Archives of Surgery. 1992;127(6):727-30.
• 17. Klyscz T, Jünger M, Schanz S, Janz M, Rassner G, Kohnen R. Quality of life in chronic venous insufficiency (CVI). Results of a study with the newly developed Tübingen Questionnaire for measuring quality of life of patients with chronic venous insufficiency. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete. 1998;49(5):372-81.
• 18. Kurz X, Lamping DL, Kahn SR, Baccaglini U, Zuccarelli F, Spreafico G, et al. Do varicose veins affect quality of life? Results of an international population-based study. Journal of vascular surgery. 2001;34(4):641-8.
• 19. Kaplan RM, Criqui MH, Denenberg JO, Bergan J, Fronek A. Quality of life in patients with chronic venous disease: San Diego population study. Journal of vascular surgery. 2003;37(5):1047-53.
• 20. Smith JJ, Guest MG, Greenhalgh RM, Davies AH. Measuring the quality of life in patients with venous ulcers. Journal of Vascular Surgery. 2000;31(4):642-9.
• 21. Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? Bmj. 1993;306(6890):1440-4.
• 22. Özdemir ÖC, Tonga E, Tekindal A, Bakar Y. Cross-cultural adaptation, reliability and validity of the Turkish version of the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20). SpringerPlus. 2016;5(1):381.
• 23. Kapci EG, Uslu R, Turkcapar H, Karaoglan A. Beck Depression Inventory II: evaluation of the psychometric properties and cut‐off points in a Turkish adult population. Depression and anxiety. 2008;25(10):E104-E10.
• 24. Otman SA. Tedavi Hareketlerinde Temal Değerlendirme Prensipleri. 4th ed. Ankara: Yücel Ofset; 2008.
• 25. Bérard A, Kurz X, Zuccarelli F, Abenhaim L. Validity of the Leg-O-Meter, an instrument to measure leg circumference. Angiology. 2002;53(1):21-8.
• 26. Wollina U, Abdel-Naser MB, Mani R. A review of the microcirculation in skin in patients with chronic venous insufficiency: the problem and the evidence available for therapeutic options. The international journal of lower extremity wounds. 2006;5(3):169-80.
• 27. Shupak NM, McKay JC, Nielson WR, Rollman GB, Prato FS, Thomas AW. Exposure to a specific pulsed low-frequency magnetic field: a double-blind placebo-controlled study of effects on pain ratings in rheumatoid arthritis and fibromyalgia patients. Pain Research and Management. 2006;11(2):85-90.
• 28. Thomas AW, Graham K, Prato FS, McKay J, Forster PM, Moulin DE, et al. A randomized, double-blind, placebo-controlled clinical trial using a low-frequency magnetic field in the treatment of musculoskeletal chronic pain. Pain Research and Management. 2007;12(4):249-58.
• 29. Haddad JB, Obolensky AG, Shinnick P. The biologic effects and the therapeutic mechanism of action of electric and electromagnetic field stimulation on bone and cartilage: new findings and a review of earlier work. The Journal of Alternative and Complementary Medicine. 2007;13(5):485-90.
• 30. Ryaby JT. Clinical effects of electromagnetic and electric fields on fracture healing. Clinical orthopaedics and related research. 1998;355:S205-S15.
• 31. Aziz Z, Cullum N, Flemming K. Electromagnetic therapy for treating venous leg ulcers. The Cochrane Library. 2013.
• 32. Athanasiou A, Karkambounas S, Batistatou A, Lykoudis E, Katsaraki A, Kartsiouni T, et al. The effect of pulsed electromagnetic fields on secondary skin wound healing: an experimental study. Bioelectromagnetics. 2007;28(5):362-8.
• 33. Bohn W. The technological development history and current significance of the “physical BEMER® vascular therapy” in medicine. Journal of Complementary and Integrative Medicine. 2013;10(Suppl):S1-S3.
• 34. Selvam R, Ganesan K, Raju KN, Gangadharan AC, Manohar BM, Puvanakrishnan R. Low frequency and low intensity pulsed electromagnetic field exerts its antiinflammatory effect through restoration of plasma membrane calcium ATPase activity. Life sciences. 2007;80(26):2403-10.
• 35. Miller BF, Gruben KG, Morgan BJ. Circulatory responses to voluntary and electrically induced muscle contractions in humans. Physical therapy. 2000;80(1):53.
• 36. Back TL, Padberg FT, Araki CT, Thompson PN, Hobson RW. Limited range of motion is a significant factor in venous ulceration. Journal of vascular surgery. 1995;22(5):519-23.
• 37. Yang D, Vandongen Y, Stacey M. Effect of exercise on calf muscle pump function in patients with chronic venous disease. British Journal of Surgery. 1999;86(3):338-41.
• 38. Desjardins C, Duling BR. Heparinase treatment suggests a role for the endothelial cell glycocalyx in regulation of capillary hematocrit. American Journal of Physiology-Heart and Circulatory Physiology. 1990;258(3):H647-H54.
• 39. Guex J, Perrin M. Edema and leg volume: methods of assessment. Angiology. 2000;51(1):9-12.
• 40. Vanhoutte P, Corcaud S, De Montrion C, Vanhoutte PM. Venous disease: from pathophysiology to quality of life. Angiology. 1997;48(7):559-67.
• 41. Abenhaim L, Kurz X. The VEINES study (VEnous Insufficiency Epidemiologic and Economic Study): an international cohort study on chronic venous disorders of the leg. Angiology. 1997;48(1):59-66.
• 42. Andreozzi G, Cordova R, Scomparin M, Martini R. Effects of elastic stocking on quality of life of patients with chronic venous insufficiency: an Italian pilot study on Triveneto Region. International angiology. 2005;24(4):325.
• 43. Salomé GM, Blanes L, Ferreira LM. Evaluation of depressive symptoms in patients with venous ulcers. Revista Brasileira de Cirurgia Plástica. 2012;27(1):124-9.
• 44. Palfreyman S, Michaels J. A systematic review of compression hosiery for uncomplicated varicose veins. Phlebology. 2009;24(1_suppl):13-33.