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PEMF for Foot and Ankle Sport-Related Injuries

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applied sciences
Applications and Future Perspective of Pulsed Electromagnetic Fields in Foot and Ankle Sport-Related Injuries
Antonio Mazzotti 1,2,* , Laura Langone 1,2, Elena Artioli 1,2 , Simone Ottavio Zielli 1,2, Alberto Arceri 1,2,
Stefania Setti 3
, Massimiliano Leigheb 4 , Elena Manuela Samaila 5 and Cesare Faldini 1,2
2 3 4
* Correspondence:
Abstract: Foot and ankle injuries are common in many sports. One of the main athletes issues is the time for sport resumption after trauma. Recently, extensive efforts have been made to speed up the athletes’ return-to-sport and to prevent joint degeneration. Among the conservative treatment options, biophysical stimulation with pulsed electromagnetic fields (PEMFs) is listed. This narrative review aims to outline current applications of PEMFs in main foot and ankle sport-related injuries, in particular in the treatment of bone marrow edema, osteochondral defects, fractures, and nonunions. Despite further high-quality studies on foot and ankle injuries are needed, PEMFs seem to be a valid aid to enhance the endogenous osteogenesis, to resolve the bone marrow edema, to inhibit the joint inflammation, preserving articular cartilage degeneration, and to relieve pain.
Keywords: pulsed electromagnetic fields; pain; bone marrow edema; fractures; nonunion; physical therapy; sport; foot and ankle
1. Introduction
Foot and ankle injuries are common in many sports [1]. These injuries often lead to a significant time to sport resumption and a variable rate of sequelae with persisting symptoms.
Extensive efforts have been made to improve the management of sports injuries, to speed up the athletes’ return-to-sport, and to prevent pathological conditions: nons- teroidal anti-inflammatory drugs, Hyaluronic-acid, Platelet Rich Plasma (PRP), different formulations of stem cells’ injection, and biophysical stimulation [2,3].
Several biophysical stimulation devices have a consolidated role in the treatment of many musculoskeletal disorders, and already shown positive effects on articular cartilage, subchondral bone, and synovium [4]. These devices are classified into electrical energy applied directly to the skin by adhesive electrodes (capacitively coupled electric field, CCEF), by ultrasound probe (low-intensity pulsed ultrasound system, LIPUS), by tran- sient pressure disturbances (extracorporeal shock wave therapy, ESWT), by low-frequency continuous laser (Low-Level Laser Therapy LLLT), or by pulsed electromagnetic energy applied by coils (pulsed electromagnetic fields, PEMFs) [4].
Among these conservative treatment options, biophysical stimulation with PEMFs consists in the application of nonionizing physical energy to a biological system in order to exert an anti-inflammatory effect and anabolic activity, acting mainly at the level of the cell membrane, and to increase and facilitate tissue regeneration [4].
IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology Clinic, University of Bologna, 40136 Bologna, Italy
Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy IGEA SpA—Clinical Biophysics, 41012 Carpi, Italy
Orthopaedics and Traumatology Unit, “Maggiore della Carità” Hospital, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
Department of Orthopedics and Trauma Surgery, University of Verona, Surgical Center “P. Confortini”, P.le A. Stefani, 1, 37126 Verona, Italy
Citation: Mazzotti, A.; Langone, L.; Artioli, E.; Zielli, S.O.; Arceri, A.; Setti, S.; Leigheb, M.; Samaila, E.M.; Faldini, C. Applications and Future Perspective of Pulsed Electromagnetic Fields in Foot and Ankle Sport- Related Injuries. Appl. Sci. 2023, 13, 5807. app13095807
Academic Editor: Daniel X. B. Chen
Received: 5 April 2023 Revised: 3 May 2023 Accepted: 5 May 2023 Published: 8 May 2023
Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// 4.0/).
Appl. Sci. 2023, 13, 5807.

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