Frequency-tuned electromagnetic field therapy improves post-stroke motor function: A pilot randomized controlled trial.

Abstract

BACKGROUND AND PURPOSE: Impaired upper extremity (UE) motor function is a common disability after ischemic stroke. Exposure to extremely low frequency and low intensity electromagnetic fields (ELF-EMF) in a frequency-specific manner (Electromagnetic Network Targeting Field therapy; ENTF therapy) is a non-invasive method available to a wide range of patients that may enhance neuroplasticity, potentially facilitating motor recovery. This study seeks to quantify the benefit of the ENTF therapy on UE motor function in a subacute ischemic stroke population. METHODS: In a randomized, sham-controlled, double-blind trial, ischemic stroke patients in the subacute phase with moderately to severely impaired UE function were randomly allocated to active or sham treatment with a novel, non-invasive, brain computer interface-based, extremely low frequency and low intensity ENTF therapy (1-100 Hz, < 1 G). Participants received 40 min of active ENTF or sham treatment 5 days/week for 8 weeks; ~three out of the five treatments were accompanied by 10 min of concurrent physical/occupational therapy. Primary efficacy outcome was improvement on the Fugl-Meyer Assessment - Upper Extremity (FMA-UE) from baseline to end of treatment (8 weeks). RESULTS: In the per protocol set (13 ENTF and 8 sham participants), mean age was 54.7 years (±15.0), 19% were female, baseline FMA-UE score was 23.7 (±11.0), and median time from stroke onset to first stimulation was 11 days (interquartile range (IQR) 8-15). Greater improvement on the FMA-UE from baseline to week 4 was seen with ENTF compared to sham stimulation, 23.2 ± 14.1 vs. 9.6 ± 9.0, = 0.007; baseline to week 8 improvement was 31.5 ± 10.7 vs. 23.1 ± 14.1. Similar favorable effects at week 8 were observed for other UE and global disability assessments, including the Action Research Arm Test (Pinch, 13.4 ± 5.6 vs. 5.3 ± 6.5, = 0.008), Box and Blocks Test (affected hand, 22.5 ± 12.4 vs. 8.5 ± 8.6, < 0.0001), and modified Rankin Scale (-2.5 ± 0.7 vs. -1.3 ± 0.7, = 0.0005). No treatment-related adverse events were reported. CONCLUSIONS: ENTF stimulation in subacute ischemic stroke patients was associated with improved UE motor function and reduced overall disability, and results support its safe use in the indicated population. These results should be confirmed in larger multicenter studies. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov, identifier: NCT04039178.

AI evidence extraction

Main findings

In the per-protocol set (13 active ENTF; 8 sham), ENTF showed greater improvement in FMA-UE from baseline to week 4 versus sham (23.2±14.1 vs 9.6±9.0; p=0.007). At week 8, ENTF showed favorable effects on multiple measures (e.g., ARAT Pinch, Box and Blocks, modified Rankin Scale), and no treatment-related adverse events were reported.

Outcomes measured

• Fugl-Meyer Assessment - Upper Extremity (FMA-UE)
• Action Research Arm Test (Pinch)
• Box and Blocks Test
• modified Rankin Scale
• Adverse events

Limitations

• Pilot trial with small per-protocol sample (13 active, 8 sham)
• Results noted as needing confirmation in larger multicenter studies

{
    "study_type": "randomized_trial",
    "exposure": {
        "band": "ELF",
        "source": "therapeutic device (ENTF therapy; brain-computer interface-based)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": "40 min/session, 5 days/week for 8 weeks (1–100 Hz; <1 G)"
    },
    "population": "Subacute ischemic stroke patients with moderately to severely impaired upper extremity motor function",
    "sample_size": 21,
    "outcomes": [
        "Fugl-Meyer Assessment - Upper Extremity (FMA-UE)",
        "Action Research Arm Test (Pinch)",
        "Box and Blocks Test",
        "modified Rankin Scale",
        "Adverse events"
    ],
    "main_findings": "In the per-protocol set (13 active ENTF; 8 sham), ENTF showed greater improvement in FMA-UE from baseline to week 4 versus sham (23.2±14.1 vs 9.6±9.0; p=0.007). At week 8, ENTF showed favorable effects on multiple measures (e.g., ARAT Pinch, Box and Blocks, modified Rankin Scale), and no treatment-related adverse events were reported.",
    "effect_direction": "benefit",
    "limitations": [
        "Pilot trial with small per-protocol sample (13 active, 8 sham)",
        "Results noted as needing confirmation in larger multicenter studies"
    ],
    "evidence_strength": "low",
    "confidence": 0.7800000000000000266453525910037569701671600341796875,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "extremely low frequency",
        "ELF-EMF",
        "electromagnetic field therapy",
        "ENTF therapy",
        "sham-controlled",
        "double-blind",
        "randomized controlled trial",
        "ischemic stroke",
        "upper extremity motor function",
        "neuroplasticity"
    ],
    "suggested_hubs": []
}

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