***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To evaluate the clinical effectiveness of low-frequency pulsed electromagnetic field ( PEMF ) therapy for women with fibromyalgia ( FM ) . Methods Fifty-six women with FM , aged 18 to 60 years , were r and omly assigned to either PEMF or sham therapy . Both the PEMF group ( n=28 ) and the sham group ( n=28 ) participated in therapy , 30 minutes per session , twice a day for 3 weeks . Treatment outcomes were assessed by the fibromyalgia Impact question naire ( FIQ ) , visual analog scale ( VAS ) , patient global assessment of response to therapy , Beck Depression Inventory ( BDI ) , and Short-Form 36 health survey ( SF-36 ) , after treatment ( at 4 wk ) and follow-up ( at 12 wk ) . Results The PEMF group showed significant improvements in FIQ , VAS pain , BDI score , and SF-36 scale in all domains at the end of therapy . These improvements in FIQ , VAS pain , and SF-36 pain score during follow-up . The sham group also showed improvement were maintained on all outcome measures except total FIQ scores after treatment . At 12 weeks follow-up , only improvements in the BDI and SF-36 scores were present in the sham group . Conclusion Low-frequency PEMF therapy might improve function , pain , fatigue , and global status in FM patients Persistent pain following back surgery remains a major treatment challenge . The primary objective of this open-label exploratory study was to investigate the analgesic effectiveness of pulsed electromagnetic field therapy administered twice daily over a 45-day period in 34 subjects ( 68 % female ) with persistent or recurrent pain following back surgery . A secondary goal was to guide the design of future r and omized controlled trials that could target responsive sub population s. All predefined primary and secondary outcomes , including change in pain intensity ( PI ) , physical function ( Oswestry Disability Index ) , analgesic consumption , and overall well-being ( Patient Global Impression of Change ) , are reported . A responder analysis ( ≥30 % reduction in PI versus baseline ) was added as a post hoc evaluation . Safety outcomes , as well as results of a cost-avoidance survey , are also summarized . Of the 30 per- protocol subjects who completed the study , 33 % reported a clinical ly meaningful ( ≥30 % ) reduction in PI . A higher response rate ( 60 % ) was reported for subjects who had undergone discectomy prior to the trial compared to subjects who had undergone other types of surgical interventions ( decompression or fusion ) without discectomy . Improvements in PI were paralleled by improvements in secondary outcomes . Relative to baseline , responders reported an average 44 % and 55 % reduction in back PI and leg PI ( respectively ) , and an average 13 % improvement in Oswestry Disability Index scores . In the per- protocol population , 50 % of responders and 12 % of nonresponders reported less analgesia consumption at the end of treatment versus baseline . Sixty-seven percent of per- protocol responders and 0 % of nonresponders reported clinical ly meaningful improvement in overall well-being on the Patient Global Impression of Change scale INTRODUCTION control of molecular traffic . Therefore it is possible to assume two therapeutic attitudes : It is a diffused opinion that biological dynamics is 1 . to directly intervene on the chemical level of the entirely dominated by chemical mechanisms and by organism furnishing chemical substances , fit to remove molecular events that follow in an orderly way in time the anomaly manifested in the molecular structure . and in the space . The living organism can be compared 2 . to intervene at the electromagnetic level removing to a true and proper generator of electromagnetic waves , the disturbance that upsets the molecular traffic . whose spectrum of frequencies , goes from a few Hz The interpretation from the living system of the useful up to ultraviolet , and is crossed by a vast number of information to the maintenance of its own homeostasis signals encoded issued , in hierarchical order , beginning is realized through the phenomenon of resonance that from the nervous system and , more especially , from the is at the base of the action on living organisms . Effects cerebral cortex , until it extends to every other component of resonance manifest themselves in the organism in of the body . These electromagnetic fields are aim ed at the whole electromagnetic spectrum every time that progressively informing the various subsystems having coherence is produced between the incidental impulses various functions that are able , therefore , to operate in a and the informative situation of the same organism . To coordinated way . It has been put in evidence that codes of this form of communication the organism will respond in recognition among the bio molecules ( of which the first a more intense way on the basis of the manifold present has been the code of recognition between the basis of conditions . Pathology comes out when the phenomenon DNA and amino acids ) that show as in the living matter of resonance does n't succeed in taking place . that the molecules do n't interact at r and om , but according A particular form of resonance is realized to the level to a well defined pattern . of the cellular membranes through which the traffic of One wonders what might be the physical mechanism ions is regulated between the inside and external part in the long distance between the molecules , through of the cell . Relatively to the phenomenon of resonance which departing from distances of the order of about tens it must be observed that beginning from the years ' 80 it of Angstrom the molecules reach precisely , without ever has been clarified that very weak magnetic fields applied mistaking the address , in the correct place at the correct to living organisms are able to produce variations of moment , for the close encounter of the chemical sort . concentration of the ions in the cells of these organisms Within thecircle ofknown concepts ofphysics , the only every time that the frequency of the applied fields c and i date for this role appears to be the electromagnetic coincides with said frequencies of " ciclotrone"(ICR ) field that is able to interact with the molecules , and also ( Liboft ) . Such phenomenon are tied up to the pairing in to operate at great distances . The existence of codes of resonance of the electromagnetic field with the ionic type recognition among molecules implicates therefore the and in other measure also to enzymatic modification , from existence of an electromagnetic level of the living matter studies done in vitro , for interaction with the frequency of that dialogues with the chemical level assuring that the cyclotron ofthe metallic ions present in active redox metal traffic of the molecules is orderly . proteins . In synthesis a system in dysfunction can find an The pathology that appears at first as an anomaly of initial primer modified in the phenomena of activation for the molecular structure of the body postpones in a second the release of ions from the dominion of coherence of the instance to a disturbance in the electromagnetic net of the water through the appearance of electric discharge ( ion ) & NA ;  Pain intensity is frequently measured on an 11‐point pain intensity numerical rating scale ( PI‐NRS ) , where 0=no pain and 10=worst possible pain . However , it is difficult to interpret the clinical importance of changes from baseline on this scale ( such as a 1‐ or 2‐point change ) . To date , there are no data driven estimates for clinical ly important differences in pain intensity scales used for chronic pain studies . We have estimated a clinical ly important difference on this scale by relating it to global assessment s of change in multiple studies of chronic pain . Data on 2724 subjects from 10 recently completed placebo‐controlled clinical trials of pregabalin in diabetic neuropathy , postherpetic neuralgia , chronic low back pain , fibromyalgia , and osteoarthritis were used . The studies had similar design s and measurement instruments , including the PI‐NRS , collected in a daily diary , and the st and ard seven‐point patient global impression of change ( PGIC ) , collected at the endpoint . The changes in the PI‐NRS from baseline to the endpoint were compared to the PGIC for each subject . Categories of ‘ much improved ’ and ‘ very much improved ’ were used as determinants of a clinical ly important difference and the relationship to the PI‐NRS was explored using graphs , box plots , and sensitivity/specificity analyses . A consistent relationship between the change in PI‐NRS and the PGIC was demonstrated regardless of study , disease type , age , sex , study result , or treatment group . On average , a reduction of approximately two points or a reduction of approximately 30 % in the PI‐NRS represented a clinical ly important difference . The relationship between percent change and the PGIC was also consistent regardless of baseline pain , while higher baseline scores required larger raw changes to represent a clinical ly important difference . The application of these results to future studies may provide a st and ard definition of clinical ly important improvement in clinical trials of chronic pain therapies . Use of a st and ard outcome across chronic pain studies would greatly enhance the comparability , validity , and clinical applicability of these studies The effect of an electromagnetic field on the healing of skin ulcers of venous origin in humans has been investigated in a double-blind study . Forty-four patients have been admitted to the study ; one-half were exposed to active stimulators ( experimental group ) and the remaining to dummy stimulators ( control group ) . The stimulation was scheduled to last a maximum of 90 days . The success rate was significantly higher in the experimental group both at day 90 ( p less than 0.02 ) and in the follow-up period ( p less than 0.005 ) . The data suggest that the effect of the electromagnetic field lasts even when the stimulation is over . No ulcers worsened in the experimental group , while four worsened in the control group . Twenty-five percent of the patients in the experimental group and 50 % in the control group experienced recurrence of the ulcer . It is concluded that stimulation with an electromagnetic field is a useful adjunctive therapy in the management of these patients A r and omized , active-controlled clinical trial was conducted to examine the effect of pulsed electromagnetic fields ( PEMFs ) on women with postmenopausal osteoporosis ( PMO ) in southwest China . Forty-four participants were r and omly assigned to receive alendronate or one course of PEMFs treatment . The primary endpoint was the mean percentage change in bone mineral density of the lumbar spine ( BMDL ) , and secondary endpoints were the mean percentage changes in left proximal femur bone mineral density ( BMDF ) , serum 25OH vitamin D3 ( 25(OH)D ) concentrations , total lower-extremity manual muscle test ( LE MMT ) score , and Berg Balance Scale ( BBS ) score . The BMDL , BMDF , total LE MMT score and BBS score were recorded at baseline , 5 , 12 , and 24 weeks . Serum concentrations of 25(OH)D were measured at baseline and 5 weeks . Using a mixed linear model , there was no significant treatment difference between the two groups in the BMDL , BMDF , total LE MMT score , and BBS score ( P ≥ 0.05 ) . For 25(OH)D concentrations , the effects were also comparable between the two groups ( P ≥ 0.05 ) with the Mann-Whitney 's U-test . These results suggested that a course of PEMFs treatment with specific parameters was as effective as alendronate in treating PMO within 24 weeks OBJECTIVES To evaluate the efficacy and safety of therapeutic electromagnetic fields ( TEMF ) on  chronic low back pain .  Secondary objectives included the investigation of the effects of TEMF on psychometric measures . SETTING Pain Research center in an Urban Academic Rehabilitation Facility . DESIGN Prospect i ve , r and omized , single-blind , placebo ( sham ) treatment-controlled design in which participants were evaluated over a 6-week period . A total of 40 subjects were r and omly assigned : 20 subjects to 15 milliTESLA ( mT ) treatment using a prototype electromagnetic field device and 20 to sham treatment . INTERVENTIONS After a 2-week baseline period , eligible individuals were r and omized to one of the treatment groups ( sham or 15 mT ) for six 30-minute treatments over 2 weeks , then a 2-week follow-up period . OUTCOME MEASURES The primary outcome measure was the self-report of pain severity using a 100 mm visual analog scale collected using a twice daily McGill Pain Question naire-Short Form . Several secondary measures were assessed . RESULTS Both groups ( 15 mT and sham ) improved over time ( P < 0.05 ) . Although groups were similar during the treatment period , treated subjects ( TEMF of 15 mT ) improved significantly over sham treatment during the 2-week follow-up period ( 20.5 % reduction in pain ; F(1,34 ) = 10.62 , P = 0.003 ) . There were no reported serious adverse events . CONCLUSIONS This study demonstrates that TEMF may be an effective and safe modality for the treatment of chronic low back pain disorders . More studies are needed to test this hypothesis Musculoskeletal system disorders ( MSDs ) are amongst the most commonly encountered problems in orthopaedics and physiotherapy practice all over the world and back pain is amongst the most prevalent of musculoskeletal presentations encountered in clinical practice . The attendant deformities , huge economic loss among many other sequelae on the affected individuals have always informed the search for cost-effective treatment modalities that are non-invasive and are devoid of or at least have minimal side effects . This r and omized controlled trial was conducted to assess the therapeutic efficacy of the use of a non-pharmacological device [ pulsed electromagnetic field ( PEMF ) ] modality in the treatment of back pain .  A total of 16 patients ( mean age : 42.82 + /- 8.63 years ) with back pain without radiculopathy who met the inclusion criteria were purposively enrolled in the study . Patients were r and omly assigned into two groups . Group A had eight patients treated with PEMF plus medications ( analgesics , nonsteroidal anti-inflammatory - diclofenac sodium ) while the eight patients in group B were treated with only st and ard medications . The PEMF device was applied in 
    Output:
    
Conclusion PEMF therapy seems to be able to relieve the pain intensity and improve functionality in individuals with low back pain conditions .