Abstract
This paper proposes and for the first time examines in parallel the most likely mechanisms of clinical effects unlocked by two modality applications: the therapeutic (acute) “take and run” and the occupational (chronic) “take and hold” of therapeutic EMFs. Electromagnetic fields (EMFs) for therapeutic use have a long pre-clinical and clinical history. The practical experience worldwide has increased the trust of the medical community due to the EMF potential for speeding up the recovery and reparative processes and for influencing the pathological ones – edema, pain, inflammation. We consider these favourable effects of the triggered stimulation of the production of endothelial NO - a consequence of the biochemical activation of the calcium-calmodulin system as well as the vasodilatative vasomotor changes by low-intensity EMFs of any range as the main clinically significant, universal therapeutic mechanism of action in the stimulation of the reparative processes.
These beneficial health effects on patients look different when assessed as an occupational factor from the perspective of the health of the physiotherapy professionals. Our recent, complex, ambispective study, which as far as we know is the first in this field, has provided evidence about their specific morbidity profile in its somatic and behavioral complexity, where seems to be endocrinal and cell damaging/ irritating processes are involved. The results indicate that the hypothesized endocrinal mechanisms concern the changes in the estrogen and melatonin levels (assessed indirectly). The immuno-endocrine EMF-induced autoreplication and disruption of adipose tissue cells are suspected to amplify the adverse effects of the occupational low-intensity mixed EMFs and were found to be in a causal relation. Our hypothesis of the main mechanism of the occupational (chronical) EMF adverse effects is based on the presumption of selective EMF targeting of the hydrated/hyper hydrated tissues (which is an indispensable physiological parameter of every vital tissue) with probable related maintenance of permanent high levels of reactive oxygen species (ROS). This requires thorough examination due to the great biological/ clinical significance of such a dependence given some common recommendations existing in Bulgarian physiotherapy facilities for an increased water intake during working hours.
Keywords: Therapeutic EMFs, therapy modality, occupational modality, mechanisms of interaction, eNO, ROS.
Graphical Abstract