{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T16:26:41Z","timestamp":1785083201529,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current treatments for knee osteoarthritis (OA) offer limited functional and structural improvements. Compared to age\u2010 and gender\u2010matched controls, patients with knee OA show a higher prevalence of muscle weakness, which negatively affects their ability to exercise\u2014a key factor in enhancing physical mobility and delaying disease progression. Pulsed electromagnetic field (PEMF) therapy shows promise in promoting myogenesis and chondrogenesis in pre\u2010clinical studies. However, its effects on muscle strength and size, cartilage deterioration and overall physical function in knee OA patients remain unclear. This randomized placebo\u2010controlled trial aimed to evaluate the impact of PEMF therapy on knee muscle power, lean muscle mass, femoral cartilage thickness, minimum joint space width (mJSW), lower limb physical functions and knee\u2010specific patient\u2010reported outcome (PRO) in patients with refractory mild\u2010to\u2010moderate knee OA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty refractory knee OA patients, aged 50 and older, with a pain score of 4 or higher were randomized to receive either PEMF or SHAM treatment for 30\u2009min, 3 times a week over 8\u2009weeks. Outcome measures, including muscle strength, lean muscle mass, cartilage thickness, mJSW, mobility and PRO were assessed at baseline, immediate post\u2010intervention and 6\u2010 and 12\u2010month post\u2010intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant interactions were observed between PEMF therapy and time for both knee extension peak torque (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and knee flexion peak torque (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). Post hoc analysis revealed that PEMF significantly increased extension peak torque compared to the SHAM group at 6\u2010month post\u2010intervention (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042). The PEMF group showed a 72% increase in knee extensor strength after 6\u2009months from baseline, whereas the SHAM group only saw a 25% increase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). However, no significant difference in knee flexion peak torque was detected between the PEMF and SHAM treatments in the post hoc analysis. Nonetheless, the knee flexor strength in the PEMF group increased by 72% at 6\u2009months from baseline, whereas the SHAM group showed only a 24% rise (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). Additionally, there were no differences between the PEMF and SHAM groups in lean muscle mass, cartilage thickness, mJSW, the 6\u2010m walk time and the number of repetitions of chair standing in 30\u2009s and WOMAC (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An 8\u2010week course of PEMF therapy significantly improved the knee extension strength in refractory patients with mild to moderate knee OA at 6\u2010month post\u2010intervention, suggesting its potential to address extensor weakness in this high\u2010risk population. However, it did not significantly enhance knee flexion strength, lean muscle mass, cartilage thickness, mJSW, lower limb physical functions or PRO up to 12\u2010month post\u2010intervention. Further research is needed to identify treatment regimens that may promote structural and functional outcomes in knee OA patients.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      : NCT05442697\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70199","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T04:14:57Z","timestamp":1769487297000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pulsed Electromagnetic Field Therapy for Mild\u2010to\u2010Moderate Knee Osteoarthritis: A Double\u2010Blind, Randomized, Placebo\u2010Controlled Clinical Trial"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9958-3044","authenticated-orcid":false,"given":"Kenney\u00a0Ki\u00a0Lee","family":"Lau","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology The Chinese University of Hong Kong  Hong Kong China"},{"name":"InnoHK Cener for Neuromusculoskeletal Restorative Medicine  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5275-8409","authenticated-orcid":false,"given":"Abbey\u00a0Ssu\u00a0Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology The Chinese University of Hong Kong  Hong Kong China"},{"name":"InnoHK Cener for Neuromusculoskeletal Restorative Medicine  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2601-7543","authenticated-orcid":false,"given":"Christine\u00a0Hoi\u00a0Yan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology The Chinese University of Hong Kong  Hong Kong China"},{"name":"InnoHK Cener for Neuromusculoskeletal Restorative Medicine  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0167-8000","authenticated-orcid":false,"given":"Jonathan\u00a0Patrick","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Prince of Wales Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-9286","authenticated-orcid":false,"given":"Michael\u00a0Tim\u00a0Yun","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7214-5503","authenticated-orcid":false,"given":"Patrick\u00a0Shu\u00a0Hang","family":"Yung","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology The Chinese University of Hong Kong  Hong Kong China"},{"name":"InnoHK Cener for Neuromusculoskeletal Restorative Medicine  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2446-6203","authenticated-orcid":false,"given":"Pauline\u00a0Po\u00a0Yee","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology The Chinese University of Hong Kong  Hong Kong China"},{"name":"InnoHK Cener for Neuromusculoskeletal Restorative Medicine  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00163-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S89585"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-020-01929-6"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsbiomaterials.9b00025"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.101597"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-025-03492-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms242316631"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2022.892287"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bem.22429"},{"issue":"1","key":"e_1_2_11_11_1","first-page":"1127","article-title":"Pulsed Electromagnetic Fields Alleviate Streptozotocin\u2010Induced Diabetic Muscle Atrophy","volume":"18","author":"Yang J.","year":"2018","journal-title":"Molecular Medicine Reports"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13636"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23278"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22584"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13071959"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzaa054"},{"issue":"11","key":"e_1_2_11_17_1","first-page":"821","article-title":"Effects of Pulsed Electromagnetic Field Therapy on Pain, Stiffness and Physical Function in Patients With Knee Osteoarthritis: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials","volume":"51","author":"Chen L.","year":"2019","journal-title":"Journal of Rehabilitation Medicine"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells14030231"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.201900057R"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actbio.2020.10.039"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.18632\/aging.204597"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0140822"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25722"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019455"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2020.04.003"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2024.05.024"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/09593980903015235"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11060922"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31138-9"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12411"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000517099"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-06347-0"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19052871"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev419"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1993.17.4.177"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2022.09.011"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1519\/JPT.0000000000000444"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14020594"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-016-0486-0"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.4061\/2011\/601416"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/82.9.866"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcsm.70199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:14:38Z","timestamp":1773015278000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.70199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,26]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/jcsm.70199"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.70199","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,26]]},"assertion":[{"value":"2025-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70199"}}