{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:04:34Z","timestamp":1775142274936,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Despite the high prevalence of low back pain (LBP), evidence supporting the clinical effects of repetitive peripheral magnetic stimulation (rPMS) remains limited. A combined double-coil and handheld rPMS approach may enhance the therapeutic potential of this technology. This observational case series analyzed prospectively collected routine clinical data from 37 patients treated with a combined protocol of static double-coil lumbar rPMS and dynamic handheld lower-limb rPMS. Pain intensity, disability, and quality of life were assessed at baseline, post-treatment, and 1-month follow-up. Statistical analyses were complemented by an evaluation of clinical relevance using established minimal clinically important difference (MCID) thresholds. Significant improvements were observed across all outcomes. Pain decreased by 62.5% post-treatment and by 87.5% at follow-up, while disability was reduced by 86.8% and 92.1%, respectively. Quality of life scores approximately doubled. High MCID responder rates and consistent within-group changes were observed; however, given the single-arm design without a control group, these findings should be interpreted as exploratory and hypothesis-generating rather than confirmatory evidence of treatment effectiveness. This combined rPMS approach was feasible and well tolerated in routine clinical practice and was associated with clinically meaningful within-group improvements in pain, function, and quality of life. Further controlled studies are warranted.<\/jats:p>","DOI":"10.3390\/life16040594","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T14:09:54Z","timestamp":1775138994000},"page":"594","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Double-Coil and Handheld rPMS in Low Back Pain: An Observational Case Series Based on Routine Clinical Practice"],"prefix":"10.3390","volume":"16","author":[{"given":"Vincenzo Di","family":"Modica","sequence":"first","affiliation":[{"name":"Rehabilitation Center, BioSalus, 87036 Surdo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe J.","family":"Sciarrone","sequence":"additional","affiliation":[{"name":"Spine and Robotic Surgery Centre, Humanitas Pio X, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milo\u0161","family":"Barna","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Clinic, Barna Medical, 130 00 Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.14245\/ns.2448266.133","article-title":"Proteoglycan dysfunction as a key hallmark of intervertebral disc degeneration","volume":"21","author":"Yurube","year":"2024","journal-title":"Neurospine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"487","DOI":"10.14245\/ns.2448372.186","article-title":"Comparative Review of the Socioeconomic Burden of Lower Back Pain in the United States and Globally","volume":"21","author":"Chang","year":"2024","journal-title":"Neurospine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1007\/s40122-024-00613-6","article-title":"Cortical Mechanisms Underlying Effects of Repetitive Peripheral Magnetic Stimulation on Dynamic and Static Postural Control in Patients with Chronic Non-Specific Low Back Pain: A Double-Blind Randomized Clinical Trial","volume":"13","author":"Yan","year":"2024","journal-title":"Pain Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1177\/1947603517695614","article-title":"Isolated Lumbar Extension Resistance Training Improves Strength, Pain, and Disability, but Not Spinal Height or Shrinkage (\u201cCreep\u201d) in Participants with Chronic Low Back Pain","volume":"11","author":"Steele","year":"2020","journal-title":"Cartilage"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1007\/s00256-013-1700-x","article-title":"Do more MRI findings imply worse disability or more intense low back pain? A cross-sectional study of candidates for lumbar disc prosthesis","volume":"42","author":"Berg","year":"2013","journal-title":"Skelet. Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s00508-019-01542-7","article-title":"Association between low back pain and various everyday performances: Activities of daily living, ability to work and sexual function","volume":"131","author":"Grabovac","year":"2019","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Chen, S., Li, Y., Shu, X., Wang, C., Wang, H., Ding, L., and Jia, J. (2020). Electroencephalography Mu Rhythm Changes and Decreased Spasticity After Repetitive Peripheral Magnetic Stimulation in Patients Following Stroke. Front. Neurol., 11.","DOI":"10.3389\/fneur.2020.546599"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pan, J.-X., Diao, Y.-X., Peng, H.-Y., Wang, X.-Z., Liao, L.-R., Wang, M.-Y., Wen, Y.-L., Jia, Y.-B., and Liu, H. (2022). Effects of repetitive peripheral magnetic stimulation on spasticity evaluated with Modified Ashworth Scale\/Ashworth Scale in patients with spastic paralysis: A systematic review and meta-analysis. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.997913"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"341","DOI":"10.4283\/JMAG.2021.26.3.341","article-title":"Effects of Repetitive Peripheral Magnetic Stimulation and Exercise on Pain, Leg Muscle Strength, and WOMAC index in Knee Osteoarthritis Patients","volume":"26","author":"Lee","year":"2021","journal-title":"J. Magn."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.2147\/JPR.S473079","article-title":"Integrating Ultrasound-Guided Multifidus Injections with Repeated Peripheral Magnetic Stimulation for Low Back Pain: A Feasibility Study","volume":"17","author":"Wu","year":"2024","journal-title":"J. Pain Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4283\/JMAG.2021.26.1.111","article-title":"Effects of Repetitive Peripheral Magnetic Stimulation on Pain, Disability, and Quality of Life in Chronic Low Back Pain Patients","volume":"26","author":"Kim","year":"2021","journal-title":"J. Magn."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"056007","DOI":"10.1088\/1741-2560\/8\/5\/056007","article-title":"Comparison of coil designs for peripheral magnetic stimulation","volume":"8","author":"Goetz","year":"2011","journal-title":"J. Neural Eng."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Bagherzadeh, H., Meng, Q., Deng, Z.D., Lu, H., Hong, E., Yang, Y., and Choa, F.S. (2022). Angle-tuned coils: Attractive building blocks for TMS with improved depth-spread performance. J. Neural Eng., 19.","DOI":"10.1088\/1741-2552\/ac697c"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kitamura, T., Yaeshima, K., Yamamoto, S., and Kawashima, N. (2013, January 3\u20137). The precise adjustment of coil location for transcranial magnetic stimulation during dynamic motion. Proceedings of the 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Osaka, Japan.","DOI":"10.1109\/EMBC.2013.6610316"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s10916-014-0064-7","article-title":"Design of a Dynamic Transcranial Magnetic Stimulation Coil System","volume":"38","author":"Ge","year":"2014","journal-title":"J. Med. Syst."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4236\/ojtr.2026.142004","article-title":"A Novel Double-Coil rPMS Approach for Treating Joint Disorders of the Upper and Lower Extremities: A Pilot Study","volume":"14","author":"Modica","year":"2026","journal-title":"Open J. Ther. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bedn\u00e1r, R., Fla\u0161kov\u00e1, M., and Fejkov\u00e1, N.A. (2026). Pilot Study Investigating Clinical and Functional Outcomes of Novel Double-Coil rPMS in Knee Osteoarthritis. Biomedicines, 14.","DOI":"10.3390\/biomedicines14030722"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.clinph.2016.12.020","article-title":"Repetitive peripheral magnetic neurostimulation of multifidus muscles combined with motor training influences spine motor control and chronic low back pain","volume":"128","author":"Beaulieu","year":"2017","journal-title":"Clin. Neurophysiol."},{"key":"ref_19","first-page":"351","article-title":"Comparison of Single- and Double-Coil rPMS Configurations in Physiotherapy: Perception and Field Distribution in Commonly Treated Areas","volume":"7","author":"Barna","year":"2025","journal-title":"J. Orthop. Sports Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"36","DOI":"10.54536\/ajahs.v2i3.1951","article-title":"A Review Gluteus Medius Muscle Function Al Limitation in Chronic Low Back Pain","volume":"2","author":"Rehman","year":"2023","journal-title":"Am. J. Arts Hum. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"137050","DOI":"10.1016\/j.neulet.2023.137050","article-title":"Spatial summation of cold and warm detection: Evidence for increased precision when brisk stimuli are delivered over larger area","volume":"797","author":"Courtin","year":"2023","journal-title":"Neurosci. Lett."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Finney, A., Dziedzic, K.S., Lewis, M., and Healey, E. (2017). Multisite peripheral joint pain: A cross-sectional study of prevalence and impact on general health, quality of life, pain intensity and consultation behaviour. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1896-3"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Sadler, S., Cassidy, S., Peterson, B., Spink, M., and Chuter, V. (2019). Gluteus medius muscle function in people with and without low back pain: A systematic review. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2833-4"},{"key":"ref_24","first-page":"20","article-title":"Modified rehabilitation exercises to strengthen the gluteal muscles with a significant improvement in the lower back pain","volume":"2","author":"Gasibat","year":"2017","journal-title":"Int. J. Yoga Physiother. Phys. Educ."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"24432","DOI":"10.1038\/s41598-024-74348-x","article-title":"Effectiveness of gluteal control training in chronic low back pain patients with functional leg length inequality","volume":"14","author":"Huang","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_26","unstructured":"Penney, T. (2012). Gluteus Medius Muscle Activation in Chronic Low Back Pain Patients During Single Leg Stance. [Master\u2019s Thesis, Memorial University Scholars Hub, Memorial University of Newfoundland]. Available online: https:\/\/memorial.scholaris.ca\/items\/86ad6beb-794c-49cb-b2f4-8a817b4e9810\/full."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/MRR.0b013e3282fc0f93","article-title":"Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain","volume":"31","author":"Boonstra","year":"2008","journal-title":"Int. J. Rehabil. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00586-010-1624-2","article-title":"Responsiveness of the Chinese version of the Oswestry Disability Index in patients with chronic low back pain","volume":"20","author":"Ma","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.jpain.2015.02.007","article-title":"Patients\u2019 impression of change following treatment for chronic pain: Global, specific, a single dimension, or many?","volume":"16","author":"Scott","year":"2015","journal-title":"J. Pain"},{"key":"ref_30","first-page":"E945","article-title":"Rational selection of patient-reported outcome measures in low back pain care and research","volume":"45","author":"Boden","year":"2020","journal-title":"Spine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1097\/BRS.0b013e31815b75ae","article-title":"Minimal Clinically Important Change for Pain Intensity and Disability in Patients with Nonspecific Low Back Pain","volume":"32","author":"Kovacs","year":"2007","journal-title":"Spine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"E474","DOI":"10.1097\/BRS.0000000000001950","article-title":"Minimum Clinically Important Difference and Substantial Clinical Benefit in Pain, Functional, and Quality of Life Scales in Failed Back Surgery Syndrome Patients","volume":"42","author":"Park","year":"2017","journal-title":"Spine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1097\/BRS.0000000000002298","article-title":"Minimal Clinically Important Difference in Quality of Life for Patients with Low Back Pain","volume":"42","author":"Royuela","year":"2017","journal-title":"Spine"},{"key":"ref_34","first-page":"e1230","article-title":"PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis","volume":"18","author":"Haddaway","year":"2022","journal-title":"Syst. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100211","DOI":"10.1016\/j.mcpsp.2021.100211","article-title":"The effect of repetitive peripheral magnetic stimulation on insomnia improving and pain in patients with chronic low back pain","volume":"4","author":"Tammasse","year":"2021","journal-title":"Med. Cl\u00ednica Pr\u00e1ctica"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"894","DOI":"10.35755\/jmedassocthai.2024.11.894-901-01419","article-title":"Short-term efficacy of repetitive peripheral magnetic stimulation for chronic low back pain: A double-blinded randomized control trial","volume":"107","author":"Jiravichitchai","year":"2024","journal-title":"J. Med. Assoc. Thail."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"229","DOI":"10.5535\/arm.2018.42.2.229","article-title":"Effects of Repetitive Peripheral Magnetic Stimulation on Patients with Acute Low Back Pain: A Pilot Study","volume":"42","author":"Lim","year":"2018","journal-title":"Ann. Rehabil. Med."},{"key":"ref_38","unstructured":"Forbes, L.H. (2009). Lumbar Spine Manipulation, Compared to Combined Lumbar Spine and Ankle Manipulation for the Treatment of Chronic Mechanical Low Back Pain. [Doctoral Dissertation, Durban University]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1249\/MSS.0000000000001396","article-title":"Comparison of Lower Limb and Back Exercises for Runners with Chronic Low Back Pain","volume":"49","author":"Cai","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_40","first-page":"1","article-title":"Evaluation of The Physiotherapy Effectiveness in Symptomatic Treatment of Low Back Pain with Radiation to the Lower Limb\u2014Pilot Study","volume":"2023","author":"Skorupska","year":"2023","journal-title":"Issue Rehabil. Orthop. Neurophysiol. Sport Promot."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1302\/0301-620X.89B9.18939","article-title":"The nerve supply of the lumbar intervertebral disc","volume":"89","author":"Edgar","year":"2007","journal-title":"J. Bone Jt. Surg. Br. Vol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/594\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T14:24:03Z","timestamp":1775139843000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/594"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["life16040594"],"URL":"https:\/\/doi.org\/10.3390\/life16040594","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]}}}