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Pulsed Electromagnetic Fields for Postoperative Analgesia: A Randomized, Triple-Masked, Sham-Controlled Pilot Study

Pulsed Electromagnetic Fields for Postoperative Analgesia: A Randomized, Triple-Masked, Sham-Controlled Pilot Study

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05399355
Enrollment
119
Registered
2022-06-01
Start date
2022-07-18
Completion date
2024-04-03
Last updated
2024-07-31

For informational purposes only โ€” not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Postoperative Pain, Acute

Brief summary

Pulsed electromagnetic field therapy is a possible method of pain control involving the application of electromagnetic energy (also termed nonthermal, pulsed, shortwave radiofrequency therapy). Food and Drug Administration-cleared devices have been in clinical use for over 70 years. For decades, available devices consisted of a large signal generator and bulky coil applicator that were not portable and produced significant electromagnetic interference, making them impractical for common use. However, small, lightweight, relatively inexpensive, noninvasive, Food and Drug Administration-cleared devices that function for 30 days are now available to treat acute and chronic pain, decrease inflammation and edema, and hasten wound healing and bone regeneration. Therefore, it has the potential to concurrently improve analgesia and decrease or even negate opioid requirements, only without the limitations of opioids and peripheral nerve blocks. The purpose of this pilot study is to explore the possibility of treating acute postoperative pain with nonthermal, pulsed shortwave (radiofrequency) therapy, optimize the study protocol, and estimate the treatment effect in preparation for developing subsequent definitive clinical trials.

Detailed description

The proposed study will be a randomized, participant- and observer-masked, sham-controlled, parallel-arm, human participants pilot study with two primary aims: Specific Aim 1: To determine the feasibility and optimize the protocol for subsequent clinical trials that will compare the addition of nonthermal, pulsed shortwave therapy to usual and customary analgesia following moderate-to-severely painful surgical procedures. Specific Aim 2: To estimate the treatment effect of adding nonthermal, pulsed shortwave therapy to usual and customary analgesia on pain and opioid consumption following moderate-to-severely painful surgical procedures. This will provide an idea of the optimal surgical procedures amenable to this analgesic technique and allow determination of the required sample sizes of subsequent definitive clinical trials. Hypothesis 1: Nonthermal, pulsed shortwave therapy decreases pain in the 7 days following moderate-to-severely painful surgical procedures. Hypothesis 2: Nonthermal, pulsed shortwave therapy decreases opioid use in the 7 days following moderate-to-severely painful surgical procedures. This will be a single-center (University of California San Diego), randomized, participant- and observer-masked, sham-controlled, parallel-arm human subjects pilot study. Enrollment. Participants will be consenting adults undergoing various surgical procedures usually resulting in moderate-to-severe postoperative pain. Study inclusion will be proposed to eligible presurgical patients. If an individual desires study participation, written, informed consent will be obtained using a current University of California San Diego Institutional Review Board-approved informed consent form. The study population of interest includes adult women and men of all races, ethnicity, sexual identity, and socioeconomic status. Procedures. Following written, informed consent, we will record baseline anthropometric information (age, sex, height, weight, amputation details and current pain levels). Participants will receive any standard peripheral nerve block(s) administered using bupivacaine or ropivacaine 0.5% with epinephrine (standard at University of California San Diego) prior to undergoing their surgical procedure per standard of care. Treatment Group Assignment. Each participant will be randomized to one of two treatment groups: Active or Sham treatment. There are sham devices produced that are identical to active devices, only they do not deliver pulsed electromagnetic energy. Randomization will be stratified by surgical procedure in block sizes of 2. The computer-generated randomization lists will be created by the University of California San Diego Investigational Drug Service in a 1:1 treatment group ratio using opaque envelopes. The active and sham devices are indistinguishable in appearance, and therefore investigators, participants, and all clinical staff other than the individual who opens the randomization envelope and chooses a sham or active device will be masked to treatment group assignment for the duration of the data collection period. An Investigational Drug Service pharmacist will open the envelope and provide the investigators with the appropriate device, keeping all investigators masked to treatment group assignment. Upon completion of data collection for a specific subgroup (e.g., amputees, total knee arthroplasty), the pharmacist will provide the investigators with a masked list of the treatment groups (e.g., Treatment A and Treatment B), and the active/sham lists only following analysis for that subgroup, resulting in a triple-masked study (investigators, participants, statistician). Study intervention. The pulsed shortwave device (2 devices, if there are multiple incisions or the incision is larger than the device diameter; 3 devices for total knee and hip arthroplasty or spinal surgery) will be affixed over the primary wound area(s) using tape and activated prior to recovery room discharge (Experimental). The optimal location to treat phantom pain is currently unknown and will partially informed by the results of this pilot study, and patients will be encouraged to move the devices to a new anatomic location until relief is optimized. Supplemental analgesics. In addition to the pulsed shortwave device(s), participants will receive standard-of-care supplemental analgesics which can include acetaminophen, ibuprofen, ketorolac, opioids, gabapentin (this is provider- and patient-dependent). Therefore, all patients of this study-regardless of the treatment arm they are randomized to-will continue to receive current usual and customary analgesia: all will receive the same combination of supplemental analgesics they would regardless of study participation. Participants (and their caretakers) will be provided with verbal and written instructions, and the telephone and pager numbers of an investigator available during business hours throughout the treatment period. Participants can shower with the device in place, but not submerge it during swimming or a bath, as advised by the manufacturer. Participants will be discharged with their pulsed shortwave device(s) in situ and a prescription for immediate-release oral opioid, preferably oxycodone 5 mg tablets, taken for breakthrough pain (surgeons occasionally prefer a different type of opioids such as hydrocodone, which is why we analyze the data using oral oxycodone equivalents). The pulsed shortwave devices will be removed by participants at home following Day 30 when the battery is exhausted (participants may remove them as early as Day 7, if they desire). Removing the devices encompasses tape removal and discarding in the trash (these are disposable, single-use devices). Of note, if a device is reported lost or nonfunctional during the study, it will be replaced by the investigators by mail if more than 7 days of treatment remain. Study outcomes: This is an exploratory pilot study to assist in planning subsequent definitive trials and we therefore have no data analysis plan. We will enroll convenience samples for each of the surgical procedures of up to 30 participants for each procedure, and anticipate analyzing each surgical procedure separately from the others. The two outcomes of primary interest will be (1) the average and worst pain measured with the Numeric Rating Scale (included in the Brief Pain Inventory pain domain), and (2) opioid consumption within the first 7 postoperative days.

Interventions

DEVICEActive Pulsed Shortwave Treatment with BioElectronics Model 088

Application of 7-30 days of nonthermal, pulsed shortwave (radiofrequency) therapy with BioElectronics Model 088

DEVICESham Treatment

Application of 7-30 days of a nonfunctional sham device(s)

Sponsors

University of California, San Diego
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Masking description

The Investigational Drug Service will create the randomization tables and provide the investigators with the appropriate device (active or sham), leaving all participants, investigators, and the statistician masked to treatment group assignment.

Intervention model description

Parallel Assignment: Randomized, Triple-Masked, Placebo-Controlled, Parallel-Arm Human Subjects Clinical Trial

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Adult patients of at least 18 years of age undergoing one of these primary surgical procedures: 1. non-mastectomy breast surgery with a single-injection paravertebral nerve block 2. laparoscopic cholecystectomy 3. laparoscopic sleeve gastrectomy 4. percutaneous nephrolithotomy 5. ventral hernia repair 6. inguinal hernia repair 7. knee or hip arthroplasty 8. foot/ankle surgery with at least moderate pain anticipated 9. shoulder acromioclavicular joint repair, labral repair, subacromial decompression, or Bankart repair (without rotator cuff repair) 10. hand/forearm/elbow surgery with at least moderate pain anticipated 11. spinal surgery with at least moderate pain anticipated

Exclusion criteria

* concurrent use of an implanted pulse generator (e.g., cardiac pacemaker) * pregnancy * incarceration * chronic opioid/tramadol use (daily use within the 2 weeks prior to surgery and duration of use \> 4 weeks) * neuro-muscular deficit of the surgical area/limb * a planned postoperative perineural local anesthetic infusion

Design outcomes

Primary

MeasureTime frameDescription
AVERAGE Pain Measured With the Numeric Rating ScaleMean value of the average daily pain measured on postoperative days 1, 2, 3, and 7The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale. The outcome will the mean value of daily average pain scores measured with the Numeric Rating Scale
WORST Pain Measured With the Numeric Rating ScaleMean value of the worst daily pain measured on postoperative days 1, 2, 3, and 7The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale. The outcome will the mean value of daily worst pain scores measured with the Numeric Rating Scale
Total OPIOID Consumption From Recovery Room Discharge Until the Data Collection Phone Call on Postoperative Day 7 (Measured in Oral Oxycodone Equivalents)Cumulative opioid consumption queried on postoperative days 1, 2, 3, and 7Total opioid consumption from recovery room discharge until the data collection phone call on postoperative day 7 (measured in oral oxycodone equivalents).

Secondary

MeasureTime frameDescription
CURRENT Pain Measured With the Numeric Rating Scalepostoperative day 7The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.
Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)postoperative day 1Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)
Brief Pain Inventory, Short Form (Interference Subscale)postoperative day 7The Brief pain Inventory short form interference subscale is an instrument specifically designed to assess pain and its impact on physical and emotional functioning using a scale of 0-70. The subscale is comprised of 7 questions involving physical and emotional functioning using a 0-10 Likert scale \[0=no interference;10=complete interference\]: general activity, mood, walking ability, normal work, relations with other people, sleep and enjoyment of life. The 7 responses for the 7 questions are totaled, producing a scale of 0-70, with 0 being preferred and 70 indicating worse functioning.
Awakenings Due to Painpostoperative day 1The number of times the participant awoke the previous night due to pain
Hospitalization Duration Measured in DaysOne single measure recorded on or following the day of surgery (whichever day patient is discharged)Day relative to the day of surgery that patient was discharged from the hospital (e.g., same day is postoperative day 0, while the day following surgery is postoperative day 1) over the first postoperative week. The surgical service determines when patients are to be discharged using their own criteria which are not defined by the study.
Passive Flexion (Knee and Hip Arthroplasty Patients Only)One measure take at the two-week postoperative check (approximately postoperative day 14)The number of degrees of passive flexion achieved from a neutral position
AVERAGE Pain Measured With the Numeric Rating Scalepostoperative day 1The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.
Desire Use of Device in Hypothetical Future Surgery?queried on postoperative day 28Would the patient want to use the device for a hypothetical surgery in the future (yes, no, or undecided)?
Surgical Start as Recorded Using Military Time FormatIntraoperative (within the operating room)The time of the surgical incision as recorded using military time format
Surgical Stop as Recorded Using Military Time FormatIntraoperative (within the operating room)The time of the final suture insertion as recorded using military time format
Surgical DurationIntraoperative (within the operating room)The time from surgical start to surgical stop measured in minutes and hours
Device Location ChangesPostoperative day 1If a patient moves the anatomic location of one of the intervention devices since the last phone contact
Day Stopped Using InterventionOne single measure recorded following the day of surgeryDay relative to the day of surgery that patient stopped using the intervention for (e.g., same day is postoperative day 0, while the day following surgery is postoperative day 1)
WORST Pain Measured With the Numeric Rating Scalepostoperative day 1The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.
LEAST Pain Measured With the Numeric Rating Scalepostoperative day 7The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Countries

United States

Participant flow

Participants by arm

ArmCount
Active Pulsed Shortwave Treatment With BioElectronics Model 088
Application of 7-30 days of nonthermal, pulsed shortwave (radiofrequency) therapy with BioElectronics Model 088 Active Pulsed Shortwave Treatment with BioElectronics Model 088: Application of 7-30 days of nonthermal, pulsed shortwave (radiofrequency) therapy with BioElectronics Model 088
59
Sham Treatment
Application of 7-30 days of a nonfunctional sham device. Sham Treatment: Application of 7-30 days of a nonfunctional sham device(s)
60
Total119

Baseline characteristics

CharacteristicActive Pulsed Shortwave Treatment With BioElectronics Model 088Sham TreatmentTotal
Adductor Canal block15 Participants15 Participants30 Participants
Age, Continuous57 years
STANDARD_DEVIATION 15
59 years
STANDARD_DEVIATION 16
58 years
STANDARD_DEVIATION 15
Body Mass Index27 kg/m^2
STANDARD_DEVIATION 5
27 kg/m^2
STANDARD_DEVIATION 5
27 kg/m^2
STANDARD_DEVIATION 5
Breast Surgery14 Participants15 Participants29 Participants
Cholecystectomy7 Participants6 Participants13 Participants
Erector spinal plane block0 Participants1 Participants1 Participants
Height170 cm
STANDARD_DEVIATION 10
169 cm
STANDARD_DEVIATION 10
169 cm
STANDARD_DEVIATION 10
Hernia8 Participants9 Participants17 Participants
Hip arthroplasty15 Participants15 Participants30 Participants
Knee arthroplasty15 Participants15 Participants30 Participants
No peripheral nerve block29 Participants27 Participants56 Participants
Paravertebral block14 Participants15 Participants29 Participants
Race and Ethnicity Not Collectedโ€”โ€”0 Participants
Rectus sheath block1 Participants1 Participants2 Participants
Region of Enrollment
United States
59 participants60 participants119 participants
Sex: Female, Male
Female
34 Participants44 Participants78 Participants
Sex: Female, Male
Male
25 Participants16 Participants41 Participants
Surgery duration86 minutes
STANDARD_DEVIATION 29
93 minutes
STANDARD_DEVIATION 39
89 minutes
STANDARD_DEVIATION 34
Transversus abdominis plane block0 Participants1 Participants1 Participants
Weight78 kg
STANDARD_DEVIATION 19
79 kg
STANDARD_DEVIATION 17
78 kg
STANDARD_DEVIATION 18

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 590 / 60
other
Total, other adverse events
0 / 590 / 60
serious
Total, serious adverse events
0 / 590 / 60

Outcome results

Primary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale. The outcome will the mean value of daily average pain scores measured with the Numeric Rating Scale

Time frame: Mean value of the average daily pain measured on postoperative days 1, 2, 3, and 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale2.4 score on a scaleStandard Deviation 1.6
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale2.6 score on a scaleStandard Deviation 1.7
Primary

Total OPIOID Consumption From Recovery Room Discharge Until the Data Collection Phone Call on Postoperative Day 7 (Measured in Oral Oxycodone Equivalents)

Total opioid consumption from recovery room discharge until the data collection phone call on postoperative day 7 (measured in oral oxycodone equivalents).

Time frame: Cumulative opioid consumption queried on postoperative days 1, 2, 3, and 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Total OPIOID Consumption From Recovery Room Discharge Until the Data Collection Phone Call on Postoperative Day 7 (Measured in Oral Oxycodone Equivalents)21 mgStandard Deviation 24
Sham TreatmentTotal OPIOID Consumption From Recovery Room Discharge Until the Data Collection Phone Call on Postoperative Day 7 (Measured in Oral Oxycodone Equivalents)17 mgStandard Deviation 26
Primary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale. The outcome will the mean value of daily worst pain scores measured with the Numeric Rating Scale

Time frame: Mean value of the worst daily pain measured on postoperative days 1, 2, 3, and 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale4.6 score on a scaleStandard Deviation 2
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale4.7 score on a scaleStandard Deviation 2.1
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 2

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale2.7 score on a scaleStandard Deviation 2
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale3.2 score on a scaleStandard Deviation 2
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 3

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale2.2 score on a scaleStandard Deviation 1.9
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale2.7 score on a scaleStandard Deviation 2.3
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale1.8 score on a scaleStandard Deviation 2
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale1.8 score on a scaleStandard Deviation 2.1
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 14

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale1.3 score on a scaleStandard Deviation 1.8
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale1 score on a scaleStandard Deviation 1.7
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 180

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale0 score on a scaleStandard Deviation 0
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale.1 score on a scaleStandard Deviation 0.5
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 28

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale.7 score on a scaleStandard Deviation 1.3
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale.7 score on a scaleStandard Deviation 1.4
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 21

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale1 score on a scaleStandard Deviation 1.8
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale.7 score on a scaleStandard Deviation 1.4
Secondary

AVERAGE Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 1

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088AVERAGE Pain Measured With the Numeric Rating Scale2.5 score on a scaleStandard Deviation 1.9
Sham TreatmentAVERAGE Pain Measured With the Numeric Rating Scale2.9 score on a scaleStandard Deviation 2.1
Secondary

Awakenings Due to Pain

The number of times the participant awoke the previous night due to pain

Time frame: postoperative day 3

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Awakenings Due to Pain.4 events of awakeningStandard Deviation 1
Sham TreatmentAwakenings Due to Pain.3 events of awakeningStandard Deviation 0.6
Secondary

Awakenings Due to Pain

The number of times the participant awoke the previous night due to pain

Time frame: postoperative day 28

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Awakenings Due to Pain.5 events of awakeningStandard Deviation 1.2
Sham TreatmentAwakenings Due to Pain.2 events of awakeningStandard Deviation 0.6
Secondary

Awakenings Due to Pain

The number of times the participant awoke the previous night due to pain

Time frame: postoperative day 1

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Awakenings Due to Pain.4 events of awakeningStandard Deviation 1
Sham TreatmentAwakenings Due to Pain.4 events of awakeningStandard Deviation 0.9
Secondary

Awakenings Due to Pain

The number of times the participant awoke the previous night due to pain

Time frame: postoperative day 21

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Awakenings Due to Pain.4 events of awakeningStandard Deviation 1.2
Sham TreatmentAwakenings Due to Pain.1 events of awakeningStandard Deviation 0.4
Secondary

Awakenings Due to Pain

The number of times the participant awoke the previous night due to pain

Time frame: postoperative day 14

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Awakenings Due to Pain.8 events of awakeningStandard Deviation 1.7
Sham TreatmentAwakenings Due to Pain.2 events of awakeningStandard Deviation 0.7
Secondary

Awakenings Due to Pain

The number of times the participant awoke the previous night due to pain

Time frame: postoperative day 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Awakenings Due to Pain.7 events of awakeningStandard Deviation 1.7
Sham TreatmentAwakenings Due to Pain.5 events of awakeningStandard Deviation 0.9
Secondary

Awakenings Due to Pain

The number of times the participant awoke the previous night due to pain

Time frame: postoperative day 2

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Awakenings Due to Pain.8 events of awakeningStandard Deviation 1.9
Sham TreatmentAwakenings Due to Pain.6 events of awakeningStandard Deviation 1.4
Secondary

Brief Pain Inventory, Short Form (Interference Subscale)

The Brief pain Inventory short form interference subscale is an instrument specifically designed to assess pain and its impact on physical and emotional functioning using a scale of 0-70. The subscale is comprised of 7 questions involving physical and emotional functioning using a 0-10 Likert scale \[0=no interference;10=complete interference\]: general activity, mood, walking ability, normal work, relations with other people, sleep and enjoyment of life. The 7 responses for the 7 questions are totaled, producing a scale of 0-70, with 0 being preferred and 70 indicating worse functioning.

Time frame: postoperative day 28

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Brief Pain Inventory, Short Form (Interference Subscale).6 score on a scaleStandard Deviation 1.5
Sham TreatmentBrief Pain Inventory, Short Form (Interference Subscale).3 score on a scaleStandard Deviation 1.1
Secondary

Brief Pain Inventory, Short Form (Interference Subscale)

The Brief pain Inventory short form interference subscale is an instrument specifically designed to assess pain and its impact on physical and emotional functioning using a scale of 0-70. The subscale is comprised of 7 questions involving physical and emotional functioning using a 0-10 Likert scale \[0=no interference;10=complete interference\]: general activity, mood, walking ability, normal work, relations with other people, sleep and enjoyment of life. The 7 responses for the 7 questions are totaled, producing a scale of 0-70, with 0 being preferred and 70 indicating worse functioning.

Time frame: postoperative day 21

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Brief Pain Inventory, Short Form (Interference Subscale)1.1 score on a scaleStandard Deviation 2.3
Sham TreatmentBrief Pain Inventory, Short Form (Interference Subscale).6 score on a scaleStandard Deviation 1.5
Secondary

Brief Pain Inventory, Short Form (Interference Subscale)

The Brief pain Inventory short form interference subscale is an instrument specifically designed to assess pain and its impact on physical and emotional functioning using a scale of 0-70. The subscale is comprised of 7 questions involving physical and emotional functioning using a 0-10 Likert scale \[0=no interference;10=complete interference\]: general activity, mood, walking ability, normal work, relations with other people, sleep and enjoyment of life. The 7 responses for the 7 questions are totaled, producing a scale of 0-70, with 0 being preferred and 70 indicating worse functioning.

Time frame: postoperative day 14

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Brief Pain Inventory, Short Form (Interference Subscale)1.7 score on a scaleStandard Deviation 2.7
Sham TreatmentBrief Pain Inventory, Short Form (Interference Subscale)1.1 score on a scaleStandard Deviation 2.3
Secondary

Brief Pain Inventory, Short Form (Interference Subscale)

The Brief pain Inventory short form interference subscale is an instrument specifically designed to assess pain and its impact on physical and emotional functioning using a scale of 0-70. The subscale is comprised of 7 questions involving physical and emotional functioning using a 0-10 Likert scale \[0=no interference;10=complete interference\]: general activity, mood, walking ability, normal work, relations with other people, sleep and enjoyment of life. The 7 responses for the 7 questions are totaled, producing a scale of 0-70, with 0 being preferred and 70 indicating worse functioning.

Time frame: postoperative day 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Brief Pain Inventory, Short Form (Interference Subscale)2.7 score on a scaleStandard Deviation 3.1
Sham TreatmentBrief Pain Inventory, Short Form (Interference Subscale)1.8 score on a scaleStandard Deviation 2.8
Secondary

CURRENT Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 14

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088CURRENT Pain Measured With the Numeric Rating Scale1.1 score on a scaleStandard Deviation 1.8
Sham TreatmentCURRENT Pain Measured With the Numeric Rating Scale.8 score on a scaleStandard Deviation 1.6
Secondary

CURRENT Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 28

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088CURRENT Pain Measured With the Numeric Rating Scale.5 score on a scaleStandard Deviation 1
Sham TreatmentCURRENT Pain Measured With the Numeric Rating Scale.4 score on a scaleStandard Deviation 1.1
Secondary

CURRENT Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088CURRENT Pain Measured With the Numeric Rating Scale1.6 score on a scaleStandard Deviation 1.9
Sham TreatmentCURRENT Pain Measured With the Numeric Rating Scale1.4 score on a scaleStandard Deviation 2.2
Secondary

CURRENT Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 21

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088CURRENT Pain Measured With the Numeric Rating Scale.7 score on a scaleStandard Deviation 1.5
Sham TreatmentCURRENT Pain Measured With the Numeric Rating Scale.5 score on a scaleStandard Deviation 1.3
Secondary

Day Stopped Using Intervention

Day relative to the day of surgery that patient stopped using the intervention for (e.g., same day is postoperative day 0, while the day following surgery is postoperative day 1)

Time frame: One single measure recorded following the day of surgery

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Day Stopped Using Intervention21.3 DaysStandard Deviation 7.8
Sham TreatmentDay Stopped Using Intervention23.4 DaysStandard Deviation 7.9
Secondary

Desire Use of Device in Hypothetical Future Surgery?

Would the patient want to use the device for a hypothetical surgery in the future (yes, no, or undecided)?

Time frame: queried on postoperative day 28

Population: The question regarding the desirability of device use in a hypothetical future surgery was inadvertently excluded from the case report forms.

Secondary

Device Location Changes

If a patient moves the anatomic location of one of the intervention devices since the last phone contact

Time frame: Postoperative day 1

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Active Pulsed Shortwave Treatment With BioElectronics Model 088Device Location Changes6 Participants
Sham TreatmentDevice Location Changes3 Participants
Secondary

Device Location Changes

If a patient moves the anatomic location of one of the intervention devices since the last phone contact

Time frame: Postoperative day 2

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Active Pulsed Shortwave Treatment With BioElectronics Model 088Device Location Changes6 Participants
Sham TreatmentDevice Location Changes3 Participants
Secondary

Device Location Changes

If a patient moves the anatomic location of one of the intervention devices since the last phone contact

Time frame: Postoperative day 3

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Active Pulsed Shortwave Treatment With BioElectronics Model 088Device Location Changes0 Participants
Sham TreatmentDevice Location Changes0 Participants
Secondary

Device Location Changes

If a patient moves the anatomic location of one of the intervention devices since the last phone contact

Time frame: Postoperative day 7

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Active Pulsed Shortwave Treatment With BioElectronics Model 088Device Location Changes0 Participants
Sham TreatmentDevice Location Changes0 Participants
Secondary

Device Location Changes

If a patient moves the anatomic location of one of the intervention devices since the last phone contact

Time frame: Postoperative day 14

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Active Pulsed Shortwave Treatment With BioElectronics Model 088Device Location Changes0 Participants
Sham TreatmentDevice Location Changes0 Participants
Secondary

Device Location Changes

If a patient moves the anatomic location of one of the intervention devices since the last phone contact

Time frame: Postoperative day 21

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Active Pulsed Shortwave Treatment With BioElectronics Model 088Device Location Changes0 Participants
Sham TreatmentDevice Location Changes0 Participants
Secondary

Device Location Changes

If a patient moves the anatomic location of one of the intervention devices since the last phone contact

Time frame: Postoperative day 28

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Active Pulsed Shortwave Treatment With BioElectronics Model 088Device Location Changes0 Participants
Sham TreatmentDevice Location Changes0 Participants
Secondary

Hospitalization Duration Measured in Days

Day relative to the day of surgery that patient was discharged from the hospital (e.g., same day is postoperative day 0, while the day following surgery is postoperative day 1) over the first postoperative week. The surgical service determines when patients are to be discharged using their own criteria which are not defined by the study.

Time frame: One single measure recorded on or following the day of surgery (whichever day patient is discharged)

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Hospitalization Duration Measured in Days.3 DaysStandard Deviation 0.5
Sham TreatmentHospitalization Duration Measured in Days.3 DaysStandard Deviation 0.5
Secondary

LEAST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 14

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088LEAST Pain Measured With the Numeric Rating Scale.6 score on a scaleStandard Deviation 1.2
Sham TreatmentLEAST Pain Measured With the Numeric Rating Scale.4 score on a scaleStandard Deviation 1.2
Secondary

LEAST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088LEAST Pain Measured With the Numeric Rating Scale.7 score on a scaleStandard Deviation 1.6
Sham TreatmentLEAST Pain Measured With the Numeric Rating Scale.9 score on a scaleStandard Deviation 1.6
Secondary

LEAST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 28

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088LEAST Pain Measured With the Numeric Rating Scale.3 score on a scaleStandard Deviation 0.8
Sham TreatmentLEAST Pain Measured With the Numeric Rating Scale.2 score on a scaleStandard Deviation 0.8
Secondary

LEAST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 21

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088LEAST Pain Measured With the Numeric Rating Scale.5 score on a scaleStandard Deviation 1.2
Sham TreatmentLEAST Pain Measured With the Numeric Rating Scale.3 score on a scaleStandard Deviation 1.1
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 3

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)1.1 mgStandard Deviation 1.8
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)1.1 mgStandard Deviation 2.2
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 2

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)1.4 mgStandard Deviation 1.7
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)1 mgStandard Deviation 1.4
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 1

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)1.3 mgStandard Deviation 1.7
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)1 mgStandard Deviation 1.3
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 180

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)0 mgStandard Deviation 0
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)0 mgStandard Deviation 0
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 28

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).2 mgStandard Deviation 0.9
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).1 mgStandard Deviation 0.4
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 21

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).1 mgStandard Deviation 0.4
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).2 mgStandard Deviation 0.7
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 14

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).4 mgStandard Deviation 0.9
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).3 mgStandard Deviation 0.9
Secondary

Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents)

Opioid consumption of the previous 24 hours (measured in oral oxycodone equivalents)

Time frame: postoperative day 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088Opioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).5 mgStandard Deviation 0.9
Sham TreatmentOpioid Consumption of the Previous 24 Hours (Measured in Oral Oxycodone Equivalents).7 mgStandard Deviation 1.5
Secondary

Passive Flexion (Knee and Hip Arthroplasty Patients Only)

The number of degrees of passive flexion achieved from a neutral position

Time frame: One measure take at the two-week postoperative check (approximately postoperative day 14)

Population: This data point was not able to be collected as participants did not return to the surgeon's office for measurement at 14 days as originally anticipated

Secondary

Surgical Duration

The time from surgical start to surgical stop measured in minutes and hours

Time frame: Intraoperative (within the operating room)

Population: This variable was miscatagorized as an outcome measure, when it was measured PRIOR to randomization following surgery. Therefore, it is captured and reported in the baseline measurements as surgical duration.

Secondary

Surgical Start as Recorded Using Military Time Format

The time of the surgical incision as recorded using military time format

Time frame: Intraoperative (within the operating room)

Population: This variable was miscatagorized as an outcome measure, when it was measured PRIOR to randomization following surgery. Therefore, it is captured and reported in the baseline measurements as surgical duration.

Secondary

Surgical Stop as Recorded Using Military Time Format

The time of the final suture insertion as recorded using military time format

Time frame: Intraoperative (within the operating room)

Population: This variable was miscatagorized as an outcome measure, when it was measured PRIOR to randomization following surgery. Therefore, it is captured and reported in the baseline measurements as surgical duration.

Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 1

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale5.1 score on a scaleStandard Deviation 2.1
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale5.6 score on a scaleStandard Deviation 2.4
Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 21

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale1.6 score on a scaleStandard Deviation 2.4
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale1.4 score on a scaleStandard Deviation 2
Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 14

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale2.5 score on a scaleStandard Deviation 2.6
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale1.9 score on a scaleStandard Deviation 2.2
Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 3

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale4.3 score on a scaleStandard Deviation 2.7
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale4.6 score on a scaleStandard Deviation 2.7
Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 7

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale3.6 score on a scaleStandard Deviation 2.6
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale3.3 score on a scaleStandard Deviation 2.9
Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 2

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale5.2 score on a scaleStandard Deviation 2.4
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale5.7 score on a scaleStandard Deviation 2.6
Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 180

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale.3 score on a scaleStandard Deviation 1.1
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale.4 score on a scaleStandard Deviation 1.1
Secondary

WORST Pain Measured With the Numeric Rating Scale

The numeric rating scale is a 0-10 Likert scale measuring pain level with 0 = no pain and 10 = worst imaginable pain scale.

Time frame: postoperative day 28

ArmMeasureValue (MEAN)Dispersion
Active Pulsed Shortwave Treatment With BioElectronics Model 088WORST Pain Measured With the Numeric Rating Scale1.3 score on a scaleStandard Deviation 2.1
Sham TreatmentWORST Pain Measured With the Numeric Rating Scale1.2 score on a scaleStandard Deviation 1.9

Source: ClinicalTrials.gov ยท Data processed: Feb 4, 2026