1. Keith R. Holden, M.D. Resonance Center Jacksonville Beach, FL www.ResonanceCenterJax.com

2.  Integrative Biophysics.  Pulsed Electromagnetic Field (PEMF) Therapy as an instrument of integrative biophysics. ◦ Biomolecular effects. ◦ Epigenetic effects. ◦ Cellular physiologic effects.

3. ◦ Optimal tissue frequencies. ◦ Proof of efficacy via peer reviewed studies, including RDBPC clinical trials. ◦ Ondamed® as a powerful instrument of integrative biophysics.

4.  Holistic integration of quantum energetic, molecular, biochemical, and physiologic processes.

5.  Reflects the web-like interconnectedness of all biologic systems within the body and that of the body with its environment.

6.  Honors energetic and biochemical individuality.

7.  PEMF = instrument for integrative biophysics.

8. ◦ Larmor Precession Model  External pulsed electromagnetic field matches the (Larmor) spin frequency of hydrogen atom causing energized electrons to emit a photon, which act as a vital energy carrier for tissue repair.  Ion/ligand binding at cell membrane.  Alters cascade of biological processes for tissue growth and repair.

9.  Amplification of the tissue repair field (current of injury).

10. ◦ Upregulation of genes involved in normal cell growth. (Goodwin, 2003)

11.  Increases osteoblast intracellular calcium & alters response to epidermal growth factor. (Shigaku,1990)  Stimulates production of type-I collagen, osteocalcin, & osteopontin. (Cornaglia, et al., 2006)  Antiinflammatory effect via restoration of plasma membrane calcium ATPase activity. (Selvam, et al., 2007)

12.  Nerve‐2 Hz  Bone‐75 Hz  Ligament‐10 Hz  Capillaries and skin‐15 Hz (Sisken, et al., 1995) (Shupak, 2003)

13.  Fracture non-union – 65-75Hz  Congenital pseudoarthrosis – 15Hz  Osteoporosis – 72Hz  Hip arthroplasty – 50Hz  Arthritis – 50Hz  Tinnitus – 0.5-17Hz  Rotator Cuff Tendonitis – 71-75Hz  Venous skin ulcers – 75Hz  Multiple sclerosis – 4-13Hz (Shupak, 2003)

14. Randomized, Double Blind, Placebo Controlled

15.  Randomized double blind placebo controlled (RDBPC) clinical trial.  PEMF 3X a week for 3 weeks for chronic lower back pain.  Significant reduction in pain and disability over placebo. (Lee, 2006)

16.  RDBPC clinical trial.  Chronic generalized pain from fibromyalgia or chronic localized musculoskeletal pain.  PEMF twice daily 40 min. for 7 days.  PEMF effect over sham for fibromyalgia approached statistical significance. (Thomas, et al., 2007)

17.  RDBPC clinical trial.  PEMF 30 min. 2X a day for 3 weeks.  Neck pain, PVMS, and disability scale scores decreased, and AROM increased significantly in the PEMF group.  No change in the sham group. (Sutbeyaz, et al., 2006)

18.  RDBPC clinical trial.  86 patients with OA of knee.  81 patients with OA of cervical spine.  Statistically significant improvement in treated patients for pain and ADLs at end of treatment and at one month follow up. (Trock, et al.,1994)

19.  RDBPC clinical trial.  Group I (PEMF), Group II (sham PEMF), Group III (corticosteroid + anesthestic inj.)  Group III had lower pain than Group I and Group II at third week.  Group I (PEMF) patients had lower pain than Groups II and III at third month. (Uzunca, et al., 2007)

20.  RDBPC clinical trial.  Preclinical studies show that PEMF limits catabolic effects of pro-inflammatory cytokines on articular cartilage.  PEMF 75 Hz 4 hours per day for 60 days.  Functional recovery occurs earlier with PEMF group. (Benazzo, et al., 2008)

21.  RDBPC clinical trial.  PEMF 30 min. twice a day for 3 weeks.  At 12 weeks follow up, PEMF group showed significant improvements in pain compared to sham PEMF. (Sutbeyaz, et al., 2009)

22.  RDBPC clinical trial.  PEMF for 90 days 6 hours per day.  PEMF group statistically significant improvement at 90 days.  NSAID use – PEMF (26%) & sham (75%).  3 year follow up, number of patients who completely recovered was higher in PEMF. (Zorzi, et al., 2007)

23.  RDBPC clinical trial.  PEMF 4 weeks.  Assessed MSQLI- fatigue, bladder control, spasticity, & QOL composite.  Statistically significant improvement in fatigue & QOL; none bladder control; mixed spasticity. (Lappin, et al., 2003)

24.  RDBPC clinical trial.  PEMF 84 sessions for 30 min.  WOMAC index dec. 84.1 to 49.7 in PEMF and 73.7 to 66.9 in sham.  Secondary parameters improved over sham – gait speed, stride length, & acceleration time. (Nicolakis, et al., 2002)

25.  RDBPC clinical trial.  Active group – 92% success rate.  Sham group – 65% success rate. (Mooney, 1990)

26.  RDBPC clinical trial.  Refractory rotator cuff tendinitis.  PEMF showed significant improvement over sham during the first four weeks.  No significant difference between groups when both received PEMF.  End of study – 65% were asymptomatic. (Binder, 1984)

27. CONDITIONFDA APPROVEDSUCCESS RATE Fracture nonunionYes75-95% Failed joint fusionsYes85-90% Spinal fusionsYes90-95% Congenital pseudoarthrosis Yes70-80% Osteonecrosis (hip)No80-100% Osteochondritis dessicans No85-90% OsteoporosisNo85-90% Chronic tendinitisNo85-90% Chronic skin ulcersNo85-90%

28. Bassett, CA, Beneficial Effects of Electromagnetic Fields. J of Cell Biochemistry. 1993; 51:387-393.

29.  T mineralization  T angiogenesis  T collagen + GAG production  Endochondral ossification  (T osteoclasis for pseudoarthrosis)

30.  T angiogenesis  T osteoblastic activity

31.  T angiogenesis  T collagen + GAG production

32. Bassett, CA, Beneficial Effects of Electromagnetic Fields. J of Cell Biochemistry. 1993; 51:387-393.

33.  Animal data showing decrease in infarct size.  Acute affects on blood flow and angiogenesis.  Questionable effect on superoxide dismutase and nitrous oxide.

34.  Animal data demonstrate decreased growth and invasiveness of Meth A sarcoma in Balb C mice, encapsulation and nuclear changes.

35.  Animal data show decrease in bone resorption in jaws.  Increased osteogenesis in tooth extraction sockets.  Improved bacterial flora spectrum.

36.  Clinical benefits on blood glucose reported.  ? Secondary to Ca ++ effects on insulin secretion.

37.  Effects on axoplasmic transport.  Neuronal protein synthesis.  Ca ++ /neurotransmitter effects at synapse.  Angiogenesis.

38.  Animal data showing improved healing.  Increased collagen and GAG synthesis.  Increased angiogenesis.

39.  Animal data showing increased protein synthesis.  Increased axon migration and function.

40.  No direct evidence.  Data on neuropathy and nerve transection may prove beneficial.  Particularly in crush injuries when sensory and motor potential evoked potentials are still present.

41.  An integrative biophysics instrument that changes the energetic terrain.  Positive affects on biologic systems with low level specific pulsed electromagnetic frequencies.  Specific frequencies via pulse testing provide intelligent information.

42.  Bassett, CA. Beneficial Effects of Electromagnetic Fields. J of Cell Biochemistry. 1993; 51:387-393.  Holden, K. Pulsed Electromagnetic Field Therapy With the Ondamed – A Tool for Integrative Biophysics. http://www.ondamed.net/web/publications/article s.html. 2009.  Shupak, N. Therapeutic Uses of Pulsed Magentic- Field Exposure: A Review. The Radio Science Bulletin. 2003 Dec; (307): 9-32.

43. Keith R. Holden, M.D. Resonance Center 496 Osceola Avenue Jacksonville Beach, FL 32250 (904) 694-0378 krholden@gmail.com www.ResonanceCenterJax.com