4. Discussion
musculoskeletal pain, chronic musculoskeletal pain, pain
MUSCULOSKELETAL DISORDERS
In the current study, we investigated the influence of a single session of PEMFs stimulation using PAPIMI device on modulating ANS activity in patients with chronic musculoskeletal pain. An HRV analysis was employed in order to detect changes in vagal tone after the intervention.Our results showed that all values of time-domain parameters and HF component of HRV significantly increased following PAP treatment, indicating that PAPIMI device modulated ANS activity by inducing a parasympathetic response. In contrast, no significant differences in all HRV indices were found following the SHAM-PAP intervention.In clinical practice, PEMFs are widely used as a safe and non-pharmacologic intervention for the treatment of musculoskeletal disorders [Among PEMFs, PAPIMI inductor represents a promising ion magnetic field device which has proven to help restore health status in subjects with pathological conditions [Our findings shed light on the effectiveness of PAPIMI device in inducing a health status-related parasympathetic response, as indirectly shown by an increased HRV, in patients with chronic musculoskeletal pain. A possible hypothesis that could explain such effect is related to the influence PEMFs have on the membrane potential of body cells [Finally, this is the first study investigating the influence of PAPIMI device on the ANS activity in patients with chronic musculoskeletal pain. Taking into account the low risk of side effects and the high tolerance of PEMFs intervention, findings from our pilot study indicate that PAPIMI inductor could be considered a potentially promising device in clinical practice for the treatment and management of chronic musculoskeletal pain, thus further contributing to improvements in patient health status. To the best of our knowledge, in the literature, only two studies have explored the effects of PAPIMI inductor in human subjects [Some limitations concerning the present pilot study should be addressed. First, the number of participants remains relatively small. Second, a comparison with a control group of healthy subjects was not planned for this study. Future non-pilot studies should preferably include a larger patient sample and a group of healthy individuals as well. Third, we did not provide an evaluation of subjects’ feeling of well-being or pain perception that could provide information on the responsiveness of patients to PAPIMI intervention. Nevertheless, it is worth mentioning that the analysis of the cardiovascular autonomic control seems to be more sensitive than a self-reported measure of pain for estimating the effectiveness of a non-pharmacological treatment in patients with musculoskeletal pain [Future studies exploring the effect of PAP treatment in subjects with chronic musculoskeletal pain should be carried out with a longer intervention period [