Math 1030 OERMagnets and Pain Relief Statistical Project Is it possible that magnetic fields can reduce pain? A fascinating study by Dr. Carlos Vallbona suggests it is. Background Magnetic fields have been shown to have an effect on living tissue as early as the 1930's. Plants have been shown to have an improved growth rate when raised in a magnetic field (Mericle et al., 1964). More recently, doctors and physical therapists have used either static or fluctuating magnetic fields to aid in pain management, most commonly for broken bones. In the case study presented here, Carlos Vallbona and his colleagues sought to answer the question "Can the chronic pain experienced by postpolio patients be relieved by magnetic fields applied directly over an identified pain trigger point?" Mericle, R. P. et al. "Plant Growth Responses" in: Biological effects of magnetic fields. New York: Plenium Press 1964. pp 183-195. Vallbona, Carlos et. al., "Response of pain to static Magnetic fields in postpolio patients, a double blind Pilot study" Archives of Physical Medicine and Rehabilitation. Nov. 1997, Vol 78, American congress of rehabilitation medicine, pp 1200-1203. Experimental Design Summary Fifty patients experiencing post-polio pain syndrome were recruited from the postpolio clinic of a large rehabilitation hospital. Some of the patients were treated with an active magnetic device and the rest were treated with an inactive device. All patients rated their pain before and after application of the device Details The experimenters recruited patients who not only had post-polio syndrome but also reported muscular or arthritic pain. These patients had significant pain for at least 4 weeks and had not taken any painkillers or anti-inflammatories for at least 3 hours before the study. The subjects all had a trigger point or painful region and had a body weight of less than 140% of the predicted weight for their age and height, and had a trigger point or circumscribed painful area. Seventy active static magnets and seventy identical inactive devices used as placebos were supplied by BIOflex® Medical Magnets in Canada. Each magnet or placebo was placed in number coded envelopes and delivered according to its shape. This was a double-blind study so the code for placebos and magnets was not broken until the end of the study. One site of reported pain was evaluated and a trigger point for this pain was found by palpitation. The patient was asked to subjectively grade pain at the trigger point under palpitation on a scale from 0 to 10 – 0 representing no pain, increasing to a maximum pain of 10. Following the initial pain assessment, an envelope containing a device was randomly selected from the box containing both active and inactive devices. This device was applied to the pain area for 45 minutes and then removed. The patient then evaluated his or her pain again at the region or trigger point. This second pain rating was then scored. Data Active Magnets Placebos Pre Post Change Pre Post Change 10 0 10 8 4 4 10 4 6 10 7 3 8 7 1 10 5 5 10 0 10 10 8 2 10 4 6 9 8 1 10 2 8 10 6 4 10 5 5 9 8 1 10 5 5 10 10 0 9 3 6 10 10 0 10 2 8 7 6 1 9 2 7 10 10 0 10 2 8 8 8 0 10 3 7 10 10 0 10 5 5 10 10 0 10 6 4 10 10 0 8 4 4 10 10 0 10 3 7 9 9 0 10 0 10 10 9 1 8 2 6 10 10 0 10 0 10 10 10 0 10 4 6 10 9 1 9 4 5 10 5 5 10 9 1 10 10 0 10 10 0 10 10 0 10 10 0 8 7 1 The data for the posttest are compared as followed: Active Magnet: mean = 4.41 . Placebo: mean = 8.43 . range = 10 . range = 6 . 0.40 0.30 frequency relative 0.20 Frequency active 0.10 Bin Frequency 0 1 2 3 4 5 6 7 8 9 10 0.00 placebo 0 1 2 3 4 5 6 7 8 9 ,10 Reported Pain The mean of the active magnets is 48% less than the mean of the placebos, and the range of the active magnets is 67% greater than placebos’ range. The histogram of the placebos is very skewed showing a lot of pain is still reported, while the histogram of the active magnets is more uniform. More than three-fourths of the active magnet scores are less than three-fourths of the placebos’ pain scores. Math 1030 Magnets & Pain Relief Name ______Jake Becker______ 1. Use the calculations below to compare the mean, range, and distribution (graphing both a double histogram using relative frequency and box plots) of the pretest for the active magnet group and the placebo group. 1a. Calculations: Placebo: mean = 9.62 Active Magnet: mean = 9.52 range = 2 range = 3 1b. Written Answer: [Write answer for #1 here - Both of these groups are fairly similar. The Pretest Active has a slightly higher mean, and the Pretest Placebo’s range is only 1 more than Pretest Active. You can see how both of these pretest groups parallel each other based upon their representation in the Relative Frequency Graph: Pain threshold of 10 is 76% for Pretest Active and 71% for Pretest Placebo, and both box graphs mimic each other well, aside from the increased distance between min. and Q1, which is represented this way because of Pretest Placebo having a bigger range. This congruency of pretest groups allows for a more accurate depiction of how the variable(active magnet) will affect those being studied. 2. Calculate the “pain relief,” i.e. the change between the initial pain and that reported after the treatment. 2a. Calculations Placebo: mean = 1.09 Active Magnet: mean = 5.2 range = 5 range = 10 2b. Written Answer The difference in change was calculated using relative frequency. This calculation allowed for me to see the change for both Active Change and Placebo Change, and also allowed for me to compare those changes within each group and between both groups. The outcomes are soundly different than the graphing comparison of Pretest Pain. Placebo Change for example, has most of its patients reporting 0 change in pain after undergoing treatment(52%), and only 25% reported having their pain reduced by at least 2. Whereas Active Change had more balanced reporting. 24% reported having their pain reduced by 8 or more, and 24% also reported having their pain reduced by 1 or less. The rest of the patients reported having their pain decrease somewhat by either 4-7. These outcomes showcase how the placebo effect didn't really augment the findings of this data, and while some patients in the Active Change group didn't feel a change in their pain—there is still evidence showing that some patients were positively affected by the magnets. Written Response On the surface, this study and the statistics supporting it show that magnets do have some affect on pain relief. The main support for this, however, doesn't come from the group who was assigned the magnetic therapy, but rather the placebo group. Why I believe this is the case is because of how many patients who did not receive magnet therapy reported having no reduction of pain(52%) and for the magnet therapy it was only 14%. This accompanied with only 14% of the patients in the magnet therapy group reporting complete reduction of pain leaves the question of if the magnetic therapy has effective application. Overall, those who were exposed to magnet therapy reported satisfactory change in pain(5-10 change(68%), but does this mean that magnet therapy is beneficial? How I would test this idea further is by allowing for the placebo group to undergo magnetic therapy. This experimentation would allow for those conducting the study to see if magnetic therapy affected the 75% of people who experienced no change of pain. This would then allow for the experimenters to see if magnetic therapy has consistency in at least reducing some pain. I would then compare the overall change in pain for those who used magnetic therapy to those who have used other means of pain reduction. Using the same measuring parameters, we could then find which pain reduction therapy has a great effect. The benefits of using these tools is that it allows for a quantitative representation of things that can’t be easily quantified. This also means that one must be diligent in looking at ways to update the methodology as well as finding ways to test the outcome for further clarification. I also think that the visual aspect of showcasing data allows for humans to pick up on similarities as well as difference, and this(especially in presentations) can allow for a better understanding a clarity to take place. Overall, I think using statistics is viable, but I do think also that one can easily abuse the interpretation of data or the methodology used in conducting experiments. Therefore, if one is going to be able to participate in this process effectively, they need to be constantly checking their controls and variables, in order to make sure that the data and results are as accurate as possible.