The Effects of 12 Weeks of Pulsed Magnetic Therapy and Multicomponent Exercise on Bone Markers and Serum Concentration of Sclerostin in Type 2 Diabetic Patients with Osteoporosis

Abstract

Background: The current study aimed to ascertain the impact of pulsed magnetic therapy, multicomponent exercise, and a combination of both modalities on bone markers type 2 diabetic patients with osteoporotic. Methods: In a randomized controlled clinical trial study, 56 older patients with type 2 diabetic osteoporosis (age: 68.18±3.67 yr; weight: 78.13±7.65 kg, body mass index: 28.40±1.76 kg/m2) were randomly assigned to either the multicomponent exercise + Full-body pulsed electromagnetic field (MCEx+PEMF, n= 18) multicomponent exercise + placebo full-body PEMF (MCEx+PPEMF, n=17) and a full-body PEMF alone (PEMF, n= 21). PEMF was applied for the whole body using a full-body mat three times per week, 60 minutes for 12 weeks, with a multicomponent exercise protocol that includes flexibility, aerobic exercise, strengthening, weight-bearing, and balance exercises followed by whole-body vibration (WBV) training. The body composition, bone mineral density (BMD), bone metabolism markers (phosphorus, calcium, sclerostin, osteocalcin, Bone-specific alkaline phosphatase (BALP)) before and after the intervention. The data were analyzed using the dependent t test and the two-way repeated measures ANOVA at the level of less than 0.05. Results: After 12 weeks of intervention, there is a significant difference in the serum levels of bone mineral density and bone metabolism markers (phosphorus, calcium, sclerostin, BALP) between the groups (P< 0.05). However, the bonferoni post-test showed an increase in serum levels of BMD, phosphorus, sclerostin, BALP with a significant decrease in calcium in the MCEx+PEMF group in compared to alone PEMF group. Conclusion: The findings showed that the PEMF rehabilitation method combined with multicomponent exercise is more effective and safer than exercise or PEMF only for improving BMD and bone metabolism markers in the type 2 diabetic population with osteoporosis. Therefore, exercise rehabilitation clinics should be encouraged to consider exercise rehabilitation as a treatment method for type 2 diabetic patients with osteoporosis. More studies with long-term follow-up should be considered to confirm these findings. © 2025 Iranian Journal of Diabetes and Metabolism and Tehran University of Medical Sciences.