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Multiple sclerosis (MS) is an inflammatory disease that affects the brain and spinal cord. There are potential impacts on neurological functions, including sensory and autonomic functions. The Primary observed in males with MS is erectile dysfunction (ED), which substantially impacts the quality of life. There is increasing literature on electromagnetic fields' biological and clinical effects, particularly on ED.
The study aims to examine the bio-electromagnetic energy regulation therapy (BEMER) on erectile dysfunction with MS. We will recruit participants with MS having ED in a Triple-blind randomized clinical trial study. All participants will be randomly assigned to either an experimental group (receive the BEMER therapy) or a comparison group (receive placebo BEMER therapy) for five days/week for three weeks. Participants will also receive pelvic floor exercises in both groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group | Experimental | (BEMER activated) |
|
| Comparison group | Placebo Comparator | (BEMER deactivated) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bio-electromagnetic energy regulation therapy (BEMER) machine model type: B.BOX CLASSIC, model NO: 420100, 12-15 Volt, (BEMER Int.AG, Liechtenstein product). | Device | The experimental group (receive the BEMER therapy) for five sessions/week for three weeks. Plus, pelvic floor exercise. |
| Measure | Description | Time Frame |
|---|---|---|
| International Index of Erectile Function - Erectile Function (IIEF-EF) | International Index of Erectile Function Erectile Function domain (IIEF-EF domain score) this means only questions 1, 2, 3, 4, 5, and 15 of IIEF-15. | Change from Baseline Erectile Function at 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The Arizona Sexual Experience (ASEX) Scale | The ASEX was designed to assess five significant aspects of sexual dysfunction: drive, arousal, penile erection/vaginal lubrication, capability to achieve orgasm, and orgasmic satisfaction. Items are measured on a 6-point scale (1-6), with higher scores reflecting impaired sexual function. This scale allows for quick detection of sexual dysfunction. Sexual dysfunction was defined as one ASEX total score of ≥19, 2, any one item with a score of 5 or 3, or any three items with a score of ≥4 |
| Measure | Description | Time Frame |
|---|---|---|
| Erection Hardness Scale (EHS) | The EHS is used to rate the hardness of a penile erection. The patient will be asked: How would you rate the hardness of your erection? EHS has a 5-point Likert scale from 0 (penis does not enlarge) to 5 (the penis is completely hard and fully rigid) | Within immediately of completion of the 3-week intervention period. |
Inclusion Criteria:
Exclusion Criteria:
Adult men (18-40 years old)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Abdulaziz A Alzahrani, PhDcandidate | Contact | +966500324592 | 2210700007@iau.edu.sa | |
| Ali M Alshami, Assoc Prof | Contact | +966552225548 | alshami@iau.edu.sa |
| Name | Affiliation | Role |
|---|---|---|
| Abdulaziz A Alzahrani, PhDcandidate | imam abdurhman bin faisal | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ali Muteb Alshami | Recruiting | Dammam | 31451 | Saudi Arabia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33966564 | Background | Abdulla FA, Albagmi FM, Al-Khamis FA. Factors that influence quality of life in patients with multiple sclerosis in Saudi Arabia. Disabil Rehabil. 2022 Aug;44(17):4775-4783. doi: 10.1080/09638288.2021.1919929. Epub 2021 May 9. | |
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The intervention will be provided by a treating therapist who has a clinical experience of more than 13 years. The intervention for both groups will be for three consecutive weeks, five days per week (a total of 15 sessions)
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The randomization sequence uses an online https://www.randomizer.org// procedure by an independent person not involved in the study. Matching is done using sequentially numbered, concealed opaque envelopes (SNOSE) for equal distribution of subjects between both therapies (Doig & Simpson, 2005). An independent assessor will assess eligibility by following the inclusion and exclusion criteria for treatment allocation. Then he will collect primary demographic data and conduct all outcome measurements pre-and post-treatment. If the participant is eligible, he chooses a sealed envelope placed in a box and goes to the treating therapist. The treating therapist will be blind to outcome measurements. The participants will be blind to the type of treatment, and the independent assessor will be blind to the participants' group.
|
| placebo BEMER | Device | Comparison group (receive placebo BEMER therapy) for five sessions/week for three weeks. Plus, pelvic floor exercise. |
|
| Within immediately of completion of the 3-week intervention period. |
| Modified Fatigue Impact Scale (MFIS) | The MFIS is a 21-item, multidimensional questionnaire that collects information about the effects of physical (9-item), psychosocial (2-item), and cognition (10-item) fatigue over the past four weeks. Participants ranked the 21 items on a 5-point Likert scale with anchors of never (0) and always (4). The optimal cutoff scores of the overall MFIS-A, physical/social, and cognitive subscales indicative of fatigue are 35.5, 18.5, and 15.5, respectively. Changes of 14.68 points or more may indicate a clinically significant change in fatigue in multiple sclerosis patients. | Within immediately of completion of the 3-week intervention period. |
| The Multiple Sclerosis, Intimacy, and Sexuality Questionnaire (MSISQ-19) | The MSISQ-19 is the most accurate and widely used tool for exploring the impact of MS on sexual function, assessing all aspects of sexual life and all three levels of sexual dysfunction (Domingo et al., 2018). It is a 19-item self-report questionnaire assessing the effect of MS symptoms on sexual activity and general sexual satisfaction during the previous six months (Carotenuto et al., 2021). Each item is scored on a Likert scale (1=never, 2=rarely, 3=sometimes, 4=often, and 5=always). In addition to the overall score, the MSISQ-19 provides scores on three different subscales: primary sexual dysfunction (calculated by items 12, 16, 17, 18, and 19) , Secondary sexual dysfunction (calculated by items 1, 2, 3, 4, 5, 6, 8, 10, and 11) and tertiary sexual dysfunction (described by items 7, 9, 13, 14, and 15) (Carotenuto et al., 2021) | Within immediately of completion of the 3-week intervention period. |
| Imam Abdulrahman Bin Faisal University | Recruiting | Dammam | 31451 | Saudi Arabia |
|
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| ID | Term |
|---|---|
| D020529 | Multiple Sclerosis, Relapsing-Remitting |
| D007172 | Erectile Dysfunction |
| D009103 | Multiple Sclerosis |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D012735 | Sexual Dysfunction, Physiological |
| D052801 | Male Urogenital Diseases |
| D020018 | Sexual Dysfunctions, Psychological |
| D001523 | Mental Disorders |
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