A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Electrotherapy

Simple Summary Numerous electrotherapeutic methods are commonly used in complementary and alternative veterinary medicine, as well as in conventional veterinary medicine. In these methods, electrical currents are commonly used to affect nerves, muscles, bones, or other tissues. In a systematic literature review, we collected information from published articles on electrotherapies used in horses, dogs, and cats. After screening 5385 articles of potential interest, we identified 41 articles that contributed to answering the overriding question: What is the scientific evidence for electrotherapy in horses, dogs, and cats? For most of the therapies, the number of studies was low with small numbers of animals. Many of the studies were of insufficient scientific quality and the electrotherapy was applied in many different clinical conditions and therapeutic settings. This made it difficult to reach robust conclusions, except for one: no current electrotherapies have sufficiently strong scientific evidence to support clinical effects in the treatment of horses, dogs, or cats with conditions affecting muscles, joints, nerves, or bones. Based on limited promising results, we have listed some electrotherapies that could be evaluated in more detail in high-quality studies. Electrotherapy modalities are currently used in the treatment of animals, but the evidence base supporting their use has not yet been systematically reviewed. Cochrane guidelines, as adapted by the Swedish Agency for Health Technology Assessment and Assessment of Social Services, were followed for this systematic review. A literature search regarding all currently known electrotherapy modalities applied to horses, dogs, and cats was conducted for the years 1980-2020 using three databases: CABI, PubMed, and Web of Science Core Collection. Of the 5385 references found, 41 articles were included in the review: 13 papers on pulsed electromagnetic field therapy (PEMFT), 7 on neural electrical muscle stimulation (NEMS), 5 on transcutaneous electrical nerve stimulation (TENS), 4 on static magnets, 3 on interference, 2 each on percutaneous electrical neural stimulation (PENS), bioelectricity, and diathermy, and 1 each on micro-pulsed stimulation, capacitive coupled electrical stimulation, and microwave therapy. The literature per modality was limited in quantity (mean 3.7 papers). Half of the articles were assessed to have a high risk of bias (20 high, 7 moderate, and 14 low). The existing literature used a spectrum of indications and treatment parameters, which makes comparisons and drawing conclusions to support the use of these modalities in clinical practice challenging. The current scientific evidence is not sufficient to support the clinical effects of electrotherapies for any clinical indication in horses, dogs or cats. The selected suggestive results warrant further high-quality research on PEMFT, NEMS, TENS, and PENS