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de la Barra Ortiz HA, Arias M, Liebano RE. A systematic review and meta-analysis of randomized controlled trials on the effectiveness of high-intensity laser therapy in the management of neck pain. Lasers Med Sci 2024; 39:124. [PMID: 38709332 DOI: 10.1007/s10103-024-04069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Abstract
The purpose of this systematic review was to evaluate the effects of high-intensity laser therapy (HILT) on pain, disability, and range of movement in patients with neck pain. Randomized controlled trials (RCTs) of HILT for neck pain disorders were searched across databases such as PubMed, Web of Science, Scopus, CINAHL, Science Direct, Cochrane Library, the PEDro database, and Google Scholar (updated January 7, 2024). The main outcome was pain intensity, with neck disability and cervical range of motion as secondary outcomes. Researchers reviewed article titles and abstracts from different databases using the Rayyan web app. Study quality was assessed using the Cochrane risk of bias tool, and evidence-based recommendations were developed using the GRADE approach. A meta-analysis was conducted to calculate the pooled effect in terms of mean differences (MD) for the outcomes of interest, along with a 95% confidence interval (95% CI). Twenty studies met the selection criteria and were potentially eligible for inclusion in the meta-analysis. At the end of the treatment, there was a statistically significant (p < 0.01) pooled MD of -14.1 mm for pain intensity (17 RCTs) with the VAS (95% CI:-18.4,-9.7), 3.9° (95% CI:1.9,6.7) for cervical extension (9 RCTs), and -8.3% (95% CI:-14.1,-4.1) for disability diminish (12 RCTs) with the neck disability index in favor of HILT. Only the results for pain intensity are in line with the minimal clinically important differences (MCID) reported in the literature. Overall, the evidence was deemed significant but with low certainty, attributed to observed heterogeneity and some risk of bias among the RCTs. HILT demonstrates effectiveness in reducing neck pain and disability while enhancing cervical extension when added to other physical therapy interventions, especially therapeutic exercise, based on a moderate level of evidence. This review highlights that the most favorable results are obtained when HILT is employed to address myofascial pain, cervical radiculopathy and chronic neck pain.PROSPERO registration number: CRD42023387394 (Registration date, 14/01/2023).
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Affiliation(s)
- Hernán Andrés de la Barra Ortiz
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Avenida Fernández Concha 700, 7591538, Las Condes, Santiago de Chile, Chile.
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil.
| | - Mariana Arias
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil
| | - Richard Eloin Liebano
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
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Ko PY, Hsu CC, Chen SY, Li CL, Jou IM, Wu PT. The Pulsed Nd:YAG Laser Therapy Enhanced Nerve Regeneration via Apoptosis Inhibition in a Rat Crushed Sciatic Nerve Model. Neurochem Res 2024; 49:949-958. [PMID: 38157112 DOI: 10.1007/s11064-023-04068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/28/2023] [Accepted: 11/14/2023] [Indexed: 01/03/2024]
Abstract
The study was aimed to validate the efficacy of the pulsed Nd:YAG laser on nerve regeneration in a rat sciatic nerve crushed model. 54 Wistar rats were randomly assigned into three groups: shame control, crush control, and laser treated group. For the laser treated group, the pulsed Nd:YAG laser (10 Hz) with 350 mJ per pulse in energy density and 50 J/cm2 in fluence was applied extracorporeally at the lesion site for 12 min to daily deliver 500 J immediately and consecutive 9 days following the crush injury. At week 1, the apoptosis-related activities in the injured nerve were examined (n = 8/each group). The sciatic functional index (SFI) was measured preoperatively and weekly until 4 weeks after the index procedure. The injured nerve and the innervated gastrocnemius muscle histology were assessed at week 4 (n = 10/each group). At week 1, the laser group showed the significant less TUNEL-positive ratio (P < 0.05), and the lower expression of cleaved caspase3/procaspase-3 and beclin-2/beclin-2-associated protein X ratios compared with the crush control. Furthermore, the laser group revealed significantly better SFI since week 1 and throughout the study (P < 0.05, all) compared with the crush control. At week 4, the laser group showed significantly higher axon density, lower myelin g-ratio, and the corresponding higher glycogen expression (P < 0.05, all) in the gastrocnemius muscle compared with those in the crush control. The pulsed Nd:YAG might enhance the injured nerve regeneration via apoptosis inhibition.
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Affiliation(s)
- Po-Yen Ko
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1 University Road, East District, Tainan, 701, Taiwan
| | - Che-Chia Hsu
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1 University Road, East District, Tainan, 701, Taiwan
| | - Shih-Yao Chen
- Department of Nursing, College of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Chia-Lung Li
- Department of Orthopedics, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - I-Ming Jou
- Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- GEG Orthopedic Clinic, Tainan, Taiwan
| | - Po-Ting Wu
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 1 University Road, East District, Tainan, 701, Taiwan.
- Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Medical Device Innovation Center, National Cheng Kung University, Tainan, 70101, Taiwan.
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Liu C, Wang Y, Yu W, Xiang J, Ding G, Liu W. Comparative effectiveness of noninvasive therapeutic interventions for myofascial pain syndrome: a network meta-analysis of randomized controlled trials. Int J Surg 2024; 110:1099-1112. [PMID: 37939115 PMCID: PMC10871620 DOI: 10.1097/js9.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Myofascial pain syndrome (MPS) has an impact on physical health and quality of life for patients, with various noninvasive methods used for relieving myofascial pain. The authors aimed to compare the effectiveness of different noninvasive therapeutic interventions for MPS. MATERIALS AND METHODS The authors searched PubMed, Embase, CINAHL Complete, Web of Science, Cochrane, and Scopus to identify randomized controlled trials describing the effects of any noninvasive treatments in patients with MPS. The primary outcome was pain intensity, while pressure pain threshold and pain-related disability were secondary outcomes. RESULTS The analysis included 40 studies. Manual therapy [mean difference (MD) of pain: -1.60, 95% CI: -2.17 to -1.03; MD of pressure pain threshold: 0.52, 95% CI: 0.19 to 0.86; MD of pain-related disability: -5.34, 95% CI: -8.09 to -2.58], laser therapy (MD of pain: -1.15, 95% CI: -1.83 to -0.46; MD of pressure pain threshold: 1.00, 95% CI: 0.46 to 1.54; MD of pain-related disability: -4.58, 95% CI: -7.80 to -1.36), extracorporeal shock wave therapy (MD of pain: -1.61, 95% CI: -2.43 to -0.78; MD of pressure pain threshold: 0.84, 95% CI: 0.33 to 1.35; MD of pain-related disability: -5.78, 95% CI: -9.45 to -2.12), and ultrasound therapy (MD of pain: -1.54, 95% CI: -2.24 to -0.84; MD of pressure pain threshold: 0.77, 95% CI: 0.31 to 1.22) were more effective than no treatment. CONCLUSION Our findings support that manual therapy, laser therapy, and extracorporeal shock wave therapy could effectively reduce pain intensity, pressure pain threshold, and pain-related disability with statistical significance when compared with placebo. This finding may provide clinicians with appropriate therapeutic modalities for patients with MPS among different scenarios.
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Affiliation(s)
| | - Yang Wang
- Department of Plastic and Reconstructive Surgery, Cell and Matrix Research Institute, Kyungpook National University School of Medicine, Daegu, Korea
| | - Wenli Yu
- Department of Anesthesiology, Tianjin First Center Hospital, Tianjin, People’s Republic of China
| | | | - Guoyong Ding
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong
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İnce S, Eyvaz N, Dündar Ü, Toktaş H, Yeşil H, Eroğlu S, Adar S. Clinical Efficiency of High-Intensity Laser Therapy in Patients With Cervical Radiculopathy: A 12-Week Follow-up, Randomized, Placebo-Controlled Trial. Am J Phys Med Rehabil 2024; 103:3-12. [PMID: 37204965 DOI: 10.1097/phm.0000000000002275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
OBJECTIVE The purpose of this study was to research the clinical effectiveness of high-intensity laser therapy combined with exercise on pain, quality of life, and disability in patients with cervical radiculopathy and compared it with that of placebo and exercise alone. DESIGN Ninety participants with cervical radiculopathy were randomized into the following three groups: high-intensity laser therapy + exercise ( n = 30), placebo + exercise ( n = 30), and exercise only ( n = 30). Pain, cervical range of motion, disability, and quality of life (36-item Short Form Health Survey) were assessed at baseline and weeks 4 and 12. RESULTS The mean age of the patients (66.7% female) was 48.9 ± 9.3 yrs. Pain intensity in the arm and neck, neuropathic and radicular pain levels, disability, and several parameters of the 36-item Short Form Health Survey showed an improvement in the short and medium term in all three groups. These improvements were greater in the high-intensity laser therapy + exercise group than in the other two groups. CONCLUSIONS High-intensity laser therapy + exercise was much more effective in improving medium-term radicular pain, quality of life, and functionality in patients with cervical radiculopathy. Thus, high-intensity laser therapy should be considered for the management of cervical radiculopathy. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES At the conclusion of this article, readers will be able to: (1) Define cervical radicular pain and its clinical presentation, and explain the main pathomechanism in cervical radiculopathy (CR); (2) Describe the effects of laser administration on neuropathic pain; and (3) Discuss the clinical significance of coadministration of high-intensity laser therapy (HILT) with exercise (HILT + EX) in CR. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Affiliation(s)
- Songül İnce
- From the Department of Physical Medicine and Rehabilitation, Dinar State Hospital, Afyonkarahisar, Turkey (Sİ); and Department of Physical Medicine and Rehabilitation, School of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey (NE, ÜD, HT, HY, SE, SA)
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Xie YH, Liao MX, Lam FMH, Gu YM, Hewith A Fernando WC, Liao LR, Pang MYC. The effectiveness of high-intensity laser therapy in individuals with neck pain: a systematic review and meta-analysis. Physiotherapy 2023; 121:23-36. [PMID: 37812850 DOI: 10.1016/j.physio.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 06/29/2023] [Accepted: 07/08/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES The primary objective of this meta-analysis was to determine whether high-intensity laser therapy (HILT) was effective in improving pain intensity, cervical range of motion (ROM), functional activity, and quality of life (QOL) in individuals with neck pain. DATA SOURCES PubMed, PEDro, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to March 26, 2022. STUDY SELECTION Randomized controlled trials (RCTs) involving HILT for neck pain were selected. DATA EXTRACTION AND DATA SYNTHESIS Two raters were independent in data extraction. The methodological quality was evaluated using the PEDro scale, and the level of evidence was assessed using the GRADE system. RevMan5.4 was used for meta-analysis. RESULTS Eight RCTs were included and their PEDro scores were moderate to high. Compared with placebo, HILT was effective in improving pain intensity (SMD 2.12, 95%CI 1.24 to 3.00; moderate quality evidence), cervical flexion (SMD 1.31, 95%CI 0.27 to 2.35; moderate quality evidence), extension (SMD 1.43, 95%CI 0.24 to 2.63; moderate quality evidence), right lateral flexion (SMD 1.36, 95%CI 0.15 to 2.56; low-quality evidence). There was a trend of better outcome in functional activity after HILT (SMD 1.73, 95%CI -0.05 to 3.54; low quality evidence). LIMITATIONS There was limited information available on QOL. CONCLUSION HILT may be considered as an adjunctive treatment modality for neck pain. There was moderate quality evidence that HILT may improve pain intensity and cervical ROM in individuals with neck pain, but there was low quality evidence that HILT was not effective in improving functional activity. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42021254078 CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Yu-Hua Xie
- Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, 523000 Dongguan, China; School of Rehabilitation Medicine, Gannan Medical University, 341000 Ganzhou, China
| | - Man-Xia Liao
- Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, 523000 Dongguan, China
| | - Freddy M H Lam
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, 999077, Hong Kong, China
| | - Yue-Ming Gu
- School of Rehabilitation Medicine, Gannan Medical University, 341000 Ganzhou, China
| | - W C Hewith A Fernando
- School of International Education, Nanjing Medical University, 210000, Nanjing, China
| | - Lin-Rong Liao
- Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, 523000 Dongguan, China.
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, 999077, Hong Kong, China.
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de la Barra Ortiz HA, Avila MA, Miranda LG, Liebano RE. Effect of high-intensity laser therapy in patients with non-specific chronic neck pain: study protocol for a randomized controlled trial. Trials 2023; 24:563. [PMID: 37653525 PMCID: PMC10472636 DOI: 10.1186/s13063-023-07599-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Chronic non-specific neck pain (CNNP) is a prevalent musculoskeletal disorder known for its significant disability and economic burden, ranking second only to low back pain in musculoskeletal conditions. Physical therapy offers effective interventions for CNNP, including low-level laser therapy (LLLT). High-intensity laser therapy (HILT) is a recent treatment for musculoskeletal pain, but studies that support its use in CNNP are limited. The objective of this study is to assess the effect of high-intensity laser therapy on pain intensity in patients with CNNP, given the existing evidence on LLLT for this condition. METHODS This is a 2-arm, randomized, placebo-controlled trial with blinded evaluators. The research will be carried out in the laboratory of physical agents at the Andrés Bello University, Campus Casona de las Condes. Eligible participants include the entire internal and external community associated with Andrés Bello University suffering from chronic non-specific NP. Participants will be stratified by sex (4 subgroups) and randomized into 2 study groups: group 1 (HILT and stretching exercises) and group 2 (sham HILT and stretching exercises). Treatments will be performed twice a week for 4 weeks with 3 assessments: before treatment (T0), at the end of treatment (T1), and 12 weeks after treatment (follow-up) (T2). The main outcomes will be pain intensity at rest, pain intensity at movement (active cervical movements: flexion, extension, right and left side bending, and right and left rotation), and pain pressure threshold (average obtained for six evaluation points). Secondary outcome measures will include neck range of motion in the sagittal, coronal, and transverse planes and neck disability. DISCUSSION In this study, HILT's effects on patients with non-specific NP will be compared to those of a sham laser intervention. This RCT will offer new evidence regarding the potential benefits of HILT in terms of pain intensity, range of movement, and disability in people suffering with non-specific NP. TRIAL REGISTRATION ClinicalTrials.gov NCT05689788. January 19, 2023.
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Affiliation(s)
- Hernán Andrés de la Barra Ortiz
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, São Paulo, Brazil
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Mariana Arias Avila
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, São Paulo, Brazil
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Luis Gómez Miranda
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile
| | - Richard Eloin Liebano
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, São Paulo, Brazil.
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA.
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He P, Fu W, Shao H, Zhang M, Xie Z, Xiao J, Li L, Liu Y, Cheng Y, Wang Q. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review. BMC Musculoskelet Disord 2023; 24:376. [PMID: 37173661 PMCID: PMC10176871 DOI: 10.1186/s12891-023-06418-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/10/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a common musculoskeletal pain and dysfunction, which is characterised by myofascial trigger points. Therapeutic physical modalities, as potentially effective treatment options, are commonly used in the clinical setting for the patients with MPS. OBJECTIVE This systematic review aimed to evaluate the safety and effectiveness of therapeutic physical modalities in the treatment of MPS, investigate its therapeutic mechanisms and provide a scientific evidence-based decision. METHODS According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, Cochrane Central Library, Embase, and CINAHL databases were searched for randomized controlled clinical studies published from database inception to October 30, 2022. A total of 25 articles met the study inclusion criteria. Data were extracted from these studies and a qualitative analysis was performed. RESULTS Transcutaneous electrical nerve stimulation therapy, extracorporeal shock wave therapy, laser therapy, and other therapeutic physical modalities have been demonstrated to improve the pain symptoms, joint mobility, psychological state, and quality of life in the patients with MPS and no side effects have been reported. The curative effect of therapeutic physical modalities was found to be possibly associated with increased blood perfusion and oxygen supply in ischaemic tissues, reduced hyperalgesia in the peripheral and central nerves, and decreased involuntary muscle contractions. CONCLUSION The systematic review has shown that therapeutic physical modalities could provide a safe and effective therapeutic option for MPS. However, the consensus is currently lacking regarding the optimal treatment paradigm, therapeutic parameters, and mutual combination of therapeutic physical modalities. The clinical trials with robust quality are required to further promote the evidence-based application of therapeutic physical modalities for MPS.
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Affiliation(s)
- Peijue He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Wenxuan Fu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Hang Shao
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Meng Zhang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Zhuoli Xie
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Juan Xiao
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Lijuan Li
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Yiwei Liu
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Yi Cheng
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan, People's Republic of China.
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High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Clin Med 2023; 12:jcm12041479. [PMID: 36836014 PMCID: PMC9963402 DOI: 10.3390/jcm12041479] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/30/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
High-intensity laser therapy (HILT) is one of the therapeutic approaches used in the treatment of musculoskeletal disorders (MSD). The main objective of this study was to examine the effectiveness of HILT for reducing pain and improving functionality in people with MSD. Ten databases were systematically searched for randomized trials published up to 28 February 2022. Randomized clinical trials (RCTs) assessing the effectiveness of HILT on MSD were included. The main outcome measures were pain and functionality. In total, 48 RCTs were included in the qualitative synthesis and 44 RCTs in the quantitative analysis. HILT showed a decrease on the pain VAS (mean difference (MD) = -1.3 cm; confidence interval (CI) 95%: -1.6 to -1.0) and an improvement in functionality (standardized mean difference (SMD) = -1.0; CI95%: -1.4 to -0.7), with low and moderate quality of evidence, respectively. A greater effect was observed when compared with control than with other conservative treatments, both on pain (χ2 = 20.6; p < 0.001) and functionality (χ2 = 5.1; p = 0.02). Differences in the effectiveness of HILT were found depending on the location (χ2 = 40.1 p < 0.001), with further improved functionality in MSD of the knee and shoulder. HILT is an effective treatment for improving pain, functionality, range of motion, and quality of life in people with MSD, although these findings must be treated with caution due to the high risk of bias in the studies. Further clinical trials should be well designed to lower the risk of bias.
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Ahi ED, Sirzai H. Comparison of the effectiveness of dry needling and high-intensity laser therapy in the treatment of myofascial pain syndrome: a randomized single-blind controlled study. Lasers Med Sci 2022; 38:3. [PMID: 36538189 DOI: 10.1007/s10103-022-03687-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 12/24/2022]
Abstract
Myofascial pain syndrome (MPS) is a very common disease in the population that seriously affects quality of life. Although many treatment modalities are used, there is still no common protocol. The aim of this study was to compare the effectiveness of high-intensity laser therapy (HILT) and dry needling options. This prospective study included 108 patients with neck and/or upper back pain, diagnosed with MPS, who were randomly separated into 3 groups: the exercise group, the exercise + HILT group (HILT group), and the exercise + dry needling group (needling group). The visual analog scale (VAS), neck disability index (NDI), short form-36 (SF-36) scores, and neck range of motion (ROM) values of the patients before and after treatment were recorded and compared between the groups. In all 3 groups, the VAS and NDI scores decreased and ROM levels increased after treatment. The results in the HILT and needling groups were statistically significantly better than those of the exercise group (p < 0.05).The addition of HILT and dry needling to exercises is seen as a more successful treatment option to reduce pain in MPS. Clinical trial registration number: NCT05078333.
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Affiliation(s)
- Emine Dundar Ahi
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Kocaeli Health and Technology University, Private Medar Hospital, Yeniköy Mahallesi Ilıca Caddesi No:29, Başiskele, Kocaeli, Turkey.
| | - Hulya Sirzai
- Private Romatem Hospital Physical Medicine and Rehabilitation Department, Fulya, Hakkı Yeten Cd. No:9 Kat:1, 34365, Şişli, Istanbul, Turkey
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Alayat MSM, Battecha KH, Elsodany AM, Alzahrani OA, Alqurashi AKA, Jawa AT, Alharthi YS. Effectiveness of Photobiomodulation Therapy in the Treatment of Myofascial Pain Syndrome of the Upper Trapezius Muscle: A Systematic Review and Meta-Analysis. Photobiomodul Photomed Laser Surg 2022; 40:661-674. [DOI: 10.1089/photob.2022.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Mohamed Salaheldien Mohmed Alayat
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Egypt
| | - Kadrya Hosney Battecha
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Dokki, Egypt
| | | | - Omer Abdulaziz Alzahrani
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
| | | | - AbdulAziz Talal Jawa
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Yazan Saleh Alharthi
- Physiotherapy and Rehabilitation Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
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Wu M, Luan L, Pranata A, Witchalls J, Adams R, Bousie J, Han J. Is high intensity laser therapy more effective than other physical therapy modalities for treating knee osteoarthritis? A systematic review and network meta-analysis. Front Med (Lausanne) 2022; 9:956188. [PMID: 36186780 PMCID: PMC9520262 DOI: 10.3389/fmed.2022.956188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/19/2022] [Indexed: 12/04/2022] Open
Abstract
Background The use of physical therapy modalities, especially high intensity laser therapy (HILT), for individuals with knee osteoarthritis (KOA) is still controversial. Objective To compare the effects of HILT to other physical therapy modalities on symptoms and function in individuals with KOA. Methods Six databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, and PEDro) were searched in March 2022. Included studies were randomized controlled trials involving HILT conducted on individuals with KOA. The end-trial weighted mean difference (WMD) and standard deviations (SD) with 95% confidence intervals (CI) were analyzed. Results Ten studies with 580 participants were obtained, of which nine were included in the final network meta-analysis. In terms of relieving pain, HILT demonstrated the highest probability of being among the most effective treatments, with surface under the cumulative ranking (SUCRA) = 100%, and compared to a control (placebo laser or exercise or a combination of both) on the visual analog scale (VAS) for pain it demonstrated significant benefits (WMD 1.66, 95% CI 1.48–1.84). For improving self-reported function, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores, the HILT SUCRA value led with 98.9%. When individuals with KOA were treated by HILT, the improvement in stiffness was statistically significant (WMD 0.78, 95% CI 0.52–1.04) but the amount of improvement was smaller than the minimal clinically important difference (MCID). Conclusion The current evidence suggests that HILT may be more effective than other physical therapy modalities for improving pain and function in individuals with KOA. For improving stiffness, however, it may not be clinically effective. Systematic review registration [https://www.researchregistry.com], identifier [1148].
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Affiliation(s)
- Menglai Wu
- School of Sports and Health, Shanghai University of International Business and Economics, Shanghai, China
| | - Lijiang Luan
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Adrian Pranata
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
- School of Physiotherapy, University of Sydney, Sydney, NSW, Australia
| | - Jaquelin Bousie
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Jia Han,
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12
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Starzec-Proserpio M, Grigol Bardin M, Fradette J, Tu LM, Bérubè-Lauzière Y, Paré J, Carroll MS, Morin M. High-Intensity Laser Therapy (HILT) as an Emerging Treatment for Vulvodynia and Chronic Musculoskeletal Pain Disorders: A Systematic Review of Treatment Efficacy. J Clin Med 2022; 11:jcm11133701. [PMID: 35806984 PMCID: PMC9267539 DOI: 10.3390/jcm11133701] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 01/02/2023] Open
Abstract
High-intensity laser therapy (HILT) has been gaining popularity in the treatment of chronic musculoskeletal pain, including vulvodynia. The objective of this study was to critically appraise and synthesize the available evidence on the efficacy of HILT for reducing pain and improving function in vulvodynia and other chronic primary musculoskeletal pain conditions. Electronic databases and the grey literature were searched. Effects on pain intensity, function, and adverse events were assessed. One study investigating HILT in the treatment of vulvodynia and 13 studies on the treatment of chronic musculoskeletal pain were selected. The study assessing vulvodynia showed favorable results for reducing pain. Regarding chronic musculoskeletal pain, 12 out of the 13 studies selected consistently showed that HILT was more effective than the placebo/active comparator for reducing pain and improving function. The available effect sizes for pain showed large to huge effects. Similar effects were observed for function except for two studies showing moderate effects. The GRADE score was moderate. Conclusions: There are insufficient data to support the use of HILT in vulvodynia, but the promising results encourage further research. HILT appears to be effective in musculoskeletal pain conditions. More high-quality studies are needed to identify effective laser protocols.
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Affiliation(s)
| | - Marcela Grigol Bardin
- Department of Obstetrics and Gynecology, School of Medical Sciences, Campinas University, São Paulo 13083-887, Brazil;
| | - Julie Fradette
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Research Center, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada;
| | - Le Mai Tu
- Urology Service, Department of Surgery, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Research Center, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada;
| | - Yves Bérubè-Lauzière
- Department of Electrical and Computer Engineering, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | - Josianne Paré
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Research Center, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada;
| | - Marie-Soleil Carroll
- Research Center, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada;
| | - Mélanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Research Center, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada;
- Correspondence:
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13
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Effectiveness of High Power Laser Therapy on Pain and Isokinetic Peak Torque in Athletes with Proximal Hamstring Tendinopathy: A Randomized Trial. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4133883. [PMID: 35647184 PMCID: PMC9142273 DOI: 10.1155/2022/4133883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 11/18/2022]
Abstract
Athletes such as long-distance runners, sprinters, hockey, and/or football players may have proximal hamstring tendinopathy (PHT). Laser therapy has been shown to be effective in tendinopathies. High power laser therapy (HPLT) is used for the treatment of several musculoskeletal conditions; however, its efficacy on PHT has not been investigated. This study is aimed at examining the effects of HPLT on pain and isokinetic peak torque (IPT) in athletes with PHT. The two-arm comparative pretest-posttest experimental design was used with random allocation of 36 athletes aged 18-35 years into two groups (experimental and conventional group). The experimental group included the application of HPLT for 3 weeks. The conventional group included treatment with a conventional physiotherapy program including ultrasound therapy, moist heat pack, and home exercises for a total of 3 weeks. Pain and IPT of the hamstring muscle were measured before and after the application of the intervention. Pain score decreased, and IPT increased significantly (p < 0.05) after application of HPLT, by 61.26% and 13.18%, respectively. In the conventional group, a significant difference (p < 0.05) was observed in pain scores only, which decreased by 41.14%. No significant difference (p > 0.05) was observed in IPT in the conventional group. When HPLT was compared with conventional physiotherapy, a significant difference was found in pain scores only. HPLT for 3 weeks was found to be effective in improving pain in athletes with PHT. However, no significant difference was found between HPLT and conventional physiotherapy (US, moist heat, and home exercises) in improving the IPT of the hamstring muscle.
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14
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Ekici Ö, Dündar Ü, Büyükbosna M. Effectiveness of high-intensity laser therapy in patients with myogenic temporomandibular joint disorder: A double-blind, placebo-controlled study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e90-e96. [PMID: 34174507 DOI: 10.1016/j.jormas.2021.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/17/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of the study is to evaluate the effectiveness of high-intensity laser therapy (HILT) in the short and long term in the treatment of patients with the myogenic temporomandibular joint disorder(TMD). METHODS This prospective, double-blind, controlled clinical study was conducted on patients with myogenic TMD at a university's oral and maxillofacial surgery clinic. Seventy-six patients were randomized into two groups (HILT, and control group), including 38 patients in one group. The patients were evaluated for pain, the range of motion of the jaw, disability, and quality of life. Assessments were performed before therapy (week 0) and after therapy (weeks 4 and 12). Data were evaluated using SPSS-20 and the level of significance was set at p <0.05. RESULTS There was no significant difference between the groups in terms of socio-demographic characteristics of the groups at the beginning of the study. In the 4th week, the VAS pain score was significantly decreased in the HILT group (47%) compared to the placebo HILT group (4%) (p <0.001). The maximum mouth opening was significantly increased in the HILT group (27%) compared to the placebo HILT group (4%) at week 12 (p <0.001). The HILT group showed a significant improvement in Jaw Functional Limitation Scale 20 (JFLS-20) and Oral Health Impact Profile (OHIP-14) compared to the placebo HILT group (p <0.001 and p <0.005 respectively). CONCLUSION As a result of the study, it was concluded that HILT is a highly effective, non-invasive therapeutic method for patients with myogenic TMD.
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Affiliation(s)
- Ömer Ekici
- DDS, Phd, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Ümit Dündar
- Prof. Dr. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Murat Büyükbosna
- Physical therapist, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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15
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Ebid AA, Alhammad RM, Alhindi RT, Alghamdi AA, Alqarhi AK, Abdullah HA, Almuqati MA, Alsharfi MA, Alotaibi RO, Rahali S. Effect of high-power Nd:YAG laser on the growth of Staphylococcus aureus and Pseudomonas aeruginosa: an experimental study. J Phys Ther Sci 2021; 33:222-228. [PMID: 33814708 PMCID: PMC8012199 DOI: 10.1589/jpts.33.222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/01/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to evaluate the effect of high-power Nd:YAG laser on
Staphylococcus aureus and Pseudomonas aeruginosa
bacterial growth. [Materials and Methods] Seven samples of S. aureus and
seven samples of P. aeruginosa were prepared in the microbiology lab, one
used as a control sample and the remaining six samples used as experimental samples, which
were irradiated by a high-power laser (LASERSIX ME, 15W) with a total dose of 500 and
700 J. The primary measure was the semi-qualitative assessment of turbidity and bacterial
count; the turbidity was assessed 24 h after laser application. [Results] There was a
significant decrease in turbidity in all experimental samples of S.
aureus and P. aeruginosa after 24 h of high-power laser
application for 500 and 700 J and a significant decrease in the colony-forming unit (CFU)
value in both types, and there were no significant differences in turbidity and CFU when
comparing 500 and 700 J. [Conclusion] A high power Nd:YAG laser was found to be an
effective modality for inhibition of S. aureus and P.
aeruginosa growth.
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Affiliation(s)
- Anwar A Ebid
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
| | - Raniah M Alhammad
- Department of Microbiology, Faculty of Medicine, Umm AlQura University, Saudi Arabia
| | - Rania T Alhindi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah A Alghamdi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulaziz K Alqarhi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hatim A Abdullah
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mishari A Almuqati
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohammad A Alsharfi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Rakan O Alotaibi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Suhil Rahali
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
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16
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Li L, Stoop R, Clijsen R, Hohenauer E, Fernández-de-Las-Peñas C, Huang Q, Barbero M. Criteria Used for the Diagnosis of Myofascial Trigger Points in Clinical Trials on Physical Therapy: Updated Systematic Review. Clin J Pain 2020; 36:955-967. [PMID: 32841969 DOI: 10.1097/ajp.0000000000000875] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this study was to conduct an updated systematic review of diagnostic criteria for myofascial trigger points (MTrPs) used in clinical trials of physical therapy interventions from 2007 to 2019. METHODS MEDLINE and Physiotherapy Evidence Database (PEDro) were searched using the following MeSH keywords: "trigger points," "trigger point," "myofascial trigger point," "myofascial trigger points," "myofascial pain," and "myofascial pain syndrome." The MeSH keywords were combined by using Boolean operators "OR"/"AND." All physiotherapy clinical trials including patients with musculoskeletal conditions characterized by at least 1 active MTrP or latent MTrP in any body area were selected. We pooled data from an individual criterion and criteria combinations used to diagnose MTrPs. The protocol was developed in accordance with the PRISMA-P guidelines. RESULTS Of 478 possibly relevant publications, 198 met the inclusion criteria. Of these 198 studies, 129 studies (65.1%) stated specifically the diagnostic criteria used for MTrPs in the main text, 56 studies (28.3%) failed to report any method whereby MTrP was diagnosed, and 13 studies (6.6%) adopted expert-based definitions for MTrPs without specification. Of 129 studies, the 6 criteria applied most commonly were: "spot tenderness" (n=125, 96.9%), "referred pain" (95, 73.6%), "local twitch response" (63, 48.8%), pain recognition (59, 45.7%), limited range of motion" (29, 22.5%), and "jump sign" (10, 7.8%). Twenty-three combinations of diagnostic criteria were identified. The most frequently used combination was "spot tenderness," "referred pain," and "local twitch response" (n=28 studies, 22%). CONCLUSIONS A number of the included studies failed in properly reporting the MTrP diagnostic criteria. Moreover, high variability in the use of MTrP diagnostic was also observed. Spot tenderness, referred pain, and local twitch response were the 3 most popular criteria (and the most frequently used combination). A lack of transparency in the reporting of MTrP diagnostic criteria is present in the literature. REGISTRY This systematic review was registered under the Centre for Reviews and Dissemination, PROSPERO number: CRD42018087420.
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Affiliation(s)
- Lihui Li
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- School of Medicine, Southern University of Science and Technology, Shenzhen
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Rahel Stoop
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
| | - Ron Clijsen
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Erich Hohenauer
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Qiangmin Huang
- Department of Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno
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Dalpiaz A, Kuriki HU, Barbosa RAP, Diefenthaeler F, Marcolino AM, Barbosa RI. Dry Needling and Photobiomodulation Decreases Myofascial Pain in Trapezius of Women: Randomized Blind Clinical Trial. J Manipulative Physiol Ther 2020; 44:61-71. [PMID: 33248747 DOI: 10.1016/j.jmpt.2020.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/22/2020] [Accepted: 07/01/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purpose of this study was to assess whether dry needling (DN) added to photobiomodulation (PBM) has effects on the treatment of active myofascial trigger points in the upper trapezius. METHODS This study was a randomized clinical trial, with 43 participants divided into 3 groups: DN and PBM (DNP), DN, and DN outside of the trigger point (DNout). Each group received 1 session of DN followed by PBM therapy with the machine turned on or off. Pain, disability, pain pressure threshold, and muscle activity were assessed before the intervention and afterward at intervals of 10 minutes, 30 minutes, 1 week, and 1 month. RESULTS Pain decreased after intervention in the DNP and DNout groups, with mean differences, respectively, of 1.33 cm (95% confidence interval [CI], 0.019-2.647) and 2.78 cm (95% CI, 1.170-2.973). Scores for the disability questionnaire decreased in all groups after intervention (F = 36.53, P < .0001) after the intervention, with mean differences of 3.8 points in the DNP group (95% CI, 1.082-5.518), 3.57 in the DN group (95% CI, 0.994-6.149), and 5.43 in the DNout group (95% CI, 3.101-7.756). There were no significant differences between or within groups in pain pressure threshold (F = 2.14, P = .139), with mean differences after 30 minutes of 0.139 kgf for the DNP group (95% CI, -0.343 to 0.622), 0.273 for the DN group (95% CI, -0.661 to 1.209), and -0.07 for the DNout group (95% CI, -0.465 to 0.324). Muscle activation for the DN group increased 8.49% after the intervention, where for the DNP group it decreased 11.5%, with a significant difference between groups. CONCLUSION DN added to PBM presented similar results compared to DNout and DN. In this sample, the effects of the application of DN outside of the trigger point had better effects on pain and disability scores than DN applied directly on the trigger point.
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Affiliation(s)
- Ameg Dalpiaz
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Heloyse Uliam Kuriki
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Renan Andrade Pereira Barbosa
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Fernando Diefenthaeler
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Alexandre Marcio Marcolino
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Rafael Inacio Barbosa
- Center of Sciences, Technologies and Health, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil.
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18
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Alayat MS, Battecha KH, ELsodany AM, Ali MI. Pulsed ND:YAG laser combined with progressive pressure release in the treatment of cervical myofascial pain syndrome: a randomized control trial. J Phys Ther Sci 2020; 32:422-427. [PMID: 32753780 PMCID: PMC7344286 DOI: 10.1589/jpts.32.422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/03/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the effect of pulsed Nd:YAG laser combined with the progressive
pressure release technique (PPRT) and exercises in the treatment of myofascial trigger
points (MTrPs) in patients with myofascial pain syndrome (MPS). [Participants and Methods]
A total of 50 patients with MTrPs in the upper trapezius muscle participated in the study.
The patients were randomly assigned to two groups and treated with laser plus PPRT (Laser
+ PPRT group) or placebo laser and exercises (PL + PPRT group). The laser was applied for
eight MTrPs with a 50 J/point. PPRT was applied for 30 seconds for each point. Exercises
included strengthening and stretching exercises applied three times per week for four
weeks. A visual analogue scale (VAS) and pressure pain threshold (PPT) were used to
measure pain and pain threshold, respectively. A cervical range of motion device (CROM)
was used to measure the cervical range of motion. [Results] Both treatment groups showed
significant improvement in CROM, PPT, and VAS post-treatment with a more significant
effect in the Laser + PPRT group compared to the PL + PPRT group. [Conclusion] PPRT and
exercises alone or that in combination with laser therapy were effective in the treatment
of active MTrPs in patients with MPS.
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Affiliation(s)
- Mohamed Salaheldein Alayat
- Faculty of Applied Medical Science, Umm Al-Qura University: 4888 Bathaa Qurish, Mecca 21955, Saudi Arabia
| | - Kadrya Hosney Battecha
- Faculty of Applied Medical Science, Umm Al-Qura University: 4888 Bathaa Qurish, Mecca 21955, Saudi Arabia
| | - Ahmed Mohamed ELsodany
- Faculty of Applied Medical Science, Umm Al-Qura University: 4888 Bathaa Qurish, Mecca 21955, Saudi Arabia
| | - Mohamed Ibrahim Ali
- Faculty of Applied Medical Science, Umm Al-Qura University: 4888 Bathaa Qurish, Mecca 21955, Saudi Arabia
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19
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Abdel-Aal NM, Ali KM, Eladl HM. Efficacy of high-intensity laser therapy on arthropathy of the hands in patients with systemic lupus erythematosus: a double-blinded, randomized controlled trial. Clin Rehabil 2020; 34:1303-1312. [PMID: 32638614 DOI: 10.1177/0269215520941059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the efficacy of high-intensity laser therapy (HILT) on arthropathy of the hands in patients with systemic lupus erythematosus. DESIGN A double-blinded randomized, controlled study. SETTING Outpatient setting. PARTICIPANTS Fifty patients, 30-50-years-old, suffering from arthropathy of the hands were randomly assigned either into the experimental group, received HILT plus the routine physical therapy program or the control group, received sham HILT plus the same routine physical therapy program. INTERVENTION All treatment interventions were applied at a frequency of three sessions per week for eight weeks. OUTCOME MEASURES Handgrip strength, joints swelling counts, joints tenderness counts, visual analog scale (VAS) were measured before and after eight-weeks of interventions. RESULTS There were statistically significant differences in handgrip strength, joint swelling count, joint tenderness count and VAS in favor of the study group (P < 0.05). After eight-weeks of intervention, the mean (SD) for handgrip strength, joint swelling counts, joint tenderness count, and pain score was 28.34 ± 8.3 kg, 4.4 ± 2.18, 5 ± 2.1, and 35.6 ± 13.87 mm in the study group, and 22.96 ± 8.76 kg, 7.36 ± 2.14, 9.08 ± 1.63, and 58.8 ± 10.54 mm in the control group, respectively. The MD (95%CI) for handgrip strength, joint swelling counts, joint tenderness count, and pain score was 5.38(0.53,10.23) kg, -2.96(-4.19, -1.73), -4.08(-5.15, -3.01), and -23.2(-30.2, -16.2) mm between groups, respectively. CONCLUSIONS Adding HILT to the routine physical therapy program might be more effective than routine physical therapy program alone in improving handgrip strength, decreasing joint swelling counts, joint tenderness counts, and pain in patients with arthropathy of the hands.
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Affiliation(s)
- Nabil Mahmoud Abdel-Aal
- Department of physical therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Khadra Mohamed Ali
- Department of physical therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hadaya Mosaad Eladl
- Department of physical therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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20
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Pignatelli Vilajeliu A, Mestre Farràs N, Escalada Recto F, Coll Molinos M. [Effectiveness of invasive and non-invasive tecniques for neck myofascial pain syndrome: a systematic review]. Rehabilitacion (Madr) 2020; 54:181-190. [PMID: 32620325 DOI: 10.1016/j.rh.2020.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/23/2019] [Accepted: 01/29/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Myofascial pain is a muscular alteration caused by one or more myofascial trigger points and is considered one of the most frequent musculoskeletal disorders. This study compared the effectiveness of invasive and non-invasive techniques in the treatment of neck myofascial pain syndrome. MATERIALS AND METHODS A literature search were performed in PubMed with a combination of key words related to myofascial pain syndrome and invasive and non-invasive therapies. Articles were included according to whether they were published less than 10 years previously and other inclusion criteria. Pain intensity, pressure pain threshold, range of movement, disability and quality of life were evaluated in the 26 articles finally selected. RESULTS There are multiple publications on pain intensity reduction and range of movement. Reports of invasive techniques are more important than those of non-invasive techniques. However, there are only a few publications on threshold pressure pain, functionality and quality of life irrespective of the type of technique. CONCLUSION Invasive and non-invasive techniques are effective in the treatment of neck myofascial pain syndrome, but it is difficult to conclude the superiority of one type of technique over the other due to multiple methodological differences among the evaluated studies.
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Affiliation(s)
| | - N Mestre Farràs
- Universidad Autónoma de Barcelona (UAB), Bellaterra, Barcelona, España.
| | - F Escalada Recto
- Universidad Autónoma de Barcelona (UAB), Bellaterra, Barcelona, España; Servei de Medicina Física i Rehabilitació, Hospital de l'Esperança, Barcelona, España; Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España
| | - M Coll Molinos
- Universidad Autónoma de Barcelona (UAB), Bellaterra, Barcelona, España; Servei de Medicina Física i Rehabilitació, Hospital de l'Esperança, Barcelona, España; Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España
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21
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Alayat MSM, Basalamah MA, Elbarrany WGEAE, El-Sawy NAM, Abdel-Kafy EM, El-Fiky AAR. Dose-dependent effect of the pulsed Nd:YAG laser in the treatment of crushed sciatic nerve in Wister rats: an experimental model. Lasers Med Sci 2020; 35:1989-1998. [PMID: 32193821 DOI: 10.1007/s10103-020-02999-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 03/09/2020] [Indexed: 12/21/2022]
Abstract
The objective of the study was to investigate the efficacy of three energy densities 4, 10, and 50 J/cm2 of pulsed Nd:YAG laser for the treatment of crushed sciatic nerve in Wister rats by evaluating changes in the sciatic functional index and the electrophysiology.A total of 180 Wistar rats were involved in the study. Rats were randomly assigned to five groups. Rats were subjected to the sciatic nerve crushing. Control negative (CONT-ve), which received no crushing; control positive (CONT+ve), which received crushing with no laser; and HILT-4, HILT-10, and HILT-50 groups, which received pulsed Nd:YAG laser (10 Hz, 360 mJ/cm2) with energy densities 4, 10, and 50 J/cm2, respectively. The SFI, the amilitude of compound motor action potential (CMAP) and sciatic motor nerve conduction velocity (MNCV) were measured before and after seven, 14, and 21 days after crushing. For the SFI and electrophysiological analysis, repeated measures ANOVA is used, followed by Bonferroni's repeated-measures test. Statistical significance was set at p < 0.05. After one week, there was no significant difference in SFI, CMAP, and MNCV among the three laser groups with significant changes between them and CONT-ve and CONT+ve groups. There was a significant increase in either CMAP amplitude or MNCV after 14 days with significant decrease in the SFI after 21 days among all treatment groups. The pulsed Nd:YAG laser applied with energy densities 4, 10, and 50 J/cm2 significantly decreased the SFI and increased the CMAP and MNCV of the crushed sciatic nerve in Wister rats. Among laser doses, the difference in the rate of recovery in the electrophysiology was found after two weeks while in the SFI after three weeks. The improvement after the nerve injury was time and dose dependent.
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Affiliation(s)
| | | | | | | | - Ehab Mohamed Abdel-Kafy
- Physical Therapy Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Amir Abdel-Raouf El-Fiky
- Physical Therapy Department, Faculty of Applied Medical Science, Umm Al-Qura University, Mecca, Saudi Arabia
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22
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Alayat MSM, Alshehri MA, Shousha TM, Abdelgalil AA, Alhasan H, Khayyat OK, Al-Attar WS. The effectiveness of high intensity laser therapy in the management of spinal disorders: A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2020; 32:869-884. [PMID: 30932879 DOI: 10.3233/bmr-181341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Spinal disorders are common health problems which include wide categories of diseases that affect the spinal soft tissues, joints and bone. OBJECTIVE The aim of this systematic review was to evaluate the effectiveness of high intensity laser therapy (HILT) on pain and function in patients with spinal disorders. METHODS Six databases were searched up to the end of February 2018 including PubMed, MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Open Grey and Grey Literature Report. In addition, the reference lists of all included studies were searched for any relevant studies. PEDro scale and GRADE system were performed to assess the quality of the studies. A meta-analysis was conducted to calculate the overall effect size. RESULTS A total of ten randomised controlled trials (RCTs) met the inclusion criteria, with four studies of the efficacy of HILT on neck pain (NP) and six on low back pain (LBP). According to the PEDro scale assessment, only two studies were rated as high quality, while the remainder were rated as fair or low quality. Forest plots showed that HILT with exercise was significantly more effective than placebo HILT with exercise in terms of pain reduction (SMD -1.11; 95% CI -1.42 to -0.80; P< 0.00001; I2 0%) and functional improvement (SMD -1.03; 95% CI -1.33 to -0.72; P< 0.00001; I2 0%). Meta-analyses also showed that HILT alone or HILT with conventional physiotherapy (CPT) significantly provided better outcomes than CPT alone. CONCLUSIONS HILT is considered as a complementary modality for pain reduction and function improvement in patients with spinal disorders. However, the quality of the body of evidence was rated from 'very low' to 'low' quality. Further high quality trials are required for standardisation of irradiation parameters and the treatment protocol to establish the efficacy of HILT for spinal disorders.
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Affiliation(s)
| | - Mansour Abdullah Alshehri
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia.,Department of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Tamer Mohamed Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Abdelgalil Allam Abdelgalil
- Department of Physical Therapy for Musculoskeletal Disorders, Faculty of Physical Therapy, Cairo University, Egypt
| | - Hammad Alhasan
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Orjwan Khalid Khayyat
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Wesam Saleh Al-Attar
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
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23
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Ezzati K, Laakso EL, Salari A, Hasannejad A, Fekrazad R, Aris A. The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review. J Lasers Med Sci 2020; 11:81-90. [PMID: 32099632 DOI: 10.15171/jlms.2020.14] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: High-intensity laser therapy (HILT) has been used more recently in the therapeutic protocols of pain managements. Adding therapeutic interventions to laser therapy is usual in clinical practice. This study aimed to evaluate the efficacy of HILT and beneficial effects of adding cointerventions to HILT in musculoskeletal pain management. Methods: The following databases were searched up to August 2018: Medline, PubMed, EMBASE, Cochrane, Google Scholar, Springer and ISI. The keywords of pain, HILT, high power laser therapy, laser therapy, photobiomodulation, physical therapy and rehabilitation were searched. The quality of the articles was assessed using the PEDro scale. The primary measure was pain severity expected to be reported in all studies. Effect size was calculated as standardized mean differences divided by the standard deviation of either the treatment or other group. Results: Initially 52 potential studies were found. Eighteen of these studies were excluded based on title and abstract. The full text of 34 remaining articles was screened and 15 of the studies were excluded. All included studies had high quality (PEDro ≥7). Approximately, 94% of included articles (n=18) revealed positive effects of HILT on pain. The effect sizes for HILT and placebo/comparator groups were 0.9-9.11 and 0.21-11.22 respectively. Also, the differences of effect size between two groups were between 0.03 to 5.85. Conclusion: It is early to determine that HILT may be an effective non-invasive agent in the management of musculoskeletal pain, as few studies have shown its clinical efficacy. Adding related co-interventions to HILT may enhance the beneficial effects of laser therapy. The variability of the study methods and outcomes suggests that further long-term follow-up, randomized controlled clinical trials with appropriate methodological design are needed regarding the effectiveness of HILT on pain.
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Affiliation(s)
- Kamran Ezzati
- Neuroscience Research Center, Poorsina Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - E-Liisa Laakso
- Allied Health Mater Research, Brisbane, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Amir Salari
- Department of Orthopaedics, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Reza Fekrazad
- Department of Dentistry, AJA University of Medical Sciences, Tehran, Iran.,Laser Research Center, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Aris
- Department of Orthopaedics, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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24
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Ebid AA, Alhammad RM, Alhendi RT, Alqarhi BA, Baweyan EM, Alfadli LH, Alzahrani MA, Alotaibi MF, Alaidrous NA, Alzahrani RA, Alqurashi RM, Alharbi SS, Azhar SJ. Immediate effect of pulsed high-intensity neodymium-doped yttrium aluminum garnet (Nd: YAG) laser on staphylococcus aureus and pseudomonas aeruginosa growth: an experimental study. J Phys Ther Sci 2019; 31:925-930. [PMID: 31871379 PMCID: PMC6879417 DOI: 10.1589/jpts.31.925] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/14/2019] [Indexed: 01/11/2023] Open
Abstract
[Purpose] The aim of this study was to evaluate the effect of pulsed high intensity
neodymium-doped yttrium aluminum garnet (Nd: YAG) laser on staphylococcus aureus (S.
aureus) and pseudomonas aeruginosa (P. aeruginosa) bacterial growth, which cause many
health problems and establish which doses are effective in bacterial inhibition.
[Materials and Methods] Five samples of S. aureus and five samples of P. aeruginosa were
prepared in the microbiology lab, one used as control sample and the other 4 samples acted
as experimental samples. The experimental samples received pulsed high intensity Nd: YAG
laser with a total dose of 500, 600, 700 and 800 joules. The primary measures are colony
count and the percentage decrease in colony count, the colony count was assessed at
baseline and after 24 h of laser application. [Result] There was significant decrease in
colony count and the percentage decrease in colony count after pulsed high intensity Nd:
YAG laser application in all experimental samples of S. aureus and P. aeruginosa after 24
h of application for all doses (500, 600, 700 and 800 j) as compared with the control
sample, with the most effect in higher doses of pulsed high intensity Nd: YAG laser than
lower doses in both types of bacteria. [Conclusion] pulsed high intensity Nd: YAG laser
was found to be an effective modality for inhibition of S. aureus and P. aeruginosa growth
after a single application.
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Affiliation(s)
- Anwar Abdelgayed Ebid
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
| | - Raniah M Alhammad
- Department of Microbiology, Faculty of Medicine, Umm AlQura University, Saudi Arabia
| | - Rania T Alhendi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Bushra A Alqarhi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Elaf M Baweyan
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Luluh H Alfadli
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mashael A Alzahrani
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mawaddah F Alotaibi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nawal A Alaidrous
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Raghad A Alzahrani
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Rafaa M Alqurashi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Shouq S Alharbi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Shuruq J Azhar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm AlQura University: PO Box 715, Postal Code 21421, Umm Al-Qura University, Makkah, Saudi Arabia
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25
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Yesil H, Dundar U, Toktas H, Eyvaz N, Yeşil M. The effect of high intensity laser therapy in the management of painful calcaneal spur: a double blind, placebo-controlled study. Lasers Med Sci 2019; 35:841-852. [PMID: 31478095 DOI: 10.1007/s10103-019-02870-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/23/2019] [Indexed: 12/29/2022]
Abstract
To evaluate the effect of high-intensity laser therapy (HILT) in patients with calcaneal spur. The patients were randomized to receive either HILT + exercise (n = 21) (five times a week for a period of 3 weeks) or placebo HILT + exercise (n = 21) (five times a week for a period of 3 weeks). Pain severity (with visual analog scale (VAS) and with Roles and Maudsley score (RMS)), functionality (with Foot and Ankle Outcome Score (FAOS)), plantar pressure measurement, and quality of life (with short form-36 (SF-36)) of the patients were evaluated at baseline, at 4 weeks, and 12 weeks. A significant improvement in the VAS (p < 0.001), RMS (p < 0.001), and most of the SF-36 subgroup scores (p < 0.05) and most of the FAOS subgroup scores (p < 0.05) at 4 and 12 weeks after treatment was achieved in both groups. Besides, there was no significant difference in VAS (p > 0.05) and RMS (p > 0.05) between the groups. FAOS symptoms (p = 0.022) and quality of life (p = 0.038) subgroups were higher in the placebo group at 12 weeks. Significant improvements were observed in dynamic pedographic measurements in the HILT group (p < 0.05), and dynamic measurement values were significantly higher in the HILT group compared to placebo group (p < 0.05). Although the evaluation parameters, except dynamic pedographic measurements, have improved in both groups, our study results showed no superiority of HILT over placebo. To conclude, when the main complaint is pain in patients, only exercise therapy can be an economical, practical, and reliable treatment.
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Affiliation(s)
- Hilal Yesil
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.
| | - Umit Dundar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Hasan Toktas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Nuran Eyvaz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Murat Yeşil
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
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26
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Song HJ, Seo HJ, Lee Y, Kim SK. Effectiveness of high-intensity laser therapy in the treatment of musculoskeletal disorders: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e13126. [PMID: 30572425 PMCID: PMC6319951 DOI: 10.1097/md.0000000000013126] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although high-intensity laser therapy (HILT) has been used for the management of musculoskeletal disorders (MSD), studies examining the effectiveness of HILT have been limited. We investigated the effectiveness of HILT in MSD using a systematic review and meta-analysis. METHODS We searched the ovid MEDLINE, ovid Embase, Cochrane CENTRAL library, and Web of Science until January, 2018. Relevant studies concerning the effectiveness of HILT in patients with MSD were included. Both placebo and active controls were considered as comparators and only randomized controlled trial (RCT) design studies were included. Risk of bias (ROB) was used for the quality assessment of the RCT. For continuous variables, a meta-analysis was conducted using an inverse variance random effects model. The mean difference (MD) for visual analog scale pain and standardized mean difference (SMD) for disability were applied. RESULTS Twelve studies were selected for this systematic review. In 11 studies, comprising 736 patients, pain was significantly improved by HILT compared with a control group (MD: -1.01; 95% confidence interval [CI]: -1.28 to -0.74). From the analysis of 688 patients from 10 studies, the pooled standardized mean difference (SMD) of HILT showed a significant improvement in disability scores compared with those in the control group (SMD, -1.09; 95% CI -1.77, -0.41). In subgroup analysis by treatment regions, the mean difference (MD) in neck pain was the highest at -1.02 (95% CI: -1.45, -0.58) than in controls, followed by back pain (MD, -0.91; 95% CI: -1.24, -0.59). CONCLUSIONS The results of this study show that HILT treatment for back and neck pain significantly improved pain and disability scores compared with controls. The ROB of the included studies was moderate; however, significant heterogeneity existed. Thus, additional well-designed studies involving larger samples with long-term follow-up are needed to further assess each laser application, treatment region, and comparator.
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Affiliation(s)
- Hyun Jin Song
- College of Pharmacy, University of Florida, Gainesville, FL
| | - Hyun-Ju Seo
- Department of Nursing, College of Medicine, Chosun University, Gwangju
| | - Youngjin Lee
- College of Nursing, Ajou University, Suwon, South Korea
| | - Sung Kyu Kim
- Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Korea
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27
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Comparison of high-intensity laser therapy and combination of ultrasound treatment and transcutaneous nerve stimulation in patients with cervical spondylosis: a randomized controlled trial. Lasers Med Sci 2018; 34:947-953. [PMID: 30443883 DOI: 10.1007/s10103-018-2682-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 11/02/2018] [Indexed: 12/31/2022]
Abstract
The aim of the study was to compare the effect of high-intensity laser therapy (HILT) and a combination of ultrasound (US) treatment and transcutaneous nerve stimulation (TENS) on pain, range of motion (ROM), and functional activity in patients with cervical spondylosis (CS). A total of 84 patients with a mean age of 51.54 years (52 women and 32 men) affected by CS were enrolled in this study. Patients were randomly divided into two groups. In group A (42 subjects), patients received 12 sessions of HILT plus exercise, while in group B (42 subjects), they received a combination of US, TENS, and exercise. The outcomes measured were cervical segment ROM, pain level measured by visual analogue scale (VAS), and functional activity measured by neck disability index (NDI) at the end of the therapy. The level of statistical significance was set as p < 0.05. In the two groups, cervical ROM, VAS, and functional scores showed significant changes. Both HILT plus exercise and US/TENS plus exercise effectively increased cervical ROM and reduced pain (with a significant greater decrease in group A). Statistically significant differences in NDI scores were observed after treatment sessions with better results for participants enrolled in group A (HILT plus exercise) Both therapeutic modalities demonstrated analgesic efficacy and improved function in patients affected by cervical spondylosis 4 weeks after the therapy. HILT plus exercise was more effective than US/TENS plus exercise. HILT can be promoted and used in this pathology with positive outcomes. However, further studies are needed to optimize the dose and duration of HILT therapy.
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28
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Comparative study of shockwave therapy and low-level laser therapy effects in patients with myofascial pain syndrome of the trapezius. Rheumatol Int 2018; 38:2045-2052. [DOI: 10.1007/s00296-018-4134-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/14/2018] [Indexed: 12/21/2022]
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29
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Chen L, Liu D, Zou L, Huang J, Chen J, Zou Y, Lai J, Chen J, Li H, Liu G. Efficacy of high intensity laser therapy in treatment of patients with lumbar disc protrusion: A randomized controlled trial. J Back Musculoskelet Rehabil 2018; 31:191-196. [PMID: 28854500 DOI: 10.3233/bmr-170793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aims to evaluate the effect of high intensity laser therapy (HILT) in patients with lumbar disc protrusion (LDP). METHODS This study included 63 patients suffering from protrusion of lumbar intervertebral disc; they were divided into Groups 1 (n= 32) and 2 (n= 31). Group 1 was treated with HILT and spinal decompression system (SDS). Patients in Group 2 received SDS alone. Evaluations were conducted on oswestry disability index (ODI), lumbosacral portion pain, and lower limb radiation pain with visual analogue scale (VAS) of two patient groups before treatment, two weeks after treatment, and 1 month after follow-up visit. Lumbar flexion range and angle of straight leg raising before treatment and 2 weeks after treatment. RESULTS After two weeks of treatment of two patient groups, ODI, VAS, lumbar flexion range and angle of straight leg raising significantly improved compared with their conditions before treatment (P< 0.01). A significant difference was noted in ODI, lumbar flexion range, and angle of straight leg raising between groups after two weeks of treatment (P< 0.05). Non-statistical significant difference was observed in lumbosacral portion pain and lower limb radiation pain with VAS (P> 0.05). However, difference in was VAS smaller in Group 1. All groups showed significantly different results in terms of ODI, lumbosacral portion pain, and lower limb radiation pain with VAS. CONCLUSION As one of available treatments for LDP, HILT can speed up improvement in lumbar segment motion, angle of straight leg raising, and overall function and allow early return of patients to their family and society. Treatment effect is long-lasting and can be widely promoted and applied clinically.
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Affiliation(s)
- Lianghua Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.,Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Dandan Liu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.,Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Liping Zou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Ju Huang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Junqi Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Yucong Zou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Jienuan Lai
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Jingjie Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Haihong Li
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Gang Liu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
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30
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White PF, Elvir Lazo OL, Galeas L, Cao X. Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management. F1000Res 2017; 6:2161. [PMID: 29333260 PMCID: PMC5749131 DOI: 10.12688/f1000research.12324.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 12/28/2022] Open
Abstract
The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy) was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck) pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”), major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral neuropathic pain, fibromyalgia, degenerative joint disease/osteoarthritis, and migraine headaches).
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Affiliation(s)
- Paul F White
- P.O. Box 548, Gualala, CA 95445, USA.,The White Mountain Institute, The Sea Ranch, CA, USA.,Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | - Ofelia Loani Elvir Lazo
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | | | - Xuezhao Cao
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA.,First Hospital of China Medical University, Shenyang, China
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31
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Song H, Zhai X, Gao Z, Lu T, Tian Q, Li H, He X. Reliability and validity of a Coda Motion 3-D Analysis system for measuring cervical range of motion in healthy subjects. J Electromyogr Kinesiol 2017; 38:56-66. [PMID: 29169054 DOI: 10.1016/j.jelekin.2017.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 10/28/2017] [Accepted: 11/14/2017] [Indexed: 11/16/2022] Open
Abstract
In the past two decades, many tools have been reported to measure the cervical range of motion (CROM), but most of the results are controversial in healthy individuals and/or individuals with neck pain. The Coda Motion 3-D Analysis system is a new instrument that measures three-dimensional joint movement. However, measurements of CROM using this system have yet to be conducted. Here, we investigate the reliability and validity of the Coda Motion 3-D Analysis System for measuring CROM in healthy adults. Sixty healthy volunteers were involved in this reliability study. Two trained investigators (M1 and M2) used the Coda Motion 3-D Analysis System to measure CROM. M1 and M2 measured all the volunteers once independently; after a short rest, M1 then measured all of them again. The intraclass correlation coefficient (ICC), standard error of the measurements (SEM), smallest detectable difference (SDD), a scatter diagram, and the limits of agreement (LoAs) were applied to evaluate the inter-tester and intra-tester reliability. Thirty healthy volunteers were involved in this validity study. The cervical flexion and extension ranges of motion were measured simultaneously with both the Coda Motion 3-D Analysis System and X-ray. A scatter diagram, the Pearson correlation coefficient and LoAs were used to evaluate the validity. Excellent intra-tester and inter-tester reliabilities were observed for the Coda Motion 3-D Analysis System (intra-tester ICC: 0.84-0.95, inter-tester ICC: 0.84-0.90). Good validity was achieved in extension and flexion with Pearson correlation coefficients ranging from 0.78 to 0.91. The Coda Motion 3-D Analysis System has excellent reliability for the measurement of CROM and good validity for measurements of flexion and extension in healthy subjects. This system has the potential to be used to measure the normal active CROM in the clinic and is accurate, safe, non-invasive, and radiation free.
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Affiliation(s)
- Hui Song
- Department of Orthopaedics, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Xu Zhai
- Department of Emergency, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Zhongyang Gao
- Department of Orthopaedics, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Teng Lu
- Department of Orthopaedics, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Qian Tian
- Department of Orthopaedics, Xi'an Fourth Hospital, Xi'an, Shaanxi, PR China
| | - Haopeng Li
- Department of Orthopaedics, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Xijing He
- Department of Orthopaedics, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.
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Comparison of photobiomodulation therapy and suprascapular nerve-pulsed radiofrequency in chronic shoulder pain: a randomized controlled, single-blind, clinical trial. Lasers Med Sci 2017; 32:1719-1726. [DOI: 10.1007/s10103-017-2237-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
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Haładaj R, Pingot M, Topol M. The Effectiveness of Cervical Spondylosis Therapy with Saunders Traction Device and High-Intensity Laser Therapy: A Randomized Controlled Trial. Med Sci Monit 2017; 23:335-342. [PMID: 28104903 PMCID: PMC5279870 DOI: 10.12659/msm.899454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Among all spinal therapies, treatment of the cervical segment is the most difficult. The cervical segment is particularly sensitive to injuries and pain, and it also requires special care due to its great mobility and most delicate construction. The aim of this research was to evaluate analgesic efficacy and improvement of active mobility of the cervical spine after traction therapy with the Saunders device and high-intensity laser therapy (HILT) immediately after therapy, and in short-, medium-, and long-term follow-up in patients with cervical spondylosis. Material/Methods The study included 174 patients (114 women and 60 men) aged 24–67 years. The patients were divided into two randomized groups. In group I (88 subjects) traction therapy with the Saunders device was applied, and in group II (86 subjects) HILT was applied. The measurement of the range of cervical spine movement, a subjective visual scale for pain (Visual Analog Scale [VAS]), and the Neck Disability Index-Polish Version (NDI) questionnaire were used. Results The results obtained by the Saunders and HILT methods were similar immediately after the therapy and after 4 weeks (the medium-term follow-up). However, in long-term follow-up, there was a significant increase in the maintenance of positive therapeutic effects with the HILT method. Conclusions Both therapeutic methods improved the efficiency and demonstrated analgesic efficacy in patients with cervical spondylosis immediately and in the medium term after the therapy. HILT was more effective than the Saunders method in long-term follow-up.
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Affiliation(s)
- Robert Haładaj
- Department of Physiotherapy, University of Social Sciences in Łódź, Łódź, Poland
| | - Mariusz Pingot
- Department of Physiotherapy, Jan Kochanowski University in Kielce, Branch in Piotrków Trybunalski, Piotrków Trybunalski, Poland
| | - Mirosław Topol
- Department of Normal and Clinical Anatomy, Medical University of Łódź, Łódź, Poland
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Alayat MSM, Mohamed AA, Helal OF, Khaled OA. Efficacy of high-intensity laser therapy in the treatment of chronic neck pain: a randomized double-blind placebo-control trial. Lasers Med Sci 2016; 31:687-94. [DOI: 10.1007/s10103-016-1910-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 02/08/2016] [Indexed: 12/21/2022]
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