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Rhee SM, Kim DH, Kim MS. Magnetic resonance imaging for relationship between the severity of perianchor fluid collection and rotator cuff integrity after arthroscopic double-row suture-bridge rotator cuff repair. Orthop Traumatol Surg Res 2024; 110:103897. [PMID: 38663742 DOI: 10.1016/j.otsr.2024.103897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/19/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE The primary purpose of this study was to assess perianchor fluid collection (PFC) severity of medial anchor and rotator cuff integrity association after arthroscopic double-row suture-bridge rotator cuff repair (RCR) and the secondary purpose was to identify the demographic and radiologic risk factors for high-grade PFC. HYPOTHESIS Re-tear rate would be significant higher in patients with high-grade PFC. METHODS We retrospectively reviewed patients with arthroscopic double-row suture-bridge RCR for full-thickness rotator cuff tear (RCT) at our institution between February 2012 and May 2018. Based on the PFC severity, they were divided into the no-fluid (no fluid collection), low-grade (minimal or local fluid collection around the anchor), and high-grade (fluid collection beyond the entire length of the anchor) groups. Magnetic resonance imaging was performed 6 months postoperatively for assessing PFC severity and repaired rotator cuff integrity association, besides evaluating correlation between severity and various demographic and radiologic factors, including work level (low/medium/high) and RCT size. RESULTS This study included 312 patients, 181 (58%) in the no fluid group, 82 (26.3%) in the low-grade PFC group, and 49 (15.7%) in the high-grade PFC group. Re-tear occurred in 73 (23.4%) patients and was more frequent in the high-grade group (26/49 [53.1%]) than in the no-fluid (27/181 [14.9%]; p<0.001) and low-grade (20/82 [24.4%]; p=0.001) groups, without statistically significant differences between the latter two (p=0.082). Among the demographic factors, work level (low/medium/high) differed significantly between the no-fluid (22.1%/58.0%/19.9%), low-grade (25.7%/46.3%/28.0%), and high-grade (26.5%/34.7%/38.8%) groups (p=0.026). Among the radiologic factors, the mediolateral tear size differed significantly between the three groups (no-fluid group: 1.7±0.8cm, low-grade group: 1.8±0.6cm, high-grade group: 2.2±1.0cm; p=0.003). Multivariate regression analysis showed that mediolateral tear size (odds ratio: 1.821; 95% confidence interval: 1.258-2.636; p=0.001) was an independent risk factor for high-grade PFC. CONCLUSIONS After arthroscopic double-row suture-bridge RCR, the highest re-tear rate was observed in patients with high-grade PFC, while there was no significant difference in rates between no-fluid and low-grade PFC groups. As PFC severity increased, the risk of re-tear increased. In particular, larger mediolateral tear size was associated with high-grade PFC. LEVEL OF EVIDENCE III; case-control study.
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Affiliation(s)
- Sung Min Rhee
- Shoulder & Elbow clinic, Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Dong Hyun Kim
- Shoulder & Elbow clinic, Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Myung Seo Kim
- Shoulder & Elbow clinic, Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
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Kim MS, Jang GY, Cho NS. Effect of Preoperative Lipidemic Control on Retear Rates After Rotator Cuff Repair in Patients With Hyperlipidemia. Am J Sports Med 2024; 52:2835-2842. [PMID: 39166295 DOI: 10.1177/03635465241264818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
BACKGROUND In patients with hyperlipidemia, the risk of retear increases after rotator cuff repair (RCR). In particular, it has been reported that preoperative low-density lipoprotein cholesterol (LDL-C) level affects cuff integrity. However, there are no studies assessing whether lipidemic control affects cuff healing. PURPOSE To evaluate the effect of preoperative lipidemic control on cuff integrity after arthroscopic RCR across cardiovascular disease risk groups in patients with hyperlipidemia. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS The authors retrospectively reviewed the charts of patients with hyperlipidemia who underwent arthroscopic double-row suture bridge RCR between 2014 and 2019. The included patients had LDL-C tested within 1 month before surgery. Magnetic resonance imaging was conducted 6 months after surgery to evaluate the integrity of the repaired cuff tendon. Patients were divided into groups of low, moderate, high, and very high risk according to the 4th Korean Dyslipidemia Guidelines. On the basis of the target LDL-C set in each risk group, patients were categorized into 2 groups: group C (controlled hyperlipidemia, less than target LDL-C) and group U (uncontrolled hyperlipidemia, target LDL-C or greater). The correlation between serum lipid profile, lipidemic control, and post-RCR integrity was evaluated. RESULTS A total of 148 patients were analyzed, 51 in group U and 97 in group C. The retear rate was significantly higher in group U than in group C (23/51 [45.1%] vs 18/97 [18.6%], respectively; P = .001). The proportion of group U was significantly higher in the retear group than in the healing group (56.1% vs 26.2%; P = .001). In addition, the proportions of patients with uncontrolled diabetes mellitus (DM) (19.5% vs 3.7%; P = .002) and mediolateral (2.6 ± 1.2 cm vs 1.7 ± 1.1 cm; P < .001) and anteroposterior (2.2 ± 1.1 cm vs 1.6 ± 0.8 cm; P = .003) tear sizes were significantly different between the retear and healing groups, respectively. No significant difference in serum lipid profile, including LDL-C level (119.6 ± 31.3 vs 116.7 ± 37.2; P = .650), was observed between the retear and healing groups. Multivariate regression analysis identified uncontrolled hyperlipidemia (OR, 4.005; P = .001), uncontrolled DM (OR, 5.096; P = .022), and mediolateral tear size (OR, 1.764; P = .002) as independent risk factors for retear. The 2.0-cm mediolateral size cutoff and the 3 independent risk factors had significant associations with retear. CONCLUSION Poor preoperative lipidemic control was significantly associated with poor healing after RCR. In addition to large mediolateral tear size, uncontrolled hyperlipidemia and DM were significant risk factors for retear. Moreover, poor lipidemic control compared with the recommended target level before surgery was more correlated with an increased retear rate than a preoperative LDL-C level.
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Affiliation(s)
- Myung-Seo Kim
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Gi-Young Jang
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Nam-Su Cho
- Department of Orthopedic Surgery, Cheil Orthopedic Hospital, Gangnam-gu, Seoul, Republic of Korea
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Poenaru D, Sandulescu MI, Potcovaru CG, Cinteza D. High-Intensity Laser Therapy in Pain Management of Knee Osteoarthritis. Biomedicines 2024; 12:1679. [PMID: 39200144 PMCID: PMC11351435 DOI: 10.3390/biomedicines12081679] [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: 07/07/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 09/01/2024] Open
Abstract
Knee osteoarthritis (KO) is an important health condition, affecting one third of people aged 65 years or more. Pain is the main cause of disability. Pain management in KO includes pharmacological and non-pharmacological modalities. Patient education, lifestyle changes, physical exercise, and physical agents are prescribed as a first approach for pain control. Laser therapy is part of many therapeutical protocols, with two forms: low-level laser therapy (LLLT) and high-intensity laser therapy (HILT). This paper aimed to stress the advantages of HILT based on a greater wavelength, higher energy delivery, and deeper tissue penetration. Research on 23 published trials revealed that the analgesic effect is rapid, cumulative, and long lasting. Compared to sham, to LLLT, or to other combinations of therapeutical modalities, HILT provided significantly better results on pain reduction and functional improvement. Ultrasound examination showed a reduction in intra-articular inflammation.
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Affiliation(s)
- Daniela Poenaru
- Rehabilitation Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.S.); (C.G.P.); (D.C.)
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Dajpratham P, Pongratanakul R, Satidwongpibool T, Kluabwang N, Akkathep P, Claikhem T. Comparative effectiveness of high-intensity laser therapy and ultrasound therapy for hemiplegic shoulder pain in stroke patients: a randomized controlled trial". Top Stroke Rehabil 2024:1-9. [PMID: 38917125 DOI: 10.1080/10749357.2024.2359343] [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: 12/04/2023] [Accepted: 05/18/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Hemiplegic shoulder pain (HSP) is a prevalent clinical manifestation following stroke, often causing considerable discomfort and disability. Various therapeutic approaches have been developed to address HSP. OBJECTIVES This study aimed to compare the effectiveness of HILT versus US therapy in alleviating HSP in stroke patients. METHODS A double-blind randomized controlled trial enrolled stroke patients with HSP within one year post-onset. Participants were randomly assigned to HILT (with sham US) or US therapy (with sham HILT). Both groups received 10-minute sessions of their assigned therapy modality along with daily shoulder range of motion (ROM) exercises 5 times per week over two consecutive weeks. Pain reduction was the primary outcome, with shoulder ROM as secondary outcomes. RESULTS Thirty patients (11 women, 19 men; mean age: 60.80 ± 11.51 years) were included. After the two-week intervention, significant improvements were observed in pain reduction at rest and during motion in the HILT group, and in pain reduction during motion and shoulder internal rotation in the US group compared to pre-treatment values within each group. However, there was no significant difference between the HILT and US therapy groups in any evaluated parameter. CONCLUSIONS Comparable efficacy was found between HILT and US therapy in reducing pain and improving shoulder ROM for HSP in stroke patients. Both modalities, when combined with shoulder ROM exercises, offer viable options for managing HSP in this population. Further research with larger sample sizes is needed to validate these findings and explore long-term outcomes.
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Affiliation(s)
- Piyapat Dajpratham
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rinlada Pongratanakul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tipchutha Satidwongpibool
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nawapat Kluabwang
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Piyapong Akkathep
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thaniyaporn Claikhem
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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de la Barra Ortiz HA, Parizotto N, Arias M, Liebano R. Effectiveness of high-intensity laser therapy in the treatment of patients with frozen shoulder: a systematic review and meta-analysis. Lasers Med Sci 2023; 38:266. [PMID: 37981583 DOI: 10.1007/s10103-023-03901-3] [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: 03/19/2023] [Accepted: 09/30/2023] [Indexed: 11/21/2023]
Abstract
The purpose of this study is to evaluate the effects of high-intensity laser therapy (HILT) in patients with frozen shoulder. PRISMA guidelines were adhered to, and a systematic search was conducted in the PubMed, Web of Science, Scopus, CINAHL, Science Direct, and PEDro databases (last update: September 4, 2023; search period: December 2022-September 2023). The inclusion criteria encompassed RCTs comparing HILT with other physical therapy interventions in frozen patients with frozen shoulders, with or without sham HILT, assessing pain intensity, shoulder ROM, and disability outcomes. The quality of the RCTs was assessed with the Cochrane Risk of Bias tool, and evidence was assessed using the GRADE approach. Five trials met the eligibility criteria and were included in the review and meta-analysis, which pooled results from the visual analog scale (VAS), goniometry, and the shoulder pain and disability index (SPADI). Mean differences (MDs) for pain intensity and disability show a pooled effect in favor of HILT both for VAS (MD = - 2.23 cm, 95% CI: - 3.25, - 1.22) and SPADI (MD = - 10.1% (95% CI = - 16.5, - 3.7), changes that are statistical (p < 0.01) and clinical. The MD for flexion (MD = 9.0°; 95% CI: - 2.36°, 20.3°; p = 0.12), abduction (MD = 3.4°; 95% CI: - 6.9°, 13.7°; p = 0.51), and external rotation (MD = - 0.95°; 95% CI: - 5.36°, 3.5°; p = 0.67) does not show statistical and clinical differences between groups after treatment. PI and disability changes were graded as important due to their clinical and statistical results. HILT into a physical therapy plan reduce pain and disability, but it does not outperform conventional physical therapy in improving shoulder ROM. It is suggested that future RCTs compare the effects of HILT and LLLT to assess their possible differences in their analgesic effects.
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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, 7591538, Santiago, Chile.
- Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil.
| | - Nivaldo Parizotto
- 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 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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Brindisino F, Girardi G, Crestani M, Fiore A, Giovannico G, Garzonio F, Venturin D, Struyf F. Effectiveness of electrophysical agents in subjects with frozen shoulder: a systematic review and meta-analysis. Disabil Rehabil 2023:1-22. [PMID: 37667875 DOI: 10.1080/09638288.2023.2251880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE This systematic review with meta-analysis aimed to assess the effectiveness of electrophysical agents in improving pain, function, disability, range of motion, quality of life, perceived stiffness, and time to recovery in subjects with frozen shoulder (FS). METHODS A thorough search of MEDLINE, Cochrane Library, PEDro, and EMBASE yielded 1143 articles, of which 23 randomized controlled trials were included. Risk of bias (RoB) was assessed through Cochrane Risk of Bias 2 tool. The certainty of evidence was evaluated through the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS The analysis included a total of 1073 subjects. None of the studies were judged as low RoB. Potentially clinically significant differences were observed in pain at 6 weeks and 5 months after extracorporeal shockwave therapy (ESWT), and in disability up to 3 months with laser therapy, albeit with uncertain results due to the high RoB and to the study heterogeneity. Ultrasound (US) therapy did not yield significant differences in any outcomes. The certainty of evidence was very low. CONCLUSIONS Based on the high heterogeneity and low quality and certainty of evidence, ESWT, laser, and US cannot be recommended for FS treatment. Caution should be exercised in interpreting the findings.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Giuseppe Girardi
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Mauro Crestani
- Rehabilitation Unit, Azienda ULSS n.9 Scaligera, Verona, Italy
| | | | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Fabiola Garzonio
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Davide Venturin
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Filip Struyf
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
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Ordahan B, Yigit F, Mülkoglu C. Efficacy of Low-level Laser Versus High-intensity Laser Therapy in the Management of Adhesive Capsulitis: A Randomized Clinical Trial. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:201-207. [PMID: 37533657 PMCID: PMC10393096 DOI: 10.4103/sjmms.sjmms_626_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/20/2023] [Accepted: 06/11/2023] [Indexed: 08/04/2023]
Abstract
Background Low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are effective in alleviating pain and improving functionality in patients with adhesive capsulitis (AC); however, no study has compared the efficacy of these two laser treatments. Objective To compare the effectiveness of LLLT and HILT in improving the shoulder joint range of motion and functional status and in reducing pain level in patients with AC. Trial Design Prospective, randomized, parallel group, patient- and assessor-blinded. Methods A total of 45 patients (aged: 18-65 years) with complaint of shoulder pain were evaluated for inclusion criteria, which included being aged 18-65 years and a diagnosis of AC based on physical examinations. Using computer-generated random numbers, eligible patients were randomized into two groups: HILT + stretching exercise and LLLT + stretching exercise groups. Both HILT and LLLT were performed three times/week for 3 weeks. Functional status and pain of the patients were evaluated with Shoulder Pain and Disability Index (SPADI) and Visual Analog Scale (VAS), while shoulder joint range of motion was measured with goniometry. All assessments were done before and 3 weeks after treatment. Results A total of 40 patients (20 in each group) completed the study. At baseline, there was no statistically significant difference in the demographic and clinical characteristics between both groups. Both the LLLT and HILT groups showed significant improvement in the VAS and SPADI scores 3 weeks after treatment; however, the improvement was significantly higher in the HILT group than the LLLT group. There was no significant improvement in goniometric scores in both groups compared with baseline. No injury or other musculoskeletal complications were recorded during or after the treatments. Conclusion HILT + stretching exercise treatment was more effective than LLLT + stretching exercise for improving functional parameters and pain in patients with AC. Trial Registration ClinicalTrials.gov Identifier: NCT05469672. Funding None.
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Affiliation(s)
- Banu Ordahan
- Department of Physical Medicine and Rehabilitation, Meram Medical School, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Yigit
- Department of Physical Medicine and Rehabilitation, Meram Medical School, Necmettin Erbakan University, Konya, Turkey
| | - Cevriye Mülkoglu
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
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Raeisi M, Mohammadi HK, Heshmatipour M, Tarrahi MJ, Taheri N. Effect of Transfer Energy Capacitive and Resistive Therapy on Shoulder Pain, Disability, and Range of Motion in Patients With Adhesive Capsulitis: A Study Protocol for a Randomized Controlled Trial. J Chiropr Med 2023; 22:116-122. [PMID: 37346238 PMCID: PMC10280083 DOI: 10.1016/j.jcm.2022.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/16/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022] Open
Abstract
Objective We describe a protocol to evaluate the effectiveness of transfer energy capacitive and resistive (TECAR) therapy on shoulder passive range of motion, shoulder pain, and disability index in patients with adhesive capsulitis. Methods This study will be a double-blinded randomized clinical trial with a 1-month follow-up. For the purpose of this research, 30 patients with a 3-month history of shoulder pain and disability diagnosed as adhesive capsulitis will be selected and then randomized into 2 groups, including conventional physiotherapy consisting of electrophysical modalities and therapeutic exercises, which will be given to the control group. In the intervention group, after conventional physiotherapy, 10 minutes of TECAR therapy in resistive mode will be applied on both the anterior and inferior aspects of the shoulder joint. Outcome measures will be related to shoulder passive range of abduction, flexion, and external rotation that will be measured using a digital inclinometer, as well as shoulder pain and disability index that will be assessed by the validated questionnaire. Assessment will be done at baseline, 1 day after the intervention, and by passing 1 month. Results The statistical analysis will describe within-group and between-group comparisons; the findings will be illustrated in tables and charts. Conclusion Given the reason that the effectiveness of TECAR therapy has not been widely evaluated in adhesive capsulitis, the findings of this pilot study would provide baseline information on the effectiveness and complications of this treatment method and possibly propose a more appropriate protocol for patients with adhesive capsulitis.
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Affiliation(s)
- Maryam Raeisi
- Department of Physical Therapy, School of Rehabilitation Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hosein Kouhzad Mohammadi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojtaba Heshmatipour
- Department of Physical Therapy, School of Rehabilitation Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Navid Taheri
- Department of Physical Therapy, School of Rehabilitation Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Ko SH, Na SC, Kim MS. Risk factors of tear progression in symptomatic small to medium-sized full-thickness rotator cuff tear: relationship between occupation ratio of supraspinatus and work level. J Shoulder Elbow Surg 2023; 32:565-572. [PMID: 36252783 DOI: 10.1016/j.jse.2022.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/07/2022] [Accepted: 09/20/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Previous studies reported that full-thickness rotator cuff tear (FTRCT) is a risk factor for tear progression. However, there is no clear consensus on the risk factors of tear progression in FTRCT. PURPOSE To identify the demographic and radiologic risk factors of tear progression in small to medium FTRCTs. METHODS We retrospectively reviewed 81 shoulders of patients diagnosed with small or medium FTRCTs using magnetic resonance imaging (MRI) who underwent conservative treatment from January 2017 to November 2021. Various demographic factors, including patient work level and radiological factors such as atrophy of rotator cuff muscles were analyzed to evaluate their association with tear progression. Work level was divided into high (heavy manual labor), medium (manual labor with less activity), and low (sedentary work activity). The atrophy of rotator cuff muscles was calculated by occupation ratio. RESULTS Tear progression was observed in 48% (39/81) of patients (criterion for tear progression was medial-lateral or anterior-posterior tear length > 5 mm). In patients with tear progression, the lengths of medial-lateral and anterior-posterior tears progressed by 6 mm and 3 mm, respectively. Among the rotator cuff muscles, fatty degeneration and occupation ratio of the supraspinatus were only worsened (P = .014, P = 0.013, respectively). The mean MRI follow-up duration was 14.8 ± 9.0 months. The significant risk factors of tear progression were high work level (odds ratio [OR], 7.728; 95% CI, 1.204-49.610; P = .031), and occupation ratio of the supraspinatus muscle (OR, 0.308; 95% CI, 0.158-0.604; P = .001). The optimal cutoff value for the occupation ratio of the supraspinatus was 0.55 (sensitivity 74%, specificity 62%). CONCLUSIONS Tear progression was observed in approximately 50% of patients with symptomatic small to medium FTRCTs. High physical work level and atrophy of the supraspinatus muscle were independent risk factors of tear progression. The risk of tear progression increases with occupation ratio of the supraspinatus muscle < 0.55 and heavy manual labor.
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Affiliation(s)
- Sang Hun Ko
- Department of Orthopaedic Surgery, Shoulder & Elbow Clinic, College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Sung Cheon Na
- Department of Orthopaedic Surgery, Shoulder & Elbow Clinic, College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Myung Seo Kim
- Department of Orthopaedic Surgery, Shoulder & Elbow Clinic, College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
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Arroyo-Fernández R, Aceituno-Gómez J, Serrano-Muñoz D, Avendaño-Coy J. High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Clin Med 2023; 12:1479. [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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Affiliation(s)
| | - Javier Aceituno-Gómez
- Nursing, Physiotherapy and Occupational Therapy Department, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Avd. Carlos III s/n., 45071 Toledo, Spain
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Kim MS, Rhee SM, Cho NS. Increased HbA1c Levels in Diabetics During the Postoperative 3-6 Months After Rotator Cuff Repair Correlated With Increased Retear Rates. Arthroscopy 2023; 39:176-182. [PMID: 36049586 DOI: 10.1016/j.arthro.2022.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/02/2022] [Accepted: 08/14/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate whether glycemic control affects the integrity of the repaired rotator cuff during the postoperative healing period after arthroscopic double-row suture bridge rotator cuff repair (RCR) METHODS: We retrospectively reviewed patients with diabetes mellitus (DM) who underwent arthroscopic double-row suture bridge RCR at our institution between March 2016 and November 2019. We included the patients who evaluated for serum glycosylated hemoglobin (HbA1c) levels within 1 month before and 3-6 months after surgery. Magnetic resonance imaging was conducted 6 months after surgery to evaluate the integrity of the repaired cuff tendon. Patients were categorized into two groups based on comparison between preoperative and postoperative HbA1c values: Group I (increased postoperative HbA1c) and Group D (same or decreased postoperative HbA1c). The correlation between preoperative/postoperative HbA1c, HbA1c increase/same or decrease (during the healing period), and post-RCR integrity was evaluated, including various demographic and radiologic factors. RESULTS A total of 103 patients were analyzed, group I was 47, and group D was 56, respectively. The retear rate of 51.1% (24/47) in Group I was significantly higher than 14.3% (8/56) in Group D (P < .001). HbA1c levels measured 3-6 months after surgery (mean: 6.9; 95% CI: 6.6-7.3 vs mean: 6.5; 95% CI: 6.3-6.7, P = .034), and the proportion of group I and group D were significantly different (75%/25% vs 32.4%/67.6%, P < .001) between the retear and healing groups. Multivariable logistic regression analysis identified increased HbA1c as an independent risk factor for retear (odds ratio: 5.402; 95% CI: 2.072-14.086; P < .001). CONCLUSIONS The glycemic control within 3-6 months after surgery when the healing process of the tendon was in progress had a significant effect on retear rate. In particular, the retear rate was higher when the HbA1c level increased at postoperative 3-6 months compared to before surgery. LEVEL OF EVIDENCE Retrospective case-control comparative study, Level III.
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Affiliation(s)
- Myung Seo Kim
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea; College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sung Min Rhee
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea; College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Nam Su Cho
- Department of Orthopedic Surgery, Cheil Orthopedic Hospital, Seoul, Republic of Korea.
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Uysal B, Özkuk K, Şahin N, Ökmen BM, Sezer R, Ateş Z. Comparison of the effectiveness of high-intensity laser and ultrasound therapies in adhesive capsulitis: A randomized controlled study. J Back Musculoskelet Rehabil 2023; 36:227-236. [PMID: 35964170 DOI: 10.3233/bmr-220026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adhesive capsulitis (AC) is a common musculoskeletal disease characterized with shoulder pain, limitation of range of motion (ROM) and disability. Although physical therapy is used in the treatment of AC, studies on its effectiveness are continuing. OBJECTIVE This study aimed to assess the effectiveness of ultrasound (US) and high-intensity laser therapy (HILT) in the treatment of AC. METHODS Sixty patients were randomized into two groups. Group I received US (15 sessions) and Group II received HILT (9 sessions) for 3 weeks. In addition, all patients received physical therapy program (hot pack, TENS and exercises). Assessments were made using VAS-pain, Shoulder Pain and Disability Index (SPADI), range of motion (ROM) at baseline and in post-treatment 3rd, 8th and 24th weeks. RESULTS There was no statistically significant difference between the groups in terms of all pre-treatment values. In intragroup assessment, statistically significant difference was identified in all the values of Groups 1 and 2 in all assessment periods compared with the pre-treatment values (p< 0.05). There was no significant difference between groups in all assessment periods. CONCLUSION According to results, US therapy and HILT were effective on the improvement of pain, ROM and functional conditions of patients in the treatment of AC.
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Affiliation(s)
- Bilal Uysal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Kağan Özkuk
- Department of Medical Ecology and Hydroclimatology, Faculty of Medicine, Usak University, Usak, Turkey
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Burcu M Ökmen
- Department of Physical Medicine and Rehabilitation, Saglik Bilimleri University Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Refia Sezer
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
| | - Zeynep Ateş
- Department of Physical Medicine and Rehabilitation, İzzet Baysal Physical Medicine and Rehabilitation Training and Research Hospital, Bolu, Turkey
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Zielińska P, Śniegucka K, Kiełbowicz Z. A Case Series of 11 Horses Diagnosed with Bone Spavin Treated with High Intensity Laser Therapy (HILT). J Equine Vet Sci 2023; 120:104188. [PMID: 36470513 DOI: 10.1016/j.jevs.2022.104188] [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: 02/16/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
The aim of this work was to characterize and describe the effect of High Intensity Laser Therapy (HILT) used in the treatment of chronic osteoarthritis in horses. Over a 2 year period, 11 horses with diagnosed bone spavin were treated with HILT as a monotherapy. The horses chosen for this report presented hind limb lameness, were positive in a spavin flexion test and showed improvement after intra-articular anesthesia of the tarsometatarsal joint. Additionally, all the horses presented radiological signs of tarsus osteoarthritis and had not been treated for bone spavin for a minimum of 6 months. Each horse received 10 HILT therapies over 14 days' treatment time with the same laser protocol. At post-treatment orthopedic examination, 4 horses (36%) had improved 2 lameness grades (in the 5 grade American Association of Equine practitioners lameness scale), 4 horses (36%) had improved 1 lameness grade and 3 horses (28%) did not improve. Additionally, 3 horses were totally sound after HILT. Post-treatment spavin test result improvement was observed in 5 horses (45%), and 6 horses (55%) showed the same spavin test grade as before treatment. There were no horses that were sound in the spavin test performed after HILT. Therefore, it seems probable that the application of HILT in horses suffering from bone spavin may decrease joint pain, which influences visual lameness reduction.
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Affiliation(s)
- Paulina Zielińska
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.
| | - Karolina Śniegucka
- Institute of Animal Breeding, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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Kim MS, Rhee SM, Cho NS. Perianchor cyst formation in all-suture anchor after rotator cuff repair: an evaluation of anchor insertion angle. J Shoulder Elbow Surg 2022; 31:1831-1839. [PMID: 35367621 DOI: 10.1016/j.jse.2022.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Previous studies reported that micromotion after all-suture anchor implantation can lead to perianchor cyst formation (PCF), leading to risk of retear. Modifying anchor insertion angle (AIA) is known to be one of the various ways to increase anchor stability. However, there currently are few studies that assess the correlation between PCF, AIA, and retear. PURPOSE To find the correlation of PCF and the repaired rotator cuff integrity with AIA after arthroscopic double-row suture-bridge rotator cuff repair (RCR) using an all-suture anchor in the medial row. METHODS A total of 218 patients who underwent arthroscopic double-row suture-bridge RCR were retrospectively reviewed. All patients underwent RCR using all-suture anchors and polyether ketone anchors in the medial and lateral rows, respectively. Magnetic resonance imaging was conducted 6 months after the surgery to evaluate PCF, AIA, and integrity of the repaired cuff. The all-suture anchor insertion angle in the medial row was measured with reference to the greater tuberosity to assess the relationship between the AIA and PCF. The correlations between PCF, AIA, and post-RCR integrity were evaluated including various demographic and radiologic factors. RESULTS Perianchor cysts were formed in 93 patients (42.7%). Mediolateral tear size (2.1 ± 1.2 cm vs. 1.7 ± 0.9 cm, P = .034) and AIA (61.9° ± 15.2° vs. 68.4° ± 13.0°, P = .001) were significantly different between patient groups with and without perianchor cysts. Multivariate logistic regression analysis showed that mediolateral tear size (odds ratio [OR] 1.318, 95% confidence interval [CI] 1.008-1.724; P = .043) and AIA (OR 0.967, 95% CI 0.947-0.988; P = .002) were independent risk factors for PCF. In addition, PCF was observed more frequently (69.6% vs. 32.1%, P < .001) and the AIA was lower (59.4° ± 13.7° vs. 67.8° ± 13.8°, P < .001) in the retear group than in the healed group. CONCLUSIONS Perianchor cysts were formed in approximately 40% of patients who underwent arthroscopic double-row suture-bridge RCR using all-suture anchors. Low AIA and large mediolateral tear size were risk factors for PCF. Moreover, perianchor cyst and AIA were correlated with post-RCR integrity. Therefore, a high AIA must be carefully considered when all-suture anchors are inserted into the medial row when performing RCR.
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Affiliation(s)
- Myung Seo Kim
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea; College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sung Min Rhee
- College of Medicine, Kyung Hee University, Seoul, Republic of Korea; Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Nam Su Cho
- Department of Orthopedic Surgery, Cheil Orthopedic Hospital, Seoul, Republic of Korea.
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15
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Ko SH, Jeon YD, Kim MS. Progression of Symptomatic Partial-Thickness Rotator Cuff Tears: Association With Initial Tear Involvement and Work Level. Orthop J Sports Med 2022; 10:23259671221105471. [PMID: 35783470 PMCID: PMC9247374 DOI: 10.1177/23259671221105471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Partial-thickness rotator cuff tears (PTRCTs) often progress to full-thickness rotator cuff tears (FTRCTs). Thus, it is important to analyze the risk factors for tear progression to determine the proper timing of repair. Purpose To identify the risk factors associated with progression of PTRCT. Study Design Case-control study; Level of evidence, 3. Methods Included were 89 patients diagnosed with PTRCT on magnetic resonance imaging (MRI) scans who underwent nonoperative treatment at the authors' institution between August 2012 and August 2019. Patient characteristics, shoulder stiffness (compared with the contralateral shoulder); work level (classified as high [heavy manual labor], medium [manual labor with less activity], and low [sedentary activity]); and radiological factors including initial tear size, acromion type (flat, curved, hooked, or heel-shaped), and initial tear involvement (as a percentage of the rotator cuff tendon footprint length) were analyzed to assess their association with tear progression, defined as >20% increase in tear involvement. Results The mean MRI follow-up period was 22.3 ± 17.2 months (median, 16.1 months; range, 6.4-89.5 months), and tear progression was observed in 12 patients (13.5%). In these 12 patients, tear involvement increased by 60% of the rotator cuff footprint, while mediolateral (ML) and anteroposterior (AP) tear sizes progressed by 1.1 and 1.8 mm, respectively. Univariate regression analysis showed that shoulder stiffness (P = .031), work level (P = .001), initial tear involvement (P < .001), ML and AP tear sizes (P < .001 and P = .005, respectively), and acromion type (P = .003) were significantly associated with tear progression. Multivariate regression analysis showed that initial tear involvement (odds ratio [OR], 1.053; 95% CI, 1.006-1.102; P = .026) and high work level (OR, 15.831; 95% CI, 1.150-217.856; P = .039) were independent risk factors for tear progression. The cutoff value for initial tear involvement was 47.5% (sensitivity, 81.8%; specificity, 85.7%). Conclusion Tear progression was observed in 14% of patients with PTRCT in this study. To predict tear progression, evaluating the tear involvement during initial MRI is essential. The risk of tear progression increased with initial tear involvement >47.5% and a heavy work level.
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Affiliation(s)
- Sang-Hun Ko
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Young-Dae Jeon
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Myung-Seo Kim
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.,College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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16
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Effect of High-Power Laser Therapy Versus Shock Wave Therapy on Pain and Function in Knee Osteoarthritis Patients: A Randomized Controlled Trial. Photobiomodul Photomed Laser Surg 2022; 40:198-204. [DOI: 10.1089/photob.2021.0136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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17
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Koevska V, Nikolic-Dimitrova E, Mitrevska B, Gjerakaroska-Savevska C, Gocevska M, Kalcovska B. Application of high-intensity laser in pain treatment of patients with knee osteoarthritis. Arch Public Health 2021. [DOI: 10.3889/aph.2021.6008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Osteoarthritis is a rheumatic disease characterized by degeneration and decay of cartilage in the joints. As the disease worsens, the joint space narrows causing numbness and pain, which often impairs movement. In addition to pharmacological therapy, low-intensity laser (LILT), high-intensity laser (HILT) and exercise are used to treat osteoarthritis (OA) of the knee. HILT is a new modality in our country and the experience from its application is small, especially in the treatment of OA of the knee. Aim of the paper was to compare the effect of HILT with LILT in the treatment of OA of the knee. Material and methods: This was a randomized comparative unilateral blind study involving 72 patients divided into two groups. The first group was treated with HILT, the second group treated with LILT. Outcome measure was the visual analogue scale (VAS) for pain, which was made on the first and tenth day of treatment. Statistical significance was defined as p <0.05. Results: We found a significant difference between the two groups in terms of VAS score after 10 therapies in favor to a significantly lower score, that is, less pain in the HILT group (p = 0.0035). The comparison of the VAS score between the two times in the two groups separately showed that in both, the HILT and the LILT groups, the VAS score after 10 days of therapy was significantly lower compared to thatat 0 time, for consequently p = 0.00001vsp = 0.00001. Conclusion: Treatment with HILT and LILT significantly reduces pain and stiffness in patients with OA. Patients treated with HILT had better results, i.e., had a significant reduction in pain than patients treated with LILT. HILT was more effective than LILT.
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18
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Nakandala P, Nanayakkara I, Wadugodapitiya S, Gawarammana I. The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review. J Back Musculoskelet Rehabil 2021; 34:195-205. [PMID: 33185587 DOI: 10.3233/bmr-200186] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adhesive capsulitis is a debilitating condition which causes the capsule of the gleno-humeral joint to thicken and contract progressively. The effectiveness of various non-operative methods has been demonstrated to improve the pain, range of motion (ROM) and functional status of patients with adhesive capsulitis. OBJECTIVE This study aims to review recent evidence on the efficacy of physiotherapy interventions in the treatment of adhesive capsulitis. METHODS PubMed, Physiotherapy Evidence Database (PEDro), Science Direct and Cochrane databases were searched for studies published since 2013. The search terms included: Frozen shoulder, adhesive capsulitis, physical therapy, rehabilitation, manual therapy, mobilization, exercise, education, and electrotherapy. The search was limited to studies published in English and studies that used human subjects. RESULTS Quality scores of 33 articles were reviewed according to the Sackett's critical appraisal criteria and the grades of recommendation were determined for physiotherapy interventions used in the studies. CONCLUSION The empirical evidence suggests that certain physical therapy techniques and modalities are strongly recommended for pain relief, improvement of ROM, and functional status in patients with adhesive capsulitis, while others are either moderately or mildly recommended. However, the efficacy of one treatment modality over another is uncertain. The poor methodological rigors demonstrated in most of the reviewed studies emphasize the urgent need of properly conducted, adequately sampled randomized controlled trials with adequate follow up to determine the superior combination of treatment.
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Affiliation(s)
- Piumi Nakandala
- Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Indumathie Nanayakkara
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Surangika Wadugodapitiya
- Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Indika Gawarammana
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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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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Cucchi D, De Giorgi S, Saccomanno MF, Uboldi F, Menon A, Friedrich MJ, Walter SG, de Girolamo L. Treatment of Primary Shoulder Stiffness: Results of a Survey on Surgeon Practice Patterns in Italy. JOINTS 2021; 7:165-173. [PMID: 34235381 PMCID: PMC8253610 DOI: 10.1055/s-0041-1730983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/19/2021] [Indexed: 11/20/2022]
Abstract
Objectives
Shoulder stiffness is a condition of restricted glenohumeral range of motion (ROM), which can arise spontaneously or as consequence of a known cause. Several treatment options are available and currently no consensus has been obtained on which treatment algorithm represents the best choice for the patient. The aim of this study was to investigate surgeon practice patterns in Italy regarding treatment of primary shoulder stiffness.
Methods
A literature review was performed to identify randomized controlled trials reporting results of shoulder stiffness treatment. The following controversial or critical points in the treatment of primary shoulder stiffness were identified: modalities of physical therapy; indication for oral corticosteroid; indication and frequency for injective corticosteroid; technique and site of injection; and indication, timing, and technique for surgery. A survey composed by 14 questions was created and administrated to the members of a national association specialized in orthopaedics and sports traumatology (SIGASCOT at the time of survey completion, recently renamed SIAGASCOT after the fusion of the societies SIGASCOT and SIA).
Results
A total of 204 completed questionnaires were collected. Physical therapy was recommended by 98% of the interviewed. The use of oral corticosteroids was considered by 51%, and injections of corticosteroids by 72%. The posterior injection approach was the one preferred and a number of three was considered the upper limit for repeated injections. Injective therapy with local anesthetics and hyaluronic acid was considered by more than 20% of the interviewed. Thirty percent of the interviewed did not treat shoulder stiffness surgically.
Conclusion
Several approaches to shoulder stiffness have been proposed and high-level evidence is available to analyze and discuss their results. Several controversial points emerged both from a literature review and from this national survey. Treatment of shoulder stiffness should be tailored to the patient's clinical situation and the stage of its pathology and should aim at pain reduction, ROM restoration, functional regain, and shortening of symptoms duration, with conservative therapy remaining the mainstay of treatment.
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Affiliation(s)
- Davide Cucchi
- Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Bonn, Germany
| | - Silvana De Giorgi
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Bari, Italy
| | | | - Francesco Uboldi
- UOC Ortopedia e Traumatologia Pediatrica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
| | - Alessandra Menon
- Department of Biomedical Sciences for Health, Laboratory of Applied Biomechanics, Università degli Studi di Milano, Milan, Italy.,1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
| | - Max J Friedrich
- Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Bonn, Germany
| | - Sebastian G Walter
- Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Bonn, Germany
| | - Laura de Girolamo
- Laboratorio di Biotecnologie applicate all Ortopedia, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Aceituno-Gómez J, García-Madero VM, Criado-Álvarez JJ, González-González J, Gómez-Soriano J, Avendaño-Coy J. Long-term effect of high-intensity laser therapy for persistent shoulder pain: A case report. J Back Musculoskelet Rehabil 2021; 33:947-951. [PMID: 31929134 DOI: 10.3233/bmr-171044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE This case report describes the long-term effect of the high-intensity laser therapy (HILT) in a patient with chronic shoulder pain refractory in comparison to other treatments. CASE DESCRIPTION Ten sessions of HILT were applied in a thirty-one-year-old woman diagnosed with subacromial syndrome. Assessment was carried out through different tests: Shoulder Pain and Disability Index (SPADI), Numeric Pain Rating Scale (NPRS) and pressure pain threshold (PPT). All measurements were taken at four different points: at the end of the 10 sessions, after one month, three months after the intervention and nine months after the initial intervention. RESULTS There was a clinically significant improvement in NPRS (decrease of 5 points), PPT (increase of 1.5 kg/cm2) and SPADI (decrease of 24 points) one month after the intervention. After three months, the increase of NPRS and SPADI required a 5-session intervention to support the clinical improvement. Six months after these booster sessions an increase in PPT and a decrease in NPRS and SPADI were observed. CONCLUSION Results indicate the suitability of developing new research lines which will optimize the use of HILT.
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Affiliation(s)
- Javier Aceituno-Gómez
- University General Hospital Nuestra Señora del Prado, Gerencia de Atención Integrada de Talavera de la Reina, Toledo, Spain
| | - Venancio Miguel García-Madero
- University General Hospital Nuestra Señora del Prado, Gerencia de Atención Integrada de Talavera de la Reina, Toledo, Spain
| | - Juan José Criado-Álvarez
- Primary Care Center of La Pueblanueva, Gerencia de Atención Integrada de Talavera de la Reina, Toledo, Spain.,Department of Medicine, Faculty of Health Sciences, Castilla-La Mancha University, Talavera, Spain
| | - Jaime González-González
- Department of Medicine, Faculty of Health Sciences, Castilla-La Mancha University, Talavera, Spain.,Primary Care Center of Santa Olalla, Gerencia de Atención Integrada de Talavera de la Reina, Toledo, Spain
| | - Julio Gómez-Soriano
- Toledo Physiotherapy Research Group, Department of Nursing, Physical Therapy and Occupational Therapy, Castilla-La Mancha University, Toledo, Spain
| | - Juan Avendaño-Coy
- Toledo Physiotherapy Research Group, Department of Nursing, Physical Therapy and Occupational Therapy, Castilla-La Mancha University, Toledo, Spain
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Song HJ, Seo HJ, Kim D. Effectiveness of high-intensity laser therapy in the management of patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. J Back Musculoskelet Rehabil 2021; 33:875-884. [PMID: 32831189 DOI: 10.3233/bmr-191738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES High-intensity laser therapy (HILT) has recently been used to control pain and symptom improvement in knee osteoarthritis. We performed a systematic review and meta-analysis of randomized controlled trials to assess the effectiveness of HILT in patients with knee osteoarthritis. METHODS We conducted a search of articles in the MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science databases up to March 2020 for randomized controlled trials investigating HILT intervention, placebo, or active intervention as comparator groups for alleviating pain in knee osteoarthritis. Two independent reviewers evaluated the methodological quality and extracted pain and functional outcomes using a pre-specified form. A meta-analysis was performed using an inverse-variance random effect model. Heterogeneity was assessed using Higgins I2 with p-values. RESULTS Six randomized controlled trials (RCTs) were included in this meta-analysis. For VAS pain, 334 patients from four studies showed that HILT significantly decreased pain compared to the control (MD, -1.18; 95% CI, -1.68 to -0.69). HILT significantly improved WOMAC stiffness (SMD -1.00; 95% CI -1.32, -0.68) and function (SMD, -5.36; 95% CI -7.39 to -3.34) compared to the control. CONCLUSION The effectiveness of HILT on pain, stiffness, and function in patients with knee osteoarthritis is promising. However, due to the limited number of studies, further randomized controlled trials with large, well-designed samples are needed.
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Affiliation(s)
- Hyun Jin Song
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Donghwi Kim
- Department of Orthopaedic Surgery, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Korea
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Korkmaz N, Gurcay E, Demir Y, Tezen Ö, Korkmaz İ, Atar MÖ, Yaşar E. The effectiveness of high-intensity laser therapy in the treatment of post-stroke patients with hemiplegic shoulder pain: a prospective randomized controlled study. Lasers Med Sci 2021; 37:645-653. [PMID: 33829317 DOI: 10.1007/s10103-021-03316-y] [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: 12/16/2020] [Accepted: 04/02/2021] [Indexed: 11/29/2022]
Abstract
To evaluate clinical and ultrasonographic efficacy of high-intensity laser therapy (HILT) in patients with hemiplegic shoulder pain (HSP) accompanied by partial thickness rotator cuff tear (PTRCT). The study was designed as a prospective, randomized, controlled trial. Patients with HSP accompanied by PTRCT (n = 44) were randomly assigned to HILT and control groups. Both groups were treated with a multidisciplinary stroke rehabilitation and a therapeutic exercise program to the affected shoulder supervised by physiotherapists. In addition, HILT group received 3 sessions of the intervention per week for 3 weeks. Primary outcome measure was visual analogue scale (VAS) for pain. Secondary outcome measures were range of motion (ROM) of the shoulder joint, Shoulder Pain and Disability Index (SPADI), Brunnstrom Recovery Stage (BRS), Modified Ashworth Scale (MAS), Nottingham Health Profile (NHP), Functional Independence Measure (FIM), and ultrasonographic PTRCT size. Participants were assessed at pre- and post-treatment. A total of 41 patients completed the study. A statistically significant improvement was observed in VAS, ROM, FIM, SPADI, NHP, and PTRCT parameters in HILT group at post-treatment compared to pre-treatment (all P < 0.05). However, control group indicated significant improvement only in VAS, ROM, and SPADI parameters (all P < 0.05). When differences in clinical parameters at pre- and post-treatment assessment were compared between two groups, change in VAS, FIM, BRS, SPADI, NHP, and PTRCT in HILT group was significantly better than control group (all P < 0.05). HILT combined with therapeutic exercise seems to be clinically and ultrasonographically more effective in the treatment of patients with HSP accompanied by PTRCT than therapeutic exercise alone in the short term. Further studies are needed with long-term follow-up. CinicalTrials.gov Identifier: NCT04669405.
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Affiliation(s)
- Nurdan Korkmaz
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey.
| | - Eda Gurcay
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Yasin Demir
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Özge Tezen
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - İzzet Korkmaz
- Department of Orthopaedic Surgery, Ankara City Hospital, Ankara, Turkey
| | - Merve Örücü Atar
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Evren Yaşar
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
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Jung W, Kim DO, Kim J, Kim SH. Novel and reproducible technique coping with intraoperative anchor pullout during arthroscopic rotator cuff repair. Knee Surg Sports Traumatol Arthrosc 2021; 29:223-229. [PMID: 32232537 DOI: 10.1007/s00167-020-05935-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 02/28/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the incidence of intraoperative anchor pullout during arthroscopic rotator cuff repair, to compare the outcomes of different methods of managing anchor pullout, and to introduce a new technique for anchor pullout. METHODS 1076 patients who underwent arthroscopic rotator cuff repair using a single-row repair technique were included. In 483 patients, rotator cuff repair was performed using a screw-in type anchor, and in 593 patients, soft anchors were used. When intraoperative anchor pullout occurred, it was managed by buddy screwing, anchor insertion in a different location, cement augmentation, or by bar anchoring using a threaded Steinmann pin. Plain radiography and sonography were used to check anchor locations and healing. RESULTS Fifty-two patients experienced anchor pullout intra- or postoperatively (48 and four patients, respectively). Anchor pullouts were more frequently observed for larger tears, women, older patients, and in patients with preoperative stiffness (limitations of both active and passive movements of the affected shoulder joint). For screw-in type anchors, pullout during surgery occurred in 16 patients (3.3%, 16/483), and all were managed using the buddy screwing technique. For soft anchor cases, pullout occurred in 32 patients (5.4%, 32/593) and was managed by anchor insertion in a different location (17 patients), cement augmentation (two patients), or bar anchoring using a threaded Steinmann pin (13 patients). Three patients managed by buddy screwing and two patients managed by anchor insertion in a different location had anchor failure after repair. Tendon healing at 6 months was observed in 12/16 patients treated by buddy screwing, 11/17 treated by anchor insertion in a different location, 2/2 treated by cement augmentation, and 12/13 treated by bar anchoring with a threaded Steinmann pin. CONCLUSION Intraoperative anchor pullout during arthroscopic rotator cuff repair is an uncommon but cumbersome complication. There are some techniques already introduced to deal with this complication. In comparison, not one technique is overwhelmingly superior to others; however, our new technique which is bar anchoring with a threaded Steinmann pin could be another solution, since it could utilize primary anchor sites and results appear to be acceptable. Level of evidence III.
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Affiliation(s)
- Whanik Jung
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea
| | - Dong Ook Kim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea
| | - Jangwoo Kim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea
| | - Sae Hoon Kim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
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Challoumas D, Biddle M, McLean M, Millar NL. Comparison of Treatments for Frozen Shoulder: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2029581. [PMID: 33326025 PMCID: PMC7745103 DOI: 10.1001/jamanetworkopen.2020.29581] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
IMPORTANCE There are a myriad of available treatment options for patients with frozen shoulder, which can be overwhelming to the treating health care professional. OBJECTIVE To assess and compare the effectiveness of available treatment options for frozen shoulder to guide musculoskeletal practitioners and inform guidelines. DATA SOURCES Medline, EMBASE, Scopus, and CINHAL were searched in February 2020. STUDY SELECTION Studies with a randomized design of any type that compared treatment modalities for frozen shoulder with other modalities, placebo, or no treatment were included. DATA EXTRACTION AND SYNTHESIS Data were independently extracted by 2 individuals. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Random-effects models were used. MAIN OUTCOMES AND MEASURES Pain and function were the primary outcomes, and external rotation range of movement (ER ROM) was the secondary outcome. Results of pairwise meta-analyses were presented as mean differences (MDs) for pain and ER ROM and standardized mean differences (SMDs) for function. Length of follow-up was divided into short-term (≤12 weeks), mid-term (>12 weeks to ≤12 months), and long-term (>12 months) follow-up. RESULTS From a total of 65 eligible studies with 4097 participants that were included in the systematic review, 34 studies with 2402 participants were included in pairwise meta-analyses and 39 studies with 2736 participants in network meta-analyses. Despite several statistically significant results in pairwise meta-analyses, only the administration of intra-articular (IA) corticosteroid was associated with statistical and clinical superiority compared with other interventions in the short-term for pain (vs no treatment or placebo: MD, -1.0 visual analog scale [VAS] point; 95% CI, -1.5 to -0.5 VAS points; P < .001; vs physiotherapy: MD, -1.1 VAS points; 95% CI, -1.7 to -0.5 VAS points; P < .001) and function (vs no treatment or placebo: SMD, 0.6; 95% CI, 0.3 to 0.9; P < .001; vs physiotherapy: SMD 0.5; 95% CI, 0.2 to 0.7; P < .001). Subgroup analyses and the network meta-analysis demonstrated that the addition of a home exercise program with simple exercises and stretches and physiotherapy (electrotherapy and/or mobilizations) to IA corticosteroid may be associated with added benefits in the mid-term (eg, pain for IA coritocosteriod with home exercise vs no treatment or placebo: MD, -1.4 VAS points; 95% CI, -1.8 to -1.1 VAS points; P < .001). CONCLUSIONS AND RELEVANCE The findings of this study suggest that the early use of IA corticosteroid in patients with frozen shoulder of less than 1-year duration is associated with better outcomes. This treatment should be accompanied by a home exercise program to maximize the chance of recovery.
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Affiliation(s)
- Dimitris Challoumas
- Institute of Infection, Immunity and Inflammation, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Scotland, United Kingdom
| | - Mairiosa Biddle
- Institute of Infection, Immunity and Inflammation, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Scotland, United Kingdom
| | - Michael McLean
- Institute of Infection, Immunity and Inflammation, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Scotland, United Kingdom
| | - Neal L. Millar
- Institute of Infection, Immunity and Inflammation, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Scotland, United Kingdom
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Ozkaraoglu DK, Tarakci D, Algun ZC. Comparison of two different electrotherapy methods in low back pain treatment. J Back Musculoskelet Rehabil 2020; 33:193-199. [PMID: 31594200 DOI: 10.3233/bmr-181199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the efficacy of High Intensity Laser Therapy (HILT) and Transcutaneous Electrical Nerve Stimulation (TENS) in low back pain (LBP). METHODS Forty patients aged between 18 to 60 were included in this study. The patients were randomized into two groups as TENS (Group I) and HILT (Group II). The severity of pain was measured by Visual Analog Scale (VAS), and the range of motion (ROM) of the joint was measured by goniometer. The Oswestry Disability Questionnaire (ODQ) was used to assess the effect of LBP on daily living activities, and the Beck Depression Inventory (BDI) was used to assess depression. All patients were taken into physical therapy program for 5 days a week for a total of 20 sessions. Patients in Group I received ultrasound, hot pack and HILT, while the patients in Group II received ultrasound, hot pack and TENS. RESULTS In the comparison of post-treatment improvements, among all parameters only VAS score had a significant difference in favor of Group I. CONCLUSIONS The study demonstrated that HILT is more effective than TENS in terms of pain reduction and that HILT can be used as an alternative to TENS.
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Affiliation(s)
- Dilanur Kutlu Ozkaraoglu
- Department of Physiotherapy and Rehabilitation, Istanbul Medipol University Faculty of Health Sciences, Istanbul, Turkey
| | - Devrim Tarakci
- Department of Ergotherapy, Istanbul Medipol University Faculty of Health Sciences, Istanbul, Turkey
| | - Zeliha Candan Algun
- Department of Physiotherapy and Rehabilitation, Istanbul Medipol University Faculty of Health Sciences, Istanbul, Turkey
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Atan T, Bahar-Ozdemir Y. Efficacy of high-intensity laser therapy in patients with adhesive capsulitis: a sham-controlled randomized controlled trial. Lasers Med Sci 2020; 36:207-217. [PMID: 32808147 DOI: 10.1007/s10103-020-03121-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/10/2020] [Indexed: 12/28/2022]
Abstract
Adhesive capsulitis is an idiopathic condition characterized by painful shoulder stiffness, impairs quality of life, and causes disability. The purpose of the study is to evaluate the effects of high-intensity laser therapy (HILT) on pain, disability, and quality of life in patients with adhesive capsulitis. The study was designed as a prospective, double-blinded, and sham-controlled randomized trial. Thirty-six patients diagnosed with adhesive capsulitis were randomized into HILT plus therapeutic exercises, sham-laser plus therapeutic exercises, and control-therapeutic exercises only groups. All groups received 25 min of exercises to the shoulder joint supervised by a physiotherapist. Patients in both the HILT and the sham-laser group were blinded to their group randomization. The interventions were performed five times a week for 3 weeks (a total of 15 sessions). The primary outcome measure was the visual analogue scale for pain (Visual Analog Scale for pain (VAS)-pain). The secondary outcome measures were shoulder pain and disability index (SPADI), short-form health survey-36 (SF-36), and range of motion (ROM) of the shoulder joint. Assessments were performed at pre-intervention, post-intervention, and 12-week follow-up by an investigator who was blinded. Thirty-one participants completed the study. HILT plus therapeutic exercises showed significant differences in VAS-pain, SPADI-pain, and SF-36 (subgroups of energy/fatigue, pain, and general health) scores (all P < 0.05). All groups provided comparable improvements in SPADI-disability and ROM of shoulder joint after the interventions and during the follow-up (all P < 0.05). Fifteen sessions of HILT are superior to improve pain and quality of life but not superior in terms of disability or function in patients with adhesive capsulitis. Clinical trial registration number: The study was registered at the US National Institutes of Health ( ClinicalTrials.gov ) (NCT03929276) and available at https://clinicaltrials.gov/ct2/show/NCT03929276?term=tu%C4%9Fba+atan&draw=2&rank=3.
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Affiliation(s)
- Tuğba Atan
- Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Education and Research Hospital, Ankara, Turkey.
| | - Yeliz Bahar-Ozdemir
- Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Selimiye, Tıbbiye Caddesi, 34668, Uskudar, İstanbul, Turkey
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Jung W, Lee S, Hoon Kim S. The natural course of and risk factors for tear progression in conservatively treated full-thickness rotator cuff tears. J Shoulder Elbow Surg 2020; 29:1168-1176. [PMID: 32044254 DOI: 10.1016/j.jse.2019.10.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/19/2019] [Accepted: 10/27/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The natural course of and risk factors for tear progression in full-thickness rotator cuff tears (FTRCTs) have not been clarified yet. The study's purpose was to retrospectively evaluate tear progression in FTRCTs by using magnetic resonance imaging (MRI) and to identify risk factors that are relevant to such tear progression. METHODS Between June 2010 and September 2019, a total of 345 patients with FTRCTs who had been diagnosed via MRI were treated conservatively. Of these, 48 patients who underwent post-treatment follow-up MRI were retrospectively enrolled. Tear progression was defined as significant when the tear size increased by >5 mm. RESULTS The mean MRI follow-up duration was 22 ± 14 months (range, 12-65 months). Among the 48 patients (mean age, 69 years; range, 53-81), 26 (54%) and 20 (41%) showed medial-lateral (M-L) and anterior-posterior (A-P) tear progression on MRI follow-up. Multivariate analysis revealed that MRI follow-up duration (P = .011), diabetes mellitus (P = .017), and infraspinatus muscle atrophy (P = .011) were independent risk factors for tear progression in the A-P plane. A high critical shoulder angle (P = .011) and supraspinatus (P = .024) and infraspinatus (P = .020) muscle atrophy were risk factors associated with M-L tear progression. CONCLUSION Among the assessed patients, a considerable number of FTRCTs increased in size during the follow-up period. Severe infraspinatus muscle atrophy was the independent risk factor for exacerbation of A-P and M-L tear progression.
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Affiliation(s)
- Whanik Jung
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sanguk Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sae Hoon Kim
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
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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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Abstract
This study retrospectively analyzed the feasible effectiveness of ultrasound-guided acupotomy (USGAP) for the treatment of frozen shoulder (FS). A total of 36 patients with FS were analyzed in this retrospective study. All 36 patients received extracorporeal shock-wave therapy (ESWT). In addition, 18 of them also underwent USGAP intervention and were assigned to a treatment group, while the other 18 patients did not receive such intervention and were assigned to a control group. The primary efficacy endpoint was pain intensity, as measured by the Numeric Rating Scale (NRS). The secondary efficacy endpoint was assessed by the score of shoulder pain and disability index (SPADI). Furthermore, the adverse events were also documented during the treatment period. All efficacy endpoints were measured after the treatment. After treatment, patients who received USGAP exerted better efficacy endpoints in pain relief, as measured by NRS scale (P < .01), and shoulder disorders, as evaluated by SPADI (P < .01), than subjects who did not receive USGAP. Additionally, no adverse events occurred in either group. The results of this study indicated that USGAP may be used for the treatment of FS effectively. More studies are still needed to warrant the present results.
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Affiliation(s)
- Xiao-Yan Cao
- Department of Ultrasound Diagnostics, Yan’an People's Hospital, Yan’an
| | - Hua-Yun Zhao
- Department of Ultrasound Diagnostics, Xi’an Gaoxin Hospital, Xi’an, China
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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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Elsodany AM, Alayat MSM, Ali MME, Khaprani HM. Long-Term Effect of Pulsed Nd:YAG Laser in the Treatment of Patients with Rotator Cuff Tendinopathy: A Randomized Controlled Trial. Photomed Laser Surg 2019; 36:506-513. [PMID: 30188253 DOI: 10.1089/pho.2018.4476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The purpose of the present study was to investigate the long-term effect of pulsed Nd:YAG laser on the treatment of rotator cuff tendinopathy. METHODS Sixty patients with rotator cuff tendinopathy participated and completed the study. The mean age was 50.2 ± 3.6 years. Participants were randomly assigned to one of two groups: the control group and the treatment group. Both groups were treated with an exercise program, in addition to the pulsed Nd:YAG laser received by the treatment group and the "sham" laser received by the control group, both for three sessions per week for 4 weeks. Outcome measures included pain, assessed by the visual analog scale, and range of motion (ROM), assessed using a traditional goniometer, while the shoulder pain and disability index were used to evaluate the functional recovery of the shoulder joint. Evaluation was carried out before treatment, immediately after treatment, 3 months posttreatment, and 6 months posttreatment. Statistical analyses were used to investigate the effect of interventions and to compare the study groups' pretreatment, posttreatment, and at follow-up points. The significance level was set to p < 0.05. RESULTS Pain was significantly decreased after treatment and at follow-up points, while ROM and shoulder functions were significantly improved after treatment and at follow-up intervals in both groups. The improvement was more significant in the treatment group than in the control group posttreatment and at follow-up intervals. CONCLUSIONS Pulsed Nd:YAG laser combined with an exercise program seems to be more effective in the treatment of patients with rotator cuff tendinopathy than a sham laser with exercises.
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Affiliation(s)
- Ahmed Mohamed Elsodany
- 1 Department of Basic Science, Faculty of Physical Therapy, Cairo University , Giza, Egypt
| | | | - Mohamed Mohamed Ebrahim Ali
- 2 Department of Physical Therapy, Faculty of Applied Medical Science, Umm Al-Qura University , Makkah, Saudi Arabia
| | - Hussien Mosa Khaprani
- 3 Department of Rehabilitation Medicine and Physical Therapy, King Faisal Hospital , Makkah, Saudi Arabia
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Aceituno-Gómez J, Avendaño-Coy J, Gómez-Soriano J, García-Madero VM, Ávila-Martín G, Serrano-Muñoz D, González-González J, Criado-Álvarez JJ. Efficacy of high-intensity laser therapy in subacromial impingement syndrome: a three-month follow-up controlled clinical trial. Clin Rehabil 2019; 33:894-903. [PMID: 30672303 DOI: 10.1177/0269215518824691] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of high-intensity laser therapy on shoulder pain and function in subacromial impingement syndrome. DESIGN Clinical controlled trial with alternate allocation. SETTING Hospital Department of Rehabilitation. SUBJECTS A total of 46 participants with subacromial impingement syndrome. INTERVENTION Participants were sequence allocated to an intervention group (high-intensity laser therapy + exercise therapy) and control group (sham-laser + exercise therapy) and received 15 sessions (five days a week during three weeks). MAIN MEASURES Patiens were evaluated at baseline, after 15 sessions, and at one month and at three months after completing the intervention. The main outcome variables were pain and functionality as measured by visual analogue scale; pressure pain threshold; Shoulder Pain and Disability Index; Constant-Murley Score; and QuickDASH. Secondary outcomes were number of sessions at discharge and drug use. RESULTS A total of 21 patients in high-intensity laser therapy group (56.7 ± 8.9 years) and 22 patients in sham-laser group (61.3 ± 8.9 years) concluded the study. Visual analogue scale (cm) at baseline, one-month, and three-months were 6.2 ± 0.5, 3 ± 2.6, and 2.6 ± 2.4 for the control group and 5.4 ± 1.5, 3.6 ± 1.3, and 1.8 ± 1.7 for experimental group, respectively. Shoulder Pain and Disability Index (points) at baseline, one-month, and three-monts were 51.8 ± 16.1, 16.3 ± 16.1, and 13.6 ± 17.1 in the control group and 41.8 ± 20.6, 20.5 ± 19.7, 11 ± 14.5 in experimental group, respectively. No differences were found between groups ( P > 0.05). CONCLUSION The effect of high-intensity laser therapy plus exercise is not higher than exercise alone to reduce pain and improve functionality in patients with subacromial syndrome.
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Affiliation(s)
- Javier Aceituno-Gómez
- 1 University General Hospital Nuestra Señora del Prado, Gerencia de Atención Integrada de Talavera de la Reina (SESCAM), Toledo, Spain
| | - Juan Avendaño-Coy
- 2 Toledo Physiotherapy Research Group (GIFTO), E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Julio Gómez-Soriano
- 2 Toledo Physiotherapy Research Group (GIFTO), E.U. Enfermería y Fisioterapia de Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Venancio Miguel García-Madero
- 1 University General Hospital Nuestra Señora del Prado, Gerencia de Atención Integrada de Talavera de la Reina (SESCAM), Toledo, Spain
| | | | - Diego Serrano-Muñoz
- 3 Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - Jaime González-González
- 4 Gerencia de Atención Integrada de Talavera de la Reina (SESCAM), Toledo, Spain.,5 Medicine Department, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Juan José Criado-Álvarez
- 4 Gerencia de Atención Integrada de Talavera de la Reina (SESCAM), Toledo, Spain.,5 Medicine Department, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Universidad de Castilla-La Mancha, Ciudad Real, Spain
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Yan J, Zhang XM. A randomized controlled trial of ultrasound-guided pulsed radiofrequency for patients with frozen shoulder. Medicine (Baltimore) 2019; 98:e13917. [PMID: 30608419 PMCID: PMC6344187 DOI: 10.1097/md.0000000000013917] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND This study assessed the effectiveness and safety of ultrasound-guided pulsed radiofrequency (UGPRF) for patients with frozen shoulder (FS). METHODS This study was designed as a randomized, double-blind, sham control trial. A total of 136 patients with FS were recruited and then were equally randomly allocated into a treatment group (n = 68) and a sham group (n = 68). The patients in the treatment group received UGPRF, while the subjects in the sham group underwent sham UGPRF. Patients in both groups were treated for a total of 12 weeks. The primary outcome was the pain intensity, measured by the visual analog scale (VAS). The secondary outcomes consisted of shoulder disorder, measured by the score of shoulder pain and disability index (SPADI); quality of life, assessed by the Short Form-36 questionnaire (SF-36); and any adverse events (AEs) during the treatment period. All outcomes were measured at baseline, at the end of 6-week, and 12-week treatment. RESULTS At the end of 6 weeks, and 12 weeks, UGPRF showed more promising outcome results in pain relief, as measured by VAS (P <.01), improvement of shoulder disorder, as assessed by SPADI score (pain, P <.01; disability, P <.01; total, P <.01), and enhancement of quality of life, as measured by the SF-36 scale (PCS, P <.01; MCS, P <.01), compared with sham UGPRF in this study. CONCLUSION The findings of this study showed that UGPRF may benefit for patients with FS after 12 weeks treatment.
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Affiliation(s)
- Juan Yan
- Department of Ultrasound, Yanan University Affiliated Hospital, Yanan
| | - Xian-min Zhang
- Department of Ultrasound, The First People's Hospital of Xianyang City, Xianyang, China
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Effect of smartphone application-supported self-rehabilitation for frozen shoulder: a prospective randomized control study. Clin Rehabil 2018; 33:653-660. [DOI: 10.1177/0269215518818866] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To evaluate the clinical efficacy of smartphone-assisted self-rehabilitation in patients with frozen shoulder. Design: A single-center, randomized controlled trial. Setting: Orthopedic department of a university hospital. Subjects: A total of 84 patients with frozen shoulder were recruited. Intervention: Patients were randomly divided into two groups: a smartphone-assisted exercise group ( n = 42) and a conventional self-exercise group ( n = 42). The study was performed over three months, during which each group performed home-based rehabilitation. Main measures: Visual analogue scale for pain and passive shoulder range of motion were assessed at baseline and after 4, 8, and 12 weeks of treatment. Technology Acceptance Model–2 and Usefulness, Satisfaction, and Ease of Use scores were evaluated in the smartphone group. Results: Initial visual analogue scale for pain of the smartphone group was 6.0 ± 2.2 and ended up with 1.8 ± 2.5 after 12 weeks, whereas the self-exercise group showed 5.8 ± 2.3 for the baseline visual analogue scale for pain and 2.2 ± 1.7 at the end. Significant time-dependent improvements in all measured values were observed in both groups (all Ps < 0.001), but no significant intergroup difference was observed after 4, 8, or 12 weeks of treatment. In the smartphone group, Technology Acceptance Model–2 and Usefulness, Satisfaction, and Ease of Use scores showed high patient satisfaction with smartphone-assisted exercise. Conclusion: There was no difference between home-based exercise using a smartphone application and a conventional self-exercise program for the treatment of frozen shoulder in terms of visual analogue scale for pain and range of motions.
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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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Wyszyńska J, Bal-Bocheńska M. Efficacy of High-Intensity Laser Therapy in Treating Knee Osteoarthritis: A First Systematic Review. Photomed Laser Surg 2018; 36:343-353. [DOI: 10.1089/pho.2017.4425] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Justyna Wyszyńska
- Centre for Innovative Research in Medical and Natural Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Monika Bal-Bocheńska
- Centre for Innovative Research in Medical and Natural Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
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Kolu E, Buyukavci R, Akturk S, Eren F, Ersoy Y. Comparison of high-intensity laser therapy and combination of transcutaneous nerve stimulation and ultrasound treatment in patients with chronic lumbar radiculopathy: A randomized single-blind study. Pak J Med Sci 2018; 34:530-534. [PMID: 30034410 PMCID: PMC6041553 DOI: 10.12669/pjms.343.14345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective: To compare the effects of high-intensity laser therapy (HILT) and a combination of transcutaneous nerve stimulation (TENS) with ultrasound (US) therapy on pain and functionality in patients with chronic lumbar radiculopathy. Methods: This prospective randomized comparative study was conducted in Department of physical medicine and rehabilitation, Turgut Ozal Medicine Center, Malatya, Turkey from April 2016 to September 2016. A total of 54 patients with chronic lumbar radiculopathy were enrolled in this study. The patients were randomly divided into two groups: Group 1 (n:27) received 10 sessions of a combination of hot pack, TENS, US and exercise, and Group 2 (n:27) received hot pack, HILT and exercise. The outcomes measured were low back with unilateral leg pain level measured by visual analog scale (VAS) and functionality measured with the Oswestry Disability Index (ODI) at the end of the therapy and four weeks later. p-value less than 0.05 considered statistically significant. Results: In two groups, VAS (low back with unilateral leg pain) and ODI scores showed significant changes. At the end of the 2 weeks intervention, participants in Group-1 showed a significantly greater decrease in pain than participants in Group-2. Statistically significant differences in pain variation and functionality (VAS and ODI) were observed four weeks after treatment sessions for participants in the TENS+US therapy group compared with participants in the HILT group. Conclusion: HILT and TENS+US combined with exercise were effective treatment modalities in decreasing the VAS and ODI scores. TENS+US combined with exercises were more effective than HILT combined with exercise.
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Affiliation(s)
- Emine Kolu
- Emine Kolu, Inonu University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Malatya, Turkey
| | - Raikan Buyukavci
- Raikan Buyukavci, Inonu University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Malatya, Turkey
| | - Semra Akturk
- Semra Akturk, Inonu University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Malatya, Turkey
| | - Fatma Eren
- Fatma Eren, Inonu University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Malatya, Turkey
| | - Yuksel Ersoy
- Yuksel Ersoy, Inonu University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Malatya, Turkey
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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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Treatment of drug-resistant fibromyalgia symptoms using high-intensity laser therapy: a case-based review. Rheumatol Int 2017; 38:517-523. [PMID: 29080932 DOI: 10.1007/s00296-017-3856-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/13/2017] [Indexed: 12/11/2022]
Abstract
Fibromyalgia is a chronic musculoskeletal condition characterized by widespread pain in the body and is associated with tender points at the shoulder, back and hip regions. A wide variety of pharmacologic drugs and dietary supplements have been used with limited success in treating the musculoskeletal pain. Early clinical studies with low level laser therapy (LLLT) alone or in combination with drugs commonly used to treat fibromyalgia suggested that LLLT may be effective in reducing musculoskeletal pain and stiffness, as well as the number of tender locations. However, a sham-controlled study reported that LLLT was not significantly better than the sham treatment and kinesiotape. Preliminary studies with high-intensity laser therapy (HILT) suggest that it may be more effective than LLLT for treating chronic pain syndromes. Therefore, we evaluated low (1 W), intermediate (42 W) and high level (75 W) HILT in a woman with long-standing fibromyalgia syndrome which was resistant to both standard pharmacotherapy and treatment in an interdisciplinary pain management program. The patient received a series of treatments with a HILT device (Phoenix Thera-lase) at a wavelength of 1275 nm administered at both the paraspinous region and tender points in the shoulder and hip regions. Although the 1 W treatment produced minimal symptom relief, both the 42 and the 75 W treatments produced a dramatic reduction in her overall pain, improved quality of sleep, and increased her level of physical activity for 4-10 days after these treatment sessions. This case illustrates the potential beneficial effects of using higher power levels of HILT for patients with fibromyalgia syndrome who have failed to respond to conventional interdisciplinary treatment regimens.
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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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Pekyavas NO, Baltaci G. Short-term effects of high-intensity laser therapy, manual therapy, and Kinesio taping in patients with subacromial impingement syndrome. Lasers Med Sci 2016; 31:1133-41. [PMID: 27220527 DOI: 10.1007/s10103-016-1963-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/13/2016] [Indexed: 11/26/2022]
Abstract
Subacromial impingement syndrome (SAIS) is a major contributing factor of shoulder pain; and treatment approaches (Kinesio® taping [KT], Exercise [EX], manual therapy [MT], and high-intensity laser therapy [HILT]) have been developed to treat the pain. The key objective of this study was to compare the effects of KT, MT, and HILT on the pain, the range of motion (ROM), and the functioning in patients with SAIS. Seventy patients with SAIS were randomly divided into four groups based on the treatment(s) each group received [EX (n = 15), KT + EX (n = 20), MT + KT + EX (n = 16), and MT + KT + HILT + EX (n = 19)]. All the patients were assessed before and at the end of the treatment (15th day). The main outcome assessments included the evaluation of severity of pain by visual analogue scale (VAS) and shoulder flexion, abduction, and external rotation ROM measurements by a universal goniometry. Shoulder pain and disability index (SPADI) was used to measure pain and disability associated with shoulder pathology. Statistically significant differences were found in the treatment results of all parameters in MT + KT + EX and HILT + MT + KT + EX groups (p < 0.05). When the means of ROM and SPADI results of three groups were compared, statistically significant differences were found between all the groups (p < 0.05). These differences were significant especially between the groups MT + KT + EX and KT + EX (p < 0.05) and HILT + MT + KT + EX and KT + EX (p < 0.05). HILT and MT were found to be more effective in minimizing pain and disability and increasing ROM in patients with SAIS. Further studies with follow-up periods are required to determine the advantages of these treatments conclusively.
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Affiliation(s)
- Nihan Ozunlu Pekyavas
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Baskent University, Baglica, 06810, Ankara, Turkey.
| | - Gul Baltaci
- Physiotherapy and Rehabilitation Center, Guven Private Hospitals, Kavaklıdere, 06540, Ankara, Turkey
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Karaca B. Effectiveness of High-Intensity Laser Therapy in Subacromial Impingement Syndrome. Photomed Laser Surg 2016; 34:223-8. [PMID: 26890913 DOI: 10.1089/pho.2015.4005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The short-term effectiveness of high-intensity laser therapy (HILT) was investigated as a retrospective case series for the treatment of the pain and disability associated with subacromial impingement syndrome (SAIS). MATERIALS AND METHODS A total of 42 patients, who were diagnosed with subacromial impingement syndrome, underwent a total of nine sessions (three sessions per week) of high-intensity laser therapy. The patients were evaluated before therapy and 8 weeks after therapy using the pain and disability subscales and the total scores of the Shoulder Pain and Disability Index (SPADI), as well as scores for the University of California at Los Angeles (UCLA) shoulder rating scale. RESULTS Significant differences were observed between SPADI pain, disability, and total scores and UCLA scores of the patients. CONCLUSIONS HILT was found to be effective in the short term in the treatment of pain and disability in patients with SAIS.
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Affiliation(s)
- Burcu Karaca
- Department of Physical Medicine and Rehabilitation, Kırıkkale University Faculty of Medicine , Kirrikale, Turkey
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