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Saleh MS, Shahien M, Mortada H, Elaraby A, Hammad YS, Hamed M, Elshennawy S. High-intensity versus low-level laser in musculoskeletal disorders. Lasers Med Sci 2024; 39:179. [PMID: 38990213 DOI: 10.1007/s10103-024-04111-1] [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: 03/06/2024] [Accepted: 06/23/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE To evaluate the current evidence comparing low level to high level laser therapy to reveal any superiorities in the treatment of musculoskeletal disorders. METHODS Five databases were searched till September 2022 to obtain relevant RCTs comparing high intensity and low-level laser therapies in the management of musculoskeletal disorders. Two authors assessed the methodological quality of the included studies using the Physiotherapy Evidence Database scale and meta-analysis was conducted for studies that showed homogeneity. RESULTS Twelve articles were included in this systematic review with a total population of 704 participants across various musculoskeletal pathologies including tennis elbow, carpal tunnel syndrome, chronic non-specific low back pain, knee arthritis, plantar fasciitis, and subacromial impingement. There were no statistical differences between the two interventions in pain, electrophysiological parameters, level of disability, quality of life, postural sway or pressure algometer, however, Low level laser therapy showed superiority in increasing grip strength compared to high intensity laser therapy while results were significant in favour of high intensity laser therapy regarding long head of biceps diameter and cross sectional area, supraspinatus thickness and echogenicity and acromio-humeral distance. CONCLUSION The current literature suggests no superiority of both types of laser therapy in musculoskeletal disorders, however, more RCTs with larger sample size are required to reach a definitive conclusion regarding the superiority of either form of laser therapy in musculoskeletal disorders.
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Affiliation(s)
- Marwa Shafiek Saleh
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | - Hossam Mortada
- Biomechanics Unit, Basic Sciences Department, Faculty of Physical Therapy, Galala University, Suez, Egypt
| | | | - Yara Samir Hammad
- Faculty of Physical Therapy, Misr University for Science and Technology, Giza, Egypt
| | - Maged Hamed
- Department of Physical Therapy, Sharm El Shiekh International Hospital, South Sinai, Egypt
| | - Shorouk Elshennawy
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Misr University for Science and Technology, Giza, Egypt.
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Zhang J, Liu J, Huang Y, Yan L, Xu S, Zhang G, Pei L, Yu H, Zhu X, Han X. Current role of magnetic resonance imaging on assessing and monitoring the efficacy of phototherapy. Magn Reson Imaging 2024; 110:149-160. [PMID: 38621553 DOI: 10.1016/j.mri.2024.04.012] [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: 03/08/2024] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
Phototherapy, also known as photobiological therapy, is a non-invasive and highly effective physical treatment method. Its broad use in clinics has led to significant therapeutic results. Phototherapy parameters, such as intensity, wavelength, and duration, can be adjusted to create specific therapeutic effects for various medical conditions. Meanwhile, Magnetic Resonance Imaging (MRI), with its diverse imaging sequences and excellent soft-tissue contrast, provides a valuable tool to understand the therapeutic effects and mechanisms of phototherapy. This review explores the clinical applications of commonly used phototherapy techniques, gives a brief overview of how phototherapy impacts different diseases, and examines MRI's role in various phototherapeutic scenarios. We argue that MRI is crucial for precise targeting, treatment monitoring, and prognosis assessment in phototherapy. Future research and applications will focus on personalized diagnosis and monitoring of phototherapy, expanding its applications in treatment and exploring multimodal imaging technology to enhance diagnostic and therapeutic precision and effectiveness.
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Affiliation(s)
- Jiangong Zhang
- Department of Nuclear Medicine, The First people's Hospital of Yancheng, The Yancheng Clinical College of Xuzhou Medical University, Yancheng, PR China
| | - Jiahuan Liu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Yang Huang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Linlin Yan
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Shufeng Xu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Guozheng Zhang
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Lei Pei
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Huachen Yu
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Xisong Zhu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Xiaowei Han
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China.
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Zhang J, Zhu Q, Shi X, Huang Y, Yan L, Zhang G, Pei L, Liu J, Han X, Zhu X. NIR-II light therapy improves cognitive performance in MPTP induced Parkinson's disease rat models: A preliminary experimental study. Heliyon 2024; 10:e32800. [PMID: 38975234 PMCID: PMC11225833 DOI: 10.1016/j.heliyon.2024.e32800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Cognitive impairment is an important component of non motor symptoms in Parkinson's disease (PD), and if not addressed in a timely manner, it can easily progress to dementia. However, no effective method currently exists to completely prevent or reverse cognitive impairment associated with PD. We therefore aimed to investigate the therapeutic effect of near-infrared region II light (NIR-II) region illumination on cognitive impairment in PD through behavioral experiments (water maze and rotary rod) and multiple fluorescence immunohistochemistry techniques. The 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP)-induced group was compared with the MPTP- untreated rat group, showing a significant reduction in escape latency and significant increase in the fall latency in the MPTP-treated group. The horizontal analysis results indicated that NIR-II phototherapy improved the learning and cognitive abilities as well as coordination and balance abilities of rats. Post-treatment, the MPTP rats showed significantly shortened, escape latency, prolonged target quadrant residence time, and prolonged fall latency compared with pre-treatment. The longitudinal analysis results reaffirmed that NIR-II phototherapy improved the learning and cognitive abilities as well as coordination and balance abilities of rats. The multiple fluorescence immunohistochemistry analysis trend plot showed that the activated microglia and astrocytes in the hippocampus were highest in MPTP-induced PD untreated group, moderate in MPTP-induced PD treatment group, and lowest in the control group. Our data indicates that NIR-II illumination improves learning and cognitive impairment as well as coordination and balance abilities in PD rats by downregulating the activation of microglia and astrocytes in the hippocampus.
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Affiliation(s)
- Jiangong Zhang
- Department of Nuclear Medicine, The First People's Hospital of Yancheng, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, The First Affiliated Hospital of Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, China
| | - Qinqin Zhu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Xun Shi
- Department of Nuclear Medicine, The First People's Hospital of Yancheng, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, The First Affiliated Hospital of Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, China
| | - Yang Huang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Linlin Yan
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Guozheng Zhang
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Lei Pei
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Jiahuan Liu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Xiaowei Han
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Xisong Zhu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
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Ozlu O, Atilgan E. The effect of high-intensity laser therapy on pain and lower extremity function in patellofemoral pain syndrome: a single-blind randomized controlled trial. Lasers Med Sci 2024; 39:103. [PMID: 38630331 PMCID: PMC11024020 DOI: 10.1007/s10103-024-04017-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/07/2024] [Indexed: 04/19/2024]
Abstract
Patellofemoral pain syndrome (PFPS) is a set of symptoms that negatively affect the daily life activities of the individual, leading to functional disability and significant loss of labor, especially in young adults. PFPS is usually due to weakness of the vastus medialis obliquus (VMO) resulting in abnormal patellar tracking and pain. Our study aims to compare the efficacy of high-intensity laser therapy (HILT) on pain and lower extremity function in the treatment of PFPS with different electrophysical agents (EPAs). The study was designed as a single-blind randomized controlled trial. Forty-five people with PFPS (aged 25-45 years) were included in the study. The patients were randomly divided into three groups and a total of ten sessions of treatment were administered to all three groups for 2 weeks, 5 days a week. High-intensity laser (HILT) and exercise program were applied to group 1. Ultrasound (US), transcutaneous electrical nerve stimulation (TENS), and exercise program were applied to group 2. In group 3, US, interferential current (IFC), and exercise program were applied. Both groups underwent three evaluations: pre-treatment, post-treatment, and 12 weeks after treatment. Outcome measures included the visual analog scale for pain severity (VAS), knee flexion range of motion (FROM), Q angle, pain threshold, muscle strength of quadriceps and hamstring, Kujala patellofemoral scoring, lower extremity functional scale (LEFS), and Timed Up and Go Test (TUG). The ANOVA was used for comparing the data of the groups, and two-way repeated measure ANOVA was used to compare at the pre-post and post-intervention 3rd month. The LSD and Bonferroni post hoc tests were also used to identify the between-group differences. Groups 2 and 3 were statistically effective in pain and functionality (p < 0.05). Group 1 was found to be statistically more effective than other groups in reducing pain (95% confidence interval (CI), 0.000/0.000; p = 0.000), increasing knee flexion angle (95% CI, 127.524/135.809; p = 0.000), and increasing lower extremity function (95% CI, 75.970/79.362; p = 0.000). This study indicated that high-intensity laser therapy was found to be a more effective method in the treatment of patellofemoral pain syndrome after 3 months of follow-up compared to US-TENS combination and US-interferential current combination treatments. Also, HILT can be used as an effective method in combination with an appropriate exercise program including vastus medialis strengthening to reduce pain and increase functionality in the patients with PFPS.
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Affiliation(s)
- Ozge Ozlu
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Istanbul Medipol University, 34815, Istanbul, Turkey.
| | - Esra Atilgan
- Department of Orthotics and Prosthetic, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Zare Bidoki M, Vafaeei Nasab MR, Khatibi Aghda A. Comparison of High-intensity Laser Therapy with Extracorporeal Shock Wave Therapy in the Treatment of Patients with Plantar Fasciitis: A Double-blind Randomized Clinical Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:147-155. [PMID: 38584653 PMCID: PMC10997849 DOI: 10.30476/ijms.2023.98042.2991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/19/2023] [Accepted: 05/18/2023] [Indexed: 04/09/2024]
Abstract
Background The most common cause of heel pain is plantar fasciitis (PF). Although conservative treatments relieve pain in more than 90% of patients, it may remain painful in some cases. This study aimed to compare High-intensity Laser Therapy (HILT) with Extracorporeal Shock Wave Therapy (ESWT) in patients with PF. Methods In this double-blinded randomized clinical trial (conducted in Yazd, Iran, from May 2020 to March 2021), patients were classified into two groups, including the ESWT and HILT, using online randomization. Nine sessions, three times a week for 3 weeks, were the treatment period in both groups. Visual Analogue Score (VAS), Heel Tenderness Index (HTI), and the SF36 questionnaire were compared and analyzed statistically at the beginning and 9 months after treatment. Results 38 patients (19 in each group) completed the study. Results showed that pain and patient satisfaction improved significantly 3 months after treatment. The VAS and HTI decreased 3 months after treatment in both groups, which was statistically significant (P<0.001). The SF36 score in both groups increased 3 months after treatment, and this increase was statistically significant (P<0.001). Although the two modalities were effective based on VAS, HTI, and SF36, a significant statistical difference was observed between them (P=0.03, P=0.006, P=0.002, respectively), and the HILT was more effective. Conclusion ESWT and HILT decrease pain and increase patient satisfaction in PF. Besides, both methods are non-invasive and safe. However, there is a significant difference between them, and HILT is more effective. Trial registration number: IRCT20210913052465N1.
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Affiliation(s)
- Marzieh Zare Bidoki
- Department of Physical Medicine and Rehabilitation, School of Medicine. Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Reza Vafaeei Nasab
- Department of Physical Medicine and Rehabilitation, School of Medicine. Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amidodin Khatibi Aghda
- Department of Physical Medicine and Rehabilitation, School of Medicine. Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Ferlito JV, Silva CF, Almeida JC, da Silva Lopes IA, da Silva Almeida R, Leal-Junior ECP, De Marchi T. Effects of photobiomodulation therapy (PBMT) on the management of pain intensity and disability in plantar fasciitis: systematic review and meta-analysis. Lasers Med Sci 2023; 38:163. [PMID: 37464155 DOI: 10.1007/s10103-023-03823-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
To review the effects of photobiomodulation therapy (PBMT) on pain intensity and disability in people with plantar fasciitis (PF) when compared with control conditions, other interventions, and adjunct therapies. Systematic searches were conducted in five database randomized controlled trials (RCT). We only included randomized controlled trials (RCTs) in adults with PF that compared PBMT to placebo, as well as RCTs that compared PBMT to other interventions; and as an adjunct to other therapies. The methodological quality and certainty were assessed through PEDro Scale and GRADE approach, respectively. The data of comparison were pooled and a meta-analysis was conducted when possible. Nineteen RCTs involving 1089 participants were included in this review. PBMT alone (MD = - 22.02 [- 35.21 to - 8.83]) or with exercise (MD = - 21.84 [- 26.14 to - 17.54]) improved pain intensity in short-term treatment. PBMT was superior to (extracorporeal shock wave therapy) EWST for relief of pain (MD = - 20.94 [- 32.74 to - 9.13]). In the follow-up, PBMT plus exercise had a superior to exercise therapy alone (MD = - 18.42 [- 26.48 to - 10.36]). PBMT may be superior to (ultrasound therapeutic) UST in medium- and long-term follow-ups for disability, but can be not clinically relevant. There is uncertainty that PBMT is capable of promoting improvement in disability. PBMT when used with adjuvant therapy does not enhance outcomes of interest. PBMT improves pain intensity with or without exercise. PBMT has been shown to be superior to ESWT for pain relief, but not superior to other interventions for pain intensity and disability. The evidence does not support PBMT as an adjunct to other electrotherapeutic modalities.
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Affiliation(s)
- João Vitor Ferlito
- Postgraduate Program in Biotechnology, Oxidative Stress and Antioxidant Laboratory, University of Caxias Do Sul, Caxias Do Sul, Rio Grande Do Sul, Brazil.
| | - Chenia Frutuoso Silva
- Department of Physical Therapy, Health Sciences Institute, Federal University of Bahia-UFBA, Salvador, Brazil
| | - Juliana Carvalho Almeida
- Department of Physical Therapy, Health Sciences Institute, Federal University of Bahia-UFBA, Salvador, Brazil
| | | | | | - Ernesto Cesar Pinto Leal-Junior
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
| | - Thiago De Marchi
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, Brazil
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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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Boob MA, Phansopkar P, Somaiya KJ. Physiotherapeutic Interventions for Individuals Suffering From Plantar Fasciitis: A Systematic Review. Cureus 2023; 15:e42740. [PMID: 37654968 PMCID: PMC10467524 DOI: 10.7759/cureus.42740] [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: 06/30/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
The foot and the lower leg comprise the ankle joint complex. The foot is crucial for the maintenance of posture. Frequently, overuse or repeated microtrauma to the fascia causes plantar fasciitis. This review aims to suggest the efficacy of various plantar fasciitis (PF) interventions based on modifications in clinical results. This review included studies from 2019 to March 2023 identified through a systematic literature search. The measures used to predict improvement in pain, discomfort, and foot function symptoms included the Visual Analog scale, Numerical Pain Rating Scale, Pressure Point Threshold by algometer, Weight-Bearing Lunge Test by inch tape, and range of motion. The review included 20 studies that fulfilled the inclusion criteria. Therapeutic interventions included insoles, foot orthosis, foam roller stretching, manual stretching, muscle strengthening, intrinsic muscle activities, extracorporeal shock wave lithotripsy, dry needling, laser, ultrasound, and others, which resulted in pain reduction, improved foot function, and ease of everyday routine. All therapeutic strategies used impacts resulting from minimal to maximal recovery. Various advanced approaches are more effective than conventional physical therapy. In conclusion, conservative therapeutic strategies with manual techniques, orthoses, and alternative intervention strategies can be combined to effectively relieve pain and improve function and overall results. Further high-quality studies are essential to learn more about the ideal dose, treatment approaches, and long-term impacts of these therapies.
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Affiliation(s)
- Manali A Boob
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratik Phansopkar
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Kamya J Somaiya
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Khammas ASA, Mahmud R, Hassan HA, Ibrahim I, Mohammed SS. An assessment of plantar fascia with ultrasound findings in patients with plantar fasciitis: a systematic review. J Ultrasound 2023; 26:13-38. [PMID: 36040577 PMCID: PMC10063743 DOI: 10.1007/s40477-022-00712-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/14/2022] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Plantar fasciitis (PFS) is described by an intense pain over medial tubercle of calcaneus, increased with the first step after waking up, after rest and during weightbearing activity. It is the most common cause of plantar heel pain in adults with the prevalence estimated 10% of the general population. Ultrasound imaging is commonly being used to measure the PF thickness, evaluate the efficacy of different treatments and a guide therapeutic technique in patients with PFS. The objective of this study was to systematically review the studies that were previously published to evaluate the role of ultrasound in the assessment of PF in patients with PFS. METHODS A systematic search was carried out over the last 5 years from 2017 to 2022 on basis the following electronic databases: Science Direct, Scopus, Web of Science, Springer and PubMed. The keywords that used in the searching were: ultrasound, sonography, ultrasonography, plantar fasciitis, imaging of plantar fascia, physiotherapy of plantar fasciitis, interventional treatment of plantar fasciitis, randomized controlled trial of plantar fasciitis and interventional ultrasound. The review focused on the assessment of PF in patients with PFS underwent different interventions using B-mode, shear wave elastography (SWE) and color Doppler ultrasound. RESULTS During the search process, 1661 were recorded using the proper keywords from 2017 to 2022 in which 666 original articles were found after removing the review and duplicated articles. Of these, thirty articles met the inclusion criteria and included in this review. The articles have assessed the PF in patients with PFS under different conditions using different ultrasound modes. Twenty-six articles evaluated the effectiveness of different treatment on PF in patients with PFS using different ultrasound modes. In 8 of 26 articles, the ultrasound was used as both an assessment tool of PF and guide therapeutic technique in patients with PFS. In 18 articles, the ultrasound was used as only assessment tool to identify the PF thickness and its observation changes in patients with PFS. Four articles compared the PF thickness and its intrafascial changes between patients with PFS and healthy subjects. CONCLUSION The ultrasound can be a reliable tool in assessment the effect of different interventions on PF by evaluating its thickness, echogenicity and stiffness changes in patients with PFS. There were different methods and treatments were used among the studies.
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Affiliation(s)
- Abdul Sattar Arif Khammas
- Department of Radiological Techniques, College of Health and Medical Techniques/Baghdad, Middle Technical University, 10047, Bab Al Muadham, Baghdad, Iraq.
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Rozi Mahmud
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Hasyma Abu Hassan
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Idris Ibrahim
- Department of Radiology and Imaging, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Safwan Saeed Mohammed
- Department of Radiological Techniques, College of Health and Medical Techniques/Baghdad, Middle Technical University, 10047, Bab Al Muadham, Baghdad, Iraq
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High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Clin Med 2023; 12:jcm12041479. [PMID: 36836014 PMCID: PMC9963402 DOI: 10.3390/jcm12041479] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/30/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
High-intensity laser therapy (HILT) is one of the therapeutic approaches used in the treatment of musculoskeletal disorders (MSD). The main objective of this study was to examine the effectiveness of HILT for reducing pain and improving functionality in people with MSD. Ten databases were systematically searched for randomized trials published up to 28 February 2022. Randomized clinical trials (RCTs) assessing the effectiveness of HILT on MSD were included. The main outcome measures were pain and functionality. In total, 48 RCTs were included in the qualitative synthesis and 44 RCTs in the quantitative analysis. HILT showed a decrease on the pain VAS (mean difference (MD) = -1.3 cm; confidence interval (CI) 95%: -1.6 to -1.0) and an improvement in functionality (standardized mean difference (SMD) = -1.0; CI95%: -1.4 to -0.7), with low and moderate quality of evidence, respectively. A greater effect was observed when compared with control than with other conservative treatments, both on pain (χ2 = 20.6; p < 0.001) and functionality (χ2 = 5.1; p = 0.02). Differences in the effectiveness of HILT were found depending on the location (χ2 = 40.1 p < 0.001), with further improved functionality in MSD of the knee and shoulder. HILT is an effective treatment for improving pain, functionality, range of motion, and quality of life in people with MSD, although these findings must be treated with caution due to the high risk of bias in the studies. Further clinical trials should be well designed to lower the risk of bias.
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Guimarães JDS, Arcanjo FL, Leporace G, Metsavaht LF, Conceição CS, Moreno MVMG, Vieira TEM, Moraes CC, Gomes Neto M. Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil 2022; 37:727-746. [PMID: 36571559 DOI: 10.1177/02692155221143865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine the effects of different therapeutic interventions that have ever been evaluated in randomized controlled trials on pain due to plantar fasciitis. METHODS We searched different electronic databases until September 2022. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the overall certainty evidence. RESULTS A total of 236 studies met the study criteria, including 15,401 patients. Botulinum toxin MD -2.14 (CI: -4.15, -0.14), micronized dehydrated human amnion/chorion membrane injection MD -3.31 (CI: -5.54, -1.08), dry needling MD -2.34 (CI: -4.64, -0.04), low-dye taping MD -3.60 (CI: -4.16, -3.03), low-level laser therapy MD -2.09 (CI: -2.28, -1.90), myofascial releases MD -1.79 (CI: -2.63, -0.94), platelet-rich plasma MD -2.40 (CI: -4.16, -0.63), radiofrequency MD -2.47 (CI: -4.65, -0.29), and stretching MD -1.14 (CI: -2.02, -0.26) resulted in being effective treatments for pain when compared to the control in the short term. In the medium and long term, only extracorporeal shock wave therapy MD -0.97 (CI: -1.13, -0.81)/MD -2.49 (CI: -3.17, -1.82) was effective for improving pain when compared to the control. CONCLUSIONS Considering the available studies, this systematic review and meta-analysis showed that different therapeutic interventions seem to be useful strategies for improving pain in patients with plantar fasciitis. In the medium and long term, only extracorporeal shock wave therapy was effective in improving pain when compared to the control.
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Affiliation(s)
- Janice de S Guimarães
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Fabio L Arcanjo
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Gustavo Leporace
- Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Biocinética, Rua Visconde de Pirajá, Rio de Janeiro, Brazil
| | | | - Cristiano Sena Conceição
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Marcus V M G Moreno
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Tulio E Marçal Vieira
- Foot and Ankle Medicine and Surgery Department, 534569Cardiopulmonar Hospital, Salvador, Bahia, Brazil
| | - Carolina Cunha Moraes
- Foot and Ankle Medicine and Surgery Department, Portuguese Hospital of Bahia, Salvador, Bahia, Brazil
| | - Mansueto Gomes Neto
- Postgraduate Program in Medicine and Health at the Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Department, Physiotherapy course, 28111Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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TECAR Therapy Associated with High-Intensity Laser Therapy (Hilt) and Manual Therapy in the Treatment of Muscle Disorders: A Literature Review on the Theorised Effects Supporting Their Use. J Clin Med 2022; 11:jcm11206149. [PMID: 36294470 PMCID: PMC9604865 DOI: 10.3390/jcm11206149] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background: It has been estimated that between 30 and 50 per cent of all injuries that take place throughout participation in a sport are the consequence of soft tissue injuries, and muscle injuries are the primary cause of physical disability. Methods: The current literature review was designed between October 2021 and April 2022, according to the PRISMA standards, using the PubMed, Scopus, and Web of Science databases. At the screening stage, we eliminated articles that did not fit into the themes developed in all subchapters of the study (n = 70), articles that dealt exclusively with orthopaedics (n = 34), 29 articles because the articles had only the abstract visible, and 17 articles that dealt exclusively with other techniques for the treatment of musculoskeletal disorders. The initial search revealed 343 titles in the databases, from which 56 duplicate articles were automatically removed, and 2 were added from other sources. Results: The combination of these three techniques results in the following advantages: It increases joint mobility, especially in stiff joints, it increases the range of motion, accelerates tissue repair, improves tissue stability, and extensibility, and it reduces soft tissue inflammation (manual therapy). In addition, it decreases the concentration of pro-inflammatory mediators and improves capillary permeability, resulting in the total eradication of inflammation (HILT). It warms the deep tissues, stimulates vascularity, promotes the repose of tissues (particularly muscle tissue), and stimulates drainage (TECAR). Conclusions: TECAR therapy, combined with manual therapy and High-Intensity Laser therapy in treating muscle diseases, presented optimal collaboration in the recovery process of all muscle diseases.
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Guimarães JS, Arcanjo FL, Leporace G, Metsavaht LF, Sena C, Moreno MVMG, Marçal Vieira TE, Gomes Neto M. Effect of low-level laser therapy on pain and disability in patients with plantar fasciitis: A systematic review and meta-analysis. Musculoskelet Sci Pract 2022; 57:102478. [PMID: 34847470 DOI: 10.1016/j.msksp.2021.102478] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 10/28/2021] [Accepted: 11/13/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE We performed a systematic review to investigate the effects of low-level laser therapy (LLLT) on pain and disability in patients with plantar fasciitis (PF). METHODS We searched Pubmed, PEDro database, Scielo, and Cochrane Central for randomized controlled trials that evaluated the effects of LLLT for patients with PF. The methodological aspects of the studies included were scored using the PEDro scale. Three comparisons were made: LLLT compared with placebo, LLLT combined with conventional rehabilitation (CR) compared with CR and LLLT compared with extracorporeal shock wave therapy. RESULTS Fourteen studies (817 patients) met the study criteria. Compared to the placebo group, LLLT improved pain (MD, -2.3; 95% CI: 2.6 to -2, I2 = 0%; 4 studies, N = 234: moderate-quality evidence) in the short term (0-6 weeks). No significant difference in short-term disability was found for participants in the LLLT group compared to the placebo group. Compared to the CR group, LLLT combined with CR improved pain (MD, -2.0; 95% CI: 2.9 to -1.1, I2 = 0%; 2 studies, N = 90: moderate-quality evidence) in the short term (0-6 weeks). Compared to extracorporeal shock wave therapy, LLLT did not significantly reduce pain intensity in the short term (MD, 0.5; 95% CI: 2.0 to 2.9, I2 = 96%; 4 studies, N = 175: low-quality evidence). CONCLUSIONS LLLT may improve pain in the short term and can be considered as a component of care of patients with PF. However, this superiority disappeared compared to extracorporeal shock wave therapy. LEVEL OF EVIDENCE Therapeutic level I.
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Affiliation(s)
- Janice S Guimarães
- Programa de Pós-Graduação em Medicina e Saúde - Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, CEP 40.110-100, Salvador, BA, Brazil; Division of Foot and Ankle Surgery of Hospital São Rafael, Av. São Rafael, 2152 - São Marcos, CEP: 41253-190, Salvador, Bahia, Brazil; Division of Foot and Ankle Surgery of Hospital Manoel Victorino - Praça Cons. Almeida Couto, s/n, Largo de Nazaré - CEP: 44.150-050, Salvador, Bahia, Brazil.
| | - Fabio L Arcanjo
- Programa de Pós-Graduação em Medicina e Saúde - Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, CEP 40.110-100, Salvador, BA, Brazil; Physiotherapy Research Group of Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, BA, CEP 40.110-100, Brazil
| | - Gustavo Leporace
- Physiotherapy Research Group of Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, BA, CEP 40.110-100, Brazil; IBTS - Instituto Brasil de Tecnologia da Saúde - Rua Visconde de Pirajá, 407 - 905 - Ipanema, CEP:22410-003, Rio de Janeiro, Brazil; Unifesp - Universidade Federal de São Paulo - Rua Sena Madureira, n.° 1.500 - Vila Clementino, CEP: 04021-001, São Paulo - SP, Brazil
| | - Leonardo F Metsavaht
- IBTS - Instituto Brasil de Tecnologia da Saúde - Rua Visconde de Pirajá, 407 - 905 - Ipanema, CEP:22410-003, Rio de Janeiro, Brazil; Unifesp - Universidade Federal de São Paulo - Rua Sena Madureira, n.° 1.500 - Vila Clementino, CEP: 04021-001, São Paulo - SP, Brazil
| | - Cristiano Sena
- Programa de Pós-Graduação em Medicina e Saúde - Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, CEP 40.110-100, Salvador, BA, Brazil; Physiotherapy Research Group of Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, BA, CEP 40.110-100, Brazil; Physical Therapy Department of Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, CEP 40.110-100, Salvador, Bahia, Brazil
| | - Marcus V M G Moreno
- Division of Foot and Ankle Surgery of Hospital Cardiopulmonar - Av. Garibaldi, 2199, Ondina, CEP: 40.170-130, Salvador, Bahia, Brazil
| | - Tulio E Marçal Vieira
- Division of Foot and Ankle Surgery of Hospital Cardiopulmonar - Av. Garibaldi, 2199, Ondina, CEP: 40.170-130, Salvador, Bahia, Brazil
| | - Mansueto Gomes Neto
- Programa de Pós-Graduação em Medicina e Saúde - Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, CEP 40.110-100, Salvador, BA, Brazil; Physiotherapy Research Group of Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, BA, CEP 40.110-100, Brazil; Physical Therapy Department of Universidade Federal da Bahia - UFBA, Av. Reitor Miguel Calmon s/n - Vale do Canela Salvador, CEP 40.110-100, Salvador, Bahia, Brazil
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Penberthy WT, Vorwaller CE. Utilization of the 1064 nm Wavelength in Photobiomodulation: A Systematic Review and Meta-Analysis. J Lasers Med Sci 2021; 12:e86. [PMID: 35155171 PMCID: PMC8837867 DOI: 10.34172/jlms.2021.86] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/18/2021] [Indexed: 07/30/2023]
Abstract
Introduction: Photobiomodulation or low-level laser therapy (LLLT;<0.5 W) has been used as a non-invasive treatment for various medical indications. Short (visible; 635-650 nm) and longer (invisible; 810-850 nm and 915-980 nm) near-infrared wavelengths have been commonly used, but power setting deficiencies or incorrect wavelength settings can cause negative outcomes. The 1064 nm wavelength as the longest wavelength is a relative newcomer in high-powered (>0.5 W) laser photobiomodulation therapy (HPL-PBMT) with unique biophysical characteristics. Methods: A comprehensive search of 2016-2021 PubMed, Google Scholar, and Cochrane databases for "photobiomodulation" restricted to clinical trials for patients with a medical diagnosis was done. "1064 nm" content was identified and restricted to high-powered lasers (>0.5 watt). Cohen's d was calculated for the effect size and the difference was determined as a measure of relative 1064 nm HPL-PBMT efficacy. Results: The 22 independent studies meeting inclusion criteria focused on knee arthropathies, spine, shoulder/elbow, wound, gynecological, or osteoporosis with evaluation of pain, function, quality of life, range of motion (ROM), and anatomy. Pain was reduced with statistical significance (P<0.05) in 90% of study assessments (n=20) and 100% of studies focused on the knee (n=6). Of 18 studies assessing functional outcome measures, 100% demonstrated statistically significant improvements. Follow-up assessments up to 6 months in 5 knee arthritis studies revealed long-term pain reduction after cessation of treatment. Improvements in wound healing, bone mineral density, and knee cartilage thickness were demonstrated. The largest effect sizes observed were pain reduction in knee arthritis (average Cohen's d effect size=2.46). Conclusion: These studies have established that 1064 nm HPL-PBMT can effectively reduce pain, increase ROM, increase functional scores, and increase the quality of life for knee osteoarthritis and spinal disorders, with limitations. More studies are needed for clinical validation of single-trial data detecting changes in musculoskeletal conditions, cartilage thickness and bone density.
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