Pain Scores And Side Effects In Response To Low Level Laser Therapy (LLLT) For Myofascial Trigger Points.

E Liisa Laakso, Carolyn Richardson, and Tess Cramond

1: Physiotherapy Department, Royal Brisbane Hospital, Brisbane;

2: Physiotherapy Department, University of Queensland, Brisbane; and

3: Pain Clinic, Royal Brisbane Hospital, Brisbane, Queensland, Australia.

Clinically, Low Level Laser Therapy - LLLT has been used successfully in the treatment of chronic pain but many have questioned the scientific basis for its use. Many studies have been poorly designed or poorly controlled. A double-blind, placebo-controlled, random-allocation study was designed to analyse the effect of second daily infrared (IR) laser (820 nm, 25 mW) and visible red laser (670 nm,10 mw) at 1 J/cm² and 5 J/cm² on chronic pain. Forty-one consenting subjects with chronic pain conditions exhibiting myofascial trigger points in the neck and upper trunk region underwent five treatment sessions over a two week period. To assess progress, pain scores were measured using visual analogue scales before and after each treatment. The incidence of side effects was recorded. All groups demonstrated significant reductions in pain over the duration of the study with those groups which received infrared (820 nm) laser at I J/cm² and 5 J/cm² demonstrating the most significant effects (p < 0.001). Only those subjects who had active laser treatment experienced side effects. Results indicated that responses to LLLT at the parameters used in this study are subject to placebo and may be dependent on power output, dose and/or wavelength.

Laser Therapy , 9:67-72.

Recherche : Treatment Of Epicondylitis with laser

Posté par administration le 01/12/2008 08:37:49 (461 lectures)

Treatment Of Medial And Lateral Epicondylitis--Tennis And Golfer's Elbow--With Low Level Laser Therapy: A Multicenter Double Blind, Placebo-Controlled Clinical Study On 324 Patients.

Simunovic Z, Trobonjaca T, Trobonjaca Z Laser Center, Locarno, Switzerland. tzlatko@mamed.medri.hr

Background And Objective: Among the other treatment modalities of medial and lateral epicondylitis, low level laser therapy (LLLT) has been promoted as a highly successful method. The aim of this clinical study was to assess the efficacy of LLLT using trigger points (TPs) and scanner application techniques under placebo-controlled conditions. STUDY DESIGN/MATERIAL AND METHODS: The current clinical study was completed at two Laser Centers (Locarno, Switzerland and Opatija, Croatia) as a double-blind, placebo controlled, crossover clinical study. The patient population (n = 324), with either medial epicondylitis (Golfer's elbow; n = 50) or lateral epicondylitis (Tennis elbow; n = 274), was recruited. Unilateral cases of either type of epicondylitis (n = 283) were randomly allocated to one of three treatment groups according to the LLLT technique applied: (1) Trigger points; (2) Scanner; (3) Combination Treatment (i.e., TPs and scanner technique). Bilateral cases of either type of epicondylitis (n = 41) were subject to crossover, placebo-controlled conditions. Laser devices used to perform these treatments were infrared (IR) diode laser (GaAlAs) 830 nm continuous wave for treatment of TPs and HeNe 632.8 nm combined with IR diode laser 904 nm, pulsed wave for scanner technique. Energy doses were equally controlled and measured in Joules/cm2 either during TPs or scanner technique sessions in all groups of patients. The treatment outcome (pain relief and functional ability) was observed and measured according to the following methods: (1) short form of McGill's Pain Questionnaire (SF-MPQ); (2) visual analogue scales (VAS); (3) verbal rating scales (VRS); (4) patient's pain diary; and (5) hand dynamometer. RESULTS: Total relief of the pain with consequently improved functional ability was achieved in 82% of acute and 66% of chronic cases, all of which were treated by combination of TPs and scanner technique. CONCLUSIONS: This clinical study has demonstrated that the best results are obtained using combination treatment (i.e., TPs and scanner technique). Good results are obtained from adequate treatment technique correctly applied, individual energy doses, adequate medical education, clinical experience, and correct approach of laser therapists. We observed that under- and over irradiation dosage can result in the absence of positive therapy effects or even opposite, negative (e.g., inhibitory) effects. The current clinical study provides further evidence of the efficacy of LLLT in the management of lateral and medial epicondylitis.

J Clin Laser Med Surg 1998 Jun;16(3):145-51

Recherche : Low Level Laser Therapy For Tendinopathy.

Posté par administration le 30/11/2008 08:30:00 (455 lectures)

Low Level Laser Therapy For Tendinopathy. Evidence Of A Dose-Response Pattern

Bjordal J M, Couppé C, Ljunggren E.

To investigate whether low level laser therapy can reduce pain from tendinopathy, the authors performed a review of randomised placebo-controlled trials with laser therapy for tendinopathy. Validity assessment of each trial was done acc. to predefined criteria for location-specific dosage and irradiation of the skin directly overlying the affected tendon. The literature search identified 78 randomised control trials of which 20 included tendinopathy. Seven trials were excluded for not meeting the validity criteria on treatment procedure and trial design. 12 of the remaining 13 trials investigated the effect of laser therapy for patients with subacute and chronic tendinopathy and provided a pooled mean effect of 21%. If results from only the nine trials adhering to assumed optimal treatment parameters were included, the mean effect over placebo increased to 32%. Low Level Laser Therapy can reduce pain in subacute and chronic tendinopathy if a valid treatment procedure and location-specific dose is used.

Physical Therapy Reviews. 2001; 6: 91-99.

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	L'équipe Olympique Américaine utilise le laser doux Le laser doux que nous utilisons impressionne le directeur du centre d'entrainement olympique américain. Ryan Edward III, directeur du département de médecine sportive pour les États-Unis, au centre d'entrainement olympique, note que les athlètes ont ressenti une forte diminution de leur douleur et un augmentation de l'amplitude de mouvements lorsqu'ils sont traités avec notre laser doux, en particulier dans les phases aiguës des blessures. Il a également remarqué une réduction du temps de guérison pour une variété de conditions. Il considère que le laser doux a été un outil valable pour le traitement et la réadaptation au cours de la préparation et lors des jeux olympiques d'Athènes, contribuant au soulagement des douleurs des athlètes dans des moments critiques.

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Pain Scores And Side Effects In Response To Low Level Laser Therapy (LLLT) For Myofascial Trigger Points.

Treatment Of Medial And Lateral Epicondylitis--Tennis And Golfer's Elbow--With Low Level Laser Therapy: A Multicenter Double Blind, Placebo-Controlled Clinical Study On 324 Patients.

Low Level Laser Therapy For Tendinopathy. Evidence Of A Dose-Response Pattern

Les joueurs de la NFL sont traités au laser doux !

L'équipe Olympique Américaine utilise le laser doux