ABSTRACT
To study the effects of Polarized Polychromatic Noncoherent Light [Bioptron] therapy on patients with carpal tunnel syndrome [CTS]. This study was designed as a randomized clinical trial. Forty four patients with mild or moderate CTS [confirmed by clinical and electrodiagnostic studies] were assigned randomly into two groups [intervention and control goups]. At the beginning of the study, both groups received wrist splinting for 8 weeks. Bioptron light was applied for the intervention group [eight sessions, for 3/weeks]. Bioptron was applied perpendicularly to the wrist from a 10 centimeters distance. Pain severity and electrodiagnostic measurements were compared from before to 8 weeks after initiating each treatment. Eight weeks after starting the treatments, the mean of pain severity based on Visual Analogue Scale [VAS] scores decreased significantly in both groups. Median Sensory Nerve Action Potential [SNAP] latency decreased significantly in both groups. However, other electrophysiological findings [median Compound Motor Action Potential [CMAP] latency and amplitude, also SNAP amplitude] did not change after the therapy in both groups. There was no meaningful difference between two groups regarding the changes in the pain severity. Bioptron with the above mentioned parameters led to therapeutic effects equal to splinting alone in patients with carpal tunnel syndrome. However, applying Bioptron with different therapeutic protocols and light parameters other than used in this study, perhaps longer duration of therapy and long term assessment may reveal different results favoring Bioptron therapy
ABSTRACT
Carpal Tunnel Syndrome [CTS] is the most common type of entrapment neuropathy. Conservative therapy is usually considered as the first step in the management of CTS. Low Level Laser Therapy [LLLT] is among the new physical modalities, which has shown therapeutic effects in CTS. The aim of the present study was to compare the effects of applying LASER and splinting together with splinting alone in patients with CTS. Fifty patients with mild and moderate CTS who met inclusion criteria were included in this study. The disease was confirmed by electrodiagnostic study [EDx] and clinical findings. Patients were randomly divided into 3 groups. Group A received LLLT and splinting. Group B received sham LLLT+ splinting and group C received only splints. Group A received LLLT [50 mw and 880nm with total dose of 6 joule/cm[2]]. Clinical and EDx parameters were evaluated before and after treatment [3 weeks and 2 months later]. Electrophysiologic parameters and clinical findings including CTS provocative tests, Symptoms severity score [SSS], Functional Severity Score [FSS] and Visual Analogue Score [VAS] were improved in all three groups at 3 weeks and 2 months after treatment. No significant changes were noticed between the three groups regarding clinical and EDX parameters. We found no superiority in applying Low Intensity Laser accompanying splinting to traditional treatment which means splinting alone in patients with CTS. However, future studies investigating LLLT with parameters other than the one used in this study may reveal different results in favor of LLLT.
Subject(s)
Humans , Nerve Compression Syndromes , Low-Level Light Therapy , Treatment Outcome , Electrodiagnosis , Carpal Tunnel Syndrome/diagnosisABSTRACT
Low-level laser therapy [LLLT] is thought to have analgesic and biomodulatory effects. Our objective was to assess the pain-relieving effect of LLLT and possible changes in joint stiffness and disability of patients with knee osteoarthritis [KOA] and compare it to the more commonly used modality; therapeutic ultrasound[US]. 37 patients with mild or moderate KOA were randomized to receive either LLLT, placebo LLLT or US. All patients received a common treatment including acetaminophen [up to 2gr/d] and medical advices for lifestyle modification and exercise. Treatments were delivered 5 times a week over a period of 2 weeks. Active laser group was treated with a diode laser [wavelength 880 nm, continuous wave, power 50 mW] at a dose of 6 J/point [24 J/knee]. The placebo control group was treated with an ineffective probe [power 0 mW] of the same appearance. The third group received pulsed ultrasound with an intensity of 1.5-2 w/cm2, and for 5 minutes per knee. Visual Analogue Scale [VAS] and Western Ontario MacMaster [WOMAC] questionnaires were used for data gathering before,1 and 3 months after completing the therapy. Pain reduced in all 3 groups but laser was superior in comparison. Stiffness improved 1 mo after therapy in the laser group but not in the others. Disability decreased in both laser and US groups [more significantly in the laser group] but not in the placebo group. Our results show that LLLT reduces pain, joint stiffness and disability in KOA and is superior to placebo and US
ABSTRACT
Hand dysfunction after stroke is among the most frequent disabilities which adversely affects many aspects of post stroke patients' life. Routinely, patients receive physical therapy and then occupational therapy in the setting of rehabilitation medicine. Neurofeedback therapy is a new modality based on biofeedback therapy principles to train the brain. The aim of the present study was to evaluate the effect of neurofeedback on improving hand function after stroke. This study was designed as a pilot randomized controlled clinical trial. Fourteen post stroke patients entered the study. Hand function was evaluated by Jebson hand function test pre and post intervention. Patients were randomly allocated into two intervention groups of occupational therapy [OT] and occupational therapy + neurofeedback therapy [NF]. All patients received 10 sessions of therapy. Neurofeedback training was performed to enhance sensorimotor rhythm [SMR]. Mean age of patients was 60 +/- 7 years. Hand function was improved significantly in both groups according to general jebson test. Some functional tasks of Jebson test improved more significantly in NF group, compared with OT group. Mean SMR increased significantly, by the end of 10 session neurofeednack therapy. Most of the patients found neurofeedback accompanying OT more enjoyable than OT alone. Drop out was more in OT group compared to NF group. Neurofeedback therapy is suggested as a complementary therapy to conventional OT with additional improvement in some aspects of hand recovery. Furthermore, it can increase patients' compliance to rehabilitation program, and improve their satisfaction from therapy protocol