Towards optimum dosimetric effect of combined mid and low power laser on tendon healing

The current study was conducted to determine the optimum energy dose of combined mid and low power laser to be used in treatment of tendon injuries. A total of forty male New Zealand rabbits, aged 12-16 weeks and weighted 2-2.5 Kg were used. The rabbits were equally divided into four groups, control group, laser 1, laser 2, and laser 3 groups. After tenotomy and repair of the right Achilles tendons, the right hind limbs were immobilized in a plaster cast with the knee joint in right angle flexion and the ankle joint in complete planter flexion. The tenotomized tendons in the laser groups 1, 2, and 3 were irradiated with combined infrared laser [904 nm] and helium neon laser [632.8 nm] at energy density of 1,3,5 J/cm[2] respectively. The treatment started from the day following surgery and continued daily for 14 days then day after day for another two weeks with a total of 20 sessions. The control group received no laser irradiation. After one month the tendons in all groups were excised and studied for differences in maximum force, maximum elongation, maximum stress, maximum strain, and energy absorption capacity. The results of the study demonstrated that laser treatment produced increase in all the tested parameters of the three laser groups. The highest results were recorded for tendons in laser groups 3 irradiated at energy density of 5 J/cm and the least improvement were recorded for tendons in laser group 1 irradiated at energy density of 1 J/cm[2]. Compared with the control group, there were significant increase in the tested parameters of laser group 2, and 3 and nonsignificant increase in laser group 1. The results also showed significant increase of laser groups 2, and 3 compared to laser group 1, while there were nonsignificant differences in all parameters between laser group 2 received laser irradiation at energy density of 3 J/cm[2] and laser group 3 irradiated at energy density 5 J/cm[2]. This study demonstrated that laser effect on tendon healing is dose dependent and that effect is pronounced at energy density of 3 and 5 J/cm[2] with the best effect at dose of 5 J/cm[2]. It is recommended to utilize combined infrared and helium neon laser to improve tendon healing using higher energy densities as 3 and 5 J/cm[2]

Intensive physical therapy program in tibial lengthening with ilizarov technique

Forty female patients participated in this study and divided into two groups. During distraction phase following tibial lengthening with Ilizarov technique, group A received daily intensive physical therapy [IPT] program under direct supervision. Group B performed routine physical therapy [RPT] program. During latency phase, all patients received conventional medical and physical therapy. Predistraction and post distraction knee flexion and ankle dorsiflexion AROM were recorded. Perceived pain intensity was measured with graphic pain- rating scale. During distraction, the pain level was measured indirectly through recording the mean amount of diclofenac intake per day during distraction phase. IPT group demonstrated significant larger knee and ankle AROM and less mean pain intensity during distraction phase. During this phase, the mean amount of diclofenac intake per day was significantly less in IPT than RPT group. The results showed that IPT, during distraction phase, enhanced physical therapy outcome in tibial lengthening with Ilizarov techniques