[ comparison between muscle energy technique with low-level laser in reducing neck and shoulder pain and disability in subjects with trapezius and levator scapula myofascial trigger points]

There is a strong relationship between trigger points with neck pain and headache. This study aimed to compare the effects of muscle energy technique using low-level laser on reducing neck and shoulder pain and disability in patients with myofascial trigger points in the upper trapezius and levator scapula muscles. This double-blinded randomized controlled trial was performed in Zahedan in 2009. Thirty patients with trigger points in the upper trapezius and levator scapula were randomly assigned to one of the three groups in equal numbers. In the laser group, a low-level Ga-As laser was applied with a pulse duration of 200 ns and 6 J/cm[2] dosages. By contrast, in the muscle energy group, we used stretching following post-isometric relaxation, and in the placebo group used low-level laser without an output. A 10-session treatment program was performed for each group. Prior to and following the intervention, We assessed the cervical ranges of motion with a goniometer, and neck and shoulder pain and disability with Neck Disability Index and Shoulder Pain and Disability Index; respectively. Paired t-test and one-way Anova were used for data analysis. The data shows that the neck pain decreased from 8.2 +/- 1.2 to 3.5 +/- 0.85 in the muscle energy group, and from 8.4 +/- 1.4 to 2.6 +/- 1.2 in the laser group. The shoulder pain and disability decreased from 102.9 +/- 10.7 to 24 +/- 10.3 in the muscle energy group, and from 104.7 +/- 11.8 to 22.6 +/- 10.7 in the laser group [P<0.05]. There were no significant differences seen between the two treatment groups regarding either the neck and shoulder pain or disability or ranges of motion [P>0.05]. The results show that low-level laser and muscle energy technique are both equally effective in decreasing the neck and shoulder pain and disability in patients with myofascial trigger points in trapezius and levator scapula muscles

[ effect of low-level LASER on pain improvement and function in patients affected anterior knee pain]

Backgroun and aims: Anterior knee pain is a common problem among adults and young people. This study aimed to investigate the effects of low-level LASER on improvement of knee pain and function in patients with anterior knee pain

Methods: This double-blind, randomized clinical trial was carried out in Zahedan University of Medical Sciences, in 2008. In this study, thirty patients were randomly divided into experimental [N=15] and control groups [N=15]. In the experimental group, beside the exercise, a low-level Ga-As LASER was applied with a 100 mW average power, wavelength 905 nm and 8 J/cm2 dosages for 3 minutes duration. In the control group, sham LASER was used. A 16 session treatment program [during 4 weeks, 4 sessions per weeks] was performed for both groups. Before and after the intervention, we measured the pain level through visual analog scale [VAS] and the function by Knee and Osteoarthritis Outcome Score [KOOS] and range of knee flexion by goniometry. Paired and Independent t-tests were used for data analysis

Results: The knee pain decreased from 6.06+/-2.6 to 2.7+/-2.6 in the experimental group [P<0.001] and from 6.4+/-1.9 to 3.4+/-1.4 in the control group [P=0.003]. KOOS score was decreased from 87.2+/-29.8 to 48.4+/-24.1 in the experimental group and from 94.8+/-20.9 to 61.7+/-15.3 in the control group [P<0.001]. Level of pain was significantly decreased in the experimental group compared to the control group [P=0.012]

Conclusion: The results showed that exercise therapy with or without LASER can reduce pain and cause better knee function and expansion of the ranges of knee flexion. However; LASER is more effective in decreasing anterior knee pain

[Comparing the effects of vibration and ultrasound waves accompanied with stretching exercises on myofascial trigger points of posterior neck muscles in athletes]

Various physical modalities and exercises have been recommended for treatment of myofacial trigger points, but there are not randomized controlled trails to compare these methods. The aim of this study was to compare the effects of vibration and ultrasound therapy accompanied with stretching exercises on myofascial trigger points of posterior neck muscles in athletes. In this double-blind randomized controlled trial study. Thirty athletes with myofascial trigger points in their posterior neck muscles were recruited through simple non-probability sampling. They were randomly assigned to either a vibration [n=15] or an ultrasound therapy accompanied with stretching exercises group [n=15]. Before and after intervention, neck disability [ordinal] was assessed with Neck Disability Index [NDI], neck pain with visual analog scale [ordinal] and Northwick Park Neck Pain Questionnaire [NPNPQ], and shoulder pain and disability with Shoulder Pain and Disability Index [SPADI]. A 10 session program which lasted 4 weeks, 3 sessions per week, and 30 minutes per session was performed for both groups. Independent t-test or Mann-Whitney U, paired t-test or Wilcoxon and One Way ANOVA were used for analysis of data. The neck disability index was decreased from 25.33 +/- 5.35 to 13.93 +/- 4.1 in the vibration group and from 25.20 +/- 4.63 to 13.80 +/- 4.36 in the ultrasound therapy group [P<0.001]. The neck pain index was decreased from 15 +/- 3.91 to 6.47 +/- 3.7 in the vibration group and from 13.47 +/- 4.56 to 5.53 +/- 4.19 in the ultrasound therapy group [P<0.001]. The shoulder pain and disability index was decreased from 69.08 +/- 30.53 to 24.83 +/- 22.36 in the vibration group and from 64.69 +/- 23.61 to 17.27 +/- 11.42 in the ultrasound therapy group [P<0.001]. However, no significant difference was observed between two groups regarding improving function and reducing pain and disability of neck and shoulder [P>0.05]. In athletes with myofascial trigger points in posterior neck muscles, both vibration and ultrasound therapy accompanied with stretching exercises causes decreasing in shoulder and neck pain and disability