ABSTRACT
STUDY DESIGN: Single-blind randomized controlled trial. INTRODUCTION: High-intensity laser therapy (HILT) was recently introduced to the physiotherapy field as a treatment option for patients with carpal tunnel syndrome (CTS). However, evidence about its effectiveness on pregnant women with CTS is sparse. PURPOSE OF STUDY: To test the effectiveness of HILT combined with a conventional physical therapy program to reduce pain intensity, sensory and motor nerve distal latency, and increase grip strength in pregnant women with CTS compared with the physical therapy alone. METHODS: Fifty-four pregnant women with mild to moderate CTS were randomized and further allocated into two groups. The HILT group (n = 27) received both HILT and conventional physical therapy, and the control group (n = 27) received only physical therapy, including nerve and tendon gliding exercises and the use of an orthotic device. Participants received the interventions at the University Hospital (omitted for review) three times per week for 5 weeks. An 11-points numerical pain rating scale, electromyography, and a handheld dynamometer were used for data collection before and after the treatment. RESULTS: Participants from both groups presented significant improvement in the median nerve motor nerve distal latency (MNDL), sensory nerve distal latency, numerical pain rating scale, and handgrip strength after the intervention. The between-group difference showed more improvements in participants of the HILT group on reducing pain intensity, mean difference (MD) = -3.11 (-4.1 to 2.1), and sensory nerve distal latency, MD = -0.3 (-0.5 to -0.1) compared with the control group. DISCUSSION: HILT produced greater improvement in outcomes of pregnant women with mild to moderate CTS whichsuggests that adding HILT to traditional CTS physical therapy protocol is beneficial and safe. CONCLUSIONS: High-intensity laser therapy combined with a standard physical therapy program for CTS in pregnant women is better than the physical therapy program alone to improve pain intensity and median nerve sensory distal latency.
ABSTRACT
OBJECTIVES: Recently, high-intensity laser therapy has been used in the therapeutic protocols for pain management. We aimed to evaluate the clinical efficacy of high-intensity laser therapy versus other different modalities for improving lateral epicondylitis symptoms. METHODOLOGY: We conducted a systematic review and meta-analysis on prospective randomized controlled trials from PubMed, Embase, Scopus, Web of Science, and Science Direct until June 2021 using relevant key words. We analyzed the data using Review Manager software (RevMan 5.4). RESULTS: Six randomized controlled trials with 344 patients were included. There is low-quality evidence that high-intensity laser therapy generates a small reduction on pain intensity compared with a control group either during activity (mean difference = -0.98, 95% confidence interval = -1.6 to -0.35, P = 0.002) or during rest (mean difference = -0.98, 95% confidence interval = -1.68 to -0.09, P = 0.03). In addition, there is low-quality evidence that high-intensity laser therapy provides small improvements in quality of life (physical component) compared with control (mean difference = 9.76, 95% confidence interval = 2.69 to 16.83, P < 0.0001). CONCLUSIONS: High-intensity laser therapy is an effective therapeutic modality to reduce pain and improve quality of life (36-item short form health survey physical component) in patients experiencing persistent symptoms of lateral epicondylitis. However, grip strength, hand function, and quality of life (36-item short form health survey) did not show significant differences between high-intensity laser therapy and other therapies.
