Efficacy of low level laser therapy associated with exercises in knee osteoarthritis: a randomized double-blind study.

OBJECTIVES: To estimate the effects of low level laser therapy in combination with a programme of exercises on pain, functionality, range of motion, muscular strength and quality of life in patients with osteoarthritis of the knee. DESIGN: A randomized double-blind placebo-controlled trial with sequential allocation of patients to different treatment groups. SETTING: Special Rehabilitation Services. SUBJECTS: Forty participants with knee osteoarthritis, 2-4 osteoarthritis degree, aged between 50 and 75 years and both genders. INTERVENTION: Participants were randomized into one of two groups: the laser group (low level laser therapy dose of 3 J and exercises) or placebo group (placebo laser and exercises). MAIN MEASURES: Pain was assessed using a visual analogue scale (VAS), functionality using the Lequesne questionnaire, range of motion with a universal goniometer, muscular strength using a dynamometer, and activity using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire at three time points: (T1) baseline, (T2) after the end of laser therapy (three weeks) and (T3) the end of the exercises (11 weeks). RESULTS: When comparing groups, significant differences in the activity were also found (P = 0.03). No other significant differences (P > 0.05) were observed in other variables. In intragroup analysis, participants in the laser group had significant improvement, relative to baseline, on pain (P = 0.001), range of motion (P = 0.01), functionality (P = 0.001) and activity (P < 0.001). No significant improvement was seen in the placebo group. CONCLUSION: Our findings suggest that low level laser therapy when associated with exercises is effective in yielding pain relief, function and activity on patients with osteoarthritis of the knees.

Nonsurgical treatment of acetabular labrum tears: a case series.

STUDY DESIGN: Case series. BACKGROUND: While the literature has emphasized surgical treatment of acetabular labrum tears, there is a lack of information regarding conservative treatment. The purpose of this case series was to describe a nonsurgical program for those with clinical evidence of an acetabular labrum tear, that emphasized hip and lumbopelvic stabilization, correction of hip muscle imbalance, biomechanical control, and sport-specific functional progression. CASE DESCRIPTION: The 4 patients in this series had clinical evidence and magnetic resonance imaging confirmation of an acetabular labrum tear and underwent a similar treatment protocol consisting of 3 phases. Phase 1 emphasized pain control, education in trunk stabilization, and correction of abnormal joint movement. Phase 2 focused on muscular strengthening, recovery of normal range of motion (ROM), and initiation of sensory motor training. And phase 3 emphasized advanced sensory motor training, with sport-specific functional progression. ROM, flexibility, pain, special tests, and level of function were assessed, and strength was measured with handheld dynamometry. OUTCOMES: All patients demonstrated decreased pain, functional improvement, and correction of muscular imbalance. Increased muscle strength, primarily for the hip flexors (1%-39%), abductors (18%-56%), and extensors (68%-139%) was also noted. DISCUSSION: All patients responded well to our program. This case series suggests that patients with clinical evidence of an acetabular labral tear confirmed with MRI can show meaningful improvement with nonsurgical intervention. LEVEL OF EVIDENCE: Therapy, level 4.

Ondas curtas pulsado em diferentes doses no tratamento de pacientes com osteoartrite de joelho / Use of different doses of pulsed short waves in the treatment of patients with osteoarthritis of the knee

Objetivo Avaliar a eficácia da aplicação de ondas curtas pulsadas na redução da dor e melhora funcional dos pacientes com osteoartrite de joelho. Investigar se há alguma diferença no tratamento entre os grupos com doses de 17 ou 33kilobytes. Métodos Participaram deste estudo 42 mulheres portadoras de osteoartrite no joelho graus II ou III, com idade acima de 40 anos, submetidas à aplicação de ondas curtas pulsadas com doses de 17 ou 33 kilojoules, avaliadas por meio do questionário knee and osteoarthritis score escala visual analógica de dor e goniometria de flexão de joelho. Resultados Os grupos ativos de 17 ou 33 kilojoules obtiveram uma melhora do quadro álgico e funcional quando comparados com o grupo controle, porém não se encontrou diferença significativa na análise entre os grupos ativos. Conclusão Este estudo demonstrou que a aplicação de ondas curtas pulsadas com doses de 17 ou 33kilobytes é eficaz no tratamento da osteoartrite de joelho

Objective To evaluate the effectiveness of the application of pulsed short waves in the reduction of pain, and functional improvement in patients with osteoarthritis of the knee, and also to investigate changes in treatment between the groups with doses of 17 kilojoules or 33 kilojoules. Methods Forty-two female subjects with type II or III osteoarthritis of the knee and over 40 years of age, participated in this study, and were submitted to the application of pulsed short wave doses of 17 or 33 kilojoules. They were evaluated by means of a knee and osteoarthritis score questionnaire, visual analog pain scale and knee flexion goniometry. Results The active groups of 17 or 33 kilojoules had less pain and improved function when compared with the control group. There was, however, no significant difference between the active groups. Conclusion This study demonstrated that the application of both 17 and 33 kilojoule doses of pulsed short waves is efficient in pain reduction and improved function in the treatment of osteoarthritis of the knee