Long-term differences between injections and Ga- resources, since the relative gain of LLLT is

Transcription

1 Effects of LLLT on the periarthritis of the shoulder: a clinical study on different treatments with corticosteroid injections or a wait-and-see policy Giuseppe Tam Proc. SPIE 5968, Laser Florence Proc. SPIE 5968, Laser Florence 2004: A Window on the Laser Medicine World, 59680J (October 25, 2005); doi: / Long-term differences between injections and Ga- The aim of this study was to compare the efficacy of three types of treatments in the periarthritis of the shoulder: corticosteroid injections, Low Level Laser Therapy (LLLT) or wait-and-see-policy. BACKGROUND DATA: Low level laser irradiation is a treatment method As widely (904 used in medical nm) science. Many disorders, were such as significantly osteoarthritis and musculoskeletal in conditions favor with pain, of have been treated with METHODS: Patients, suffering from periarthritis of the shoulder of at least 6 weeks' duration, were recruited by family doctors. LLLT. We randomly allocated eligible patients to 6 weeks of treatment n. 20 (%) with corticosteroid injection, n. 21 (5%) with LLLT and with wait-and-see policy n.19 (1%). We applied a number of 12 sessions with infrared Diode Laser Ga-As (904 nm), 60 W maximum power, peak power per pulse 27 W, pulse frequency 1280 Hz, average point region 2-8 J; dose/point = -4 J; total energy density 24 J/cm2. Outcome measures included general improvement, severity of the main complaint, pain, shoulder disability, and patient satisfaction. Severity of shoulder complaints, abduction and elevation of the arm, and the pressure pain threshold were assessed. The principal analysis The was done decision an intention treatment to treat basis. We assessed with all outcomes LLLT at,6, or 12, 26, to 52 weeks. adopt RESULTS: a We randomly waitand-see rates were 90% (18) policy compared with might 52% (11) for LLLT depend and 5% (7) for wait-and-see on available policy. Long-term differences between assigned 60 patients. At 6 weeks, corticosteroid injections were significantly better than all other therapy options for all outcome measures. Success injections and LLLT were significantly in favour of LLLT. Success rate at 52 weeks were 14 (70%) for injections, 19 (90.5%) for LLLT, and 16 (84%) for wait-and-see policy. LLLT had better results than a wait-and-see policy, but differences were not significant ( p < ). resources, since the relative gain of LLLT is CONCLUSIONS: Patients should be properly informed about the advantages and disadvantages of the treatment options for the periarthritis of the shoulder. The decision to treat with LLLT or to adopt a wait-and-see policy might depend on available resources, since the relative gain of LLLT is better, but also small at long-term. better, but also small at long-term. 201 Laser Therapy U. All rights reserved.

2 <48 Hours (Acute Injury) Hz Minutes

3 0 Pain (PRN) (PRN) 2nd Inflammation 50 Hz DOSE 4a rd Spasms 1000 Hz PRN Pontinen s Principle 4th (a) Pain (Systemic) 1000 Hz NRT See Method OR (b) Pain (Local) 1000, 000 or 5000 Hz -5 minutes 2 4b

4 5th (a) (b) (Primary) (Secondary) 550 Hz DOSE and 50 Hz subclavian artery 5 minutes 5a 5b

5 4a <48 Hours (Acute Injury) 0 Pain (PRN) (PRN) Hz Minutes 2nd Inflammation 50 Hz DOSE 5b rd Spasms 1000 Hz Pontinen s Principle 4th (a) Pain (Systemic) 1000 Hz NRT See Method 2 OR (b) Pain (Local) 1000, 000 or 5000 Hz -5 minutes 4b 5a 5th (a) (Primary) 550 Hz DOSE and (b) (Secondary) 50 Hz PHT (Popliteal) 5 minutes