Comparison of high-intensity and low-level laser therapy effecton combined sensory index, sensory conduction velocity and distal motoric latency: a study in moderate carpal tunnel syndrome patients

Abstract

Carpal tunnel syndrome (CTS) is the most common neuropathy compression syndrome. The effectiveness of low-level laser therapy (LLLT) as one of the conservative therapy for CTS is still debatable. High-intensity laser therapy (HILT) is developed with higher energy and deeper tissue penetration than LLLT. This study aimed to compare the effect of HILT and LLLT on sensory and motoric electrophysiologic parameters in moderate CTS patients. This was an experimental randomized pre and post-test group study. Sixteen patients (fifteen females and one male) with moderate CTS were randomly assigned into two groups. The HILT group was given HILT with analgesic dosage 10 J/cm 2 and biostimulation dosage 120 J/cm 2 . The LLLT group was given LLLT with dosage 6 J/cm 2 . All treatments were given for ten sessions in 2 weeks. Combined sensory index (CSI), sensory nerve conduction velocity (SNCV), and distal motoric latency (DML) were recorded before and three days after the last treatment. The mean decrease of CSI was more significant in HILT group (-0.37±0.37 ms; p=0.03). There were no significant differences in the mean increase of SNCV (HILT = 3.16±3.15 m/s, LLLT= 2.74±1.42 m/s; p=0.73) and mean decrease in DML between two groups (HILT = -0.20 ± 0.18 ms , LLLT = -0.14 ± 0.21 ms; p=0.52). In conclusion, the HILT is more effective than LLLT in improving the CSI values in moderate CTS patients.

Literature Review: Perbandingan Efektivitas High Intensity Laser Therapy dengan Ultrasound Diathermy terhadap Intensitas Nyeri pada Pasien Osteoartritis Lutut

“…7 High intesity laser therapy (HILT) merupakan terapi yang menggunakan teknologi berdasarkan prinsip dari low level laser therapy (LLLT) tapi 100 kali lebih kuat dari LLLT. 8 High intesity laser therapy memanfaatkan laser kelas empat dengan daya keluaran lebih dari 500 mW sehingga menghasilkan tiga efek yaitu biostimulasi, fotoakustik, dan panas. 9,10 Biostimulasi meningkatkan tingkat penyembuhan dan pemulihan melalui pengaktifan organisme pada level selular.…”

Medical Rehabilitation Management of Carpal Tunnel Syndrome

“…Bekhet dkk juga menunjukkan LLLT superior terhadap placebo dalam hal kekuatan otot tangan (27). Pada studi perbandingan antara high intensity laser therapy (HILT) dengan LLLT didapatkan HILT lebih superior dibandingkan LLLT meskipun pada combined sensory index (CSI) saja (28). Menurut Cochrane review, studi LLLT menunjukkan efek tidak berbeda dibandingkan placebo maupun ultrasound terapi (29).…”

Level of Functional Impairment using Symptom Severity and Functional Status Scales in Patients with Carpal Tunnel Syndrome

“….2 That MN moves up to 9.6 mm and allows wrist flexion and extension to some extent as CTS is most common nerve compression syndrome. 3 The MN entrapment in carpal tunnel produces numbness and sometimes pain in patients. These symptoms felt in first three fingers as well as radial side of ring finger as these zones are innervated by MN.…”