Synergic effects of ultrasound and laser on the pain relief in women with hand osteoarthritis

Abstract

Patients with pain avoid movements, leading to a gradual impairment of their physical condition and functionality. In this context, the use of ultrasound (US) and low-level laser therapy (LLLT) show promising results for nonpharmacological and noninvasive treatment. The aim of this study was evaluated the synergistic effects of the US and the LLLT (new prototype) with or without therapeutic exercises (TE) on pain and grip strength in women with hand osteoarthritis. Forty-five women with hand osteoarthritis, aged 60 to 80 years, were randomly assigned to one of three groups, but 43 women successfully completed the full study. The three groups were as follows: (i) the placebo group which did not perform TE, but the prototype without emitting electromagnetic or mechanical waves was applied (n = 11); (ii) the US + LLLT group which carried out only the prototype (n = 13); and (iii) the TE + US + LLLT group which performed TE before the prototype is applied (n = 13). The parameters of US were frequency 1 MHz; 1.0 W/cm(2) intensity, pulsed mode 1:1 (duty cycle 50%). Regarding laser, the output power of the each laser was fixed at 100 mW leading to an energy value of 18 J per laser. Five points were irradiated per hand, during 3 min per point and 15 min per session. The prototype was applied after therapeutic exercises. The treatments are done once a week for 3 months. Grip strength and pressure pain thresholds (PPT) were measured. Grip strength did not differ significantly for any of the groups (p ≥ 0.05). The average PPT between baseline and 3 months shows significant decrease of the pain sensitivity for both the US + LLLT group (∆ = 30 ± 19 N, p˂0.001) and the TE + US + LLLT group (∆ = 32 ± 13 N, p < 0.001). However, there were no significant differences in average PPT for placebo group (∆ = -0.3 ± 9 N). There was no placebo effect. The new prototype that combines US and LLLT reduced pain in women with hand osteoarthritis.

Ultrasound conjugated with Laser Therapy in treatment of osteoarthritis: A case study

“…In addition to such signi icance, there was a return to the activity of playing the piano, without any sign of pain or limitation. In this way, our results corroborate the results of singular treatments found in the literature [7,8]. However, the results obtained make this model of equipment and therapy potentially used more bene icial for the treatment of osteoarthritis.…”

“…The Auscan questionnaire presented a signi icant decrease for pain quanti ication of -233.33% (Table 1). These results are corroborated by recent studies published by our group, which points out a great improvement in pain questionnaires for knee and hand osteoarthritis [7,8]. In addition to such signi icance, there was a return to the activity of playing the piano, without any sign of pain or limitation.…”

“…It was used gel and total contact in order to ensure an optimal energy delivery. The time of application was 12 minutes for each hand [7,8].…”

Positive effects of low level laser therapy (LLLT) on Bouchard's and Heberden's osteoarthritis

“…Our results are in line with Paolillo et al who combined LLLT with ultrasound. The present results are also reconcilable with Brosseau et al who admittedly found only few significant differences between sham and active LLLT patients, yet demonstrated improvement over time in both groups with a general tendency for greater changes in the main outcome measures, such as pain, morning stiffness, grip strength, and functional status, in the active LLLT group.…”

Effects of Low-Level Laser Therapy Applied Before Treadmill Training on Recovery of Injured Skeletal Muscle in Wistar Rats

“…26 We choose an infrared wavelength, because the penetration is deeper if compared with the red wavelength used in in vitro studies. In addition, we used a greater power and fluence, if compared with in vitro studies, but smaller values compared with clinical trials, 27,28 because human skin levels, skin color, and body composition (fat, muscle, and bone) may create a biological barrier for the phototherapy, suggesting the use of a greater power and fluence in treatment protocols, in contrast to what is used in animals. The principle of the Arndt-Schultz law states that very low doses of radiation can cause a strong physiological response.…”