4. Kongres fizijatara BiH

THE IMPORTANCE OF RADIATION PARAMETERS FOR THE EFFICIENCY OF LASER THERAPY IN INFLAMMATORY MUSCULOSKELETAL DISEASE. A PLACEBO CONTROLLED DOUBLE-BLIND INVESTIGATION

Аутори:
1. Milica Lazović, Albania
2. Olivera Ilic Stojanovic, Institut za rehabilitaciju, Albania

Апстракт:
Reports on the effectiveness of low level laser therapy (LLLT) on musculoskeletal diseases are still insufficient and conflicting. The use of LLLT particularly in Rheumatoid arthritis (RA) patients has applied to only a relatively small number of studies, mainly inadequately designed. Therefore the Cochrane database conclusion considering the effectiveness of LLLT in RA patients recommended LLLT for short-term relief of pain and morning stiffness. After some years common opinion has been reached that power density and energy density are more important than the energy dose. In order to obtain better results in musculoskeletal pathology the energy density and energy per point could be decreased as partly confirmed in the last WALA dose regime recommendations. Of particular importance in musculoskeletal pathology are the application site and location-specific doses to ensure laser therapy efficiency. The Disease Activity Score (DAS28), extensively validated during clinical trials and daily clinical practice in RA patients, has never been used in LLLT studies. The aim therefore was to examine the effect of pulsed infrared LLLT in a randomised, placebo-controlled double-blind investigation on RA activity, by comparing the DAS 28 index with the functional activity score Health Assessment Questionnaire (HAQ). According to ACR criteria, 136 patients belonged to the elementary and 29 to the placebo-control group. LLLT parameters were applied in individually assesed doses for 10 consecutive days (λ=890nm, pulse power 7 W), exposure time (60-240 sec.per point). Dose per one treatment ranged from 0.035 J to 7.32 J and energy density from 0.008 J/cm2 to 0. 16 J/cm2 depending on the selected frequency pulse (80-1500Hz). The elementary group showed significantly decreased values of DAS 28 (p<0.01) whereas they increased in the placebo group (p<0.01). LLLT had the greatest effect on RA patients with a high activity DAS28 score with numbers decreasing from 74 (54.4 %) to 20 (14.7%). Data showed a statistically significant improvement of HAQ outcome in the elementary (p<0.01) vs the placebo group ( p>0.05). 30% of patients in the elementary group had very mild and 23.5% severe functional disability. While the percentage doubled after LLLT therapy in patients with mild functional disability, it lessened to 6.6% in severe. HAQ level was positively correlated with the RA DAS28 score in all categories. This placebo-controlled investigation proved that LLLT, even in high activity RA patients, under optimal chosen irradiation parameters and application sites decreases the DAS28 score and improves functional activity.

Кључне речи:
low level laser therapy, power density, energy density, application site, rheumatoid arthritis

Тематска област:
Савремени принципи у лијечењу и рехабилитацији зап

Уводни рад:
Да

Датум пријаве сажетка:
19.07.2012.

Бр. отварања:
429

Конференцијa:
4. Kongres fizijatara BiH