Comparative evaluation of low-level laser therapy and multi-wave locked system laser therapy for carpal tunnel syndrome: a retrospective study

Year 2023, Volume: 10 Issue: 3, 186 - 193, 29.12.2023

Ahmet Üşen Ahmet Akyol İlknur Topal

https://doi.org/10.15437/jetr.1322400

Abstract

Purpose: This study aimed to evaluate the effects of Low-Level Laser Therapy (LLLT) and Multi-Wave Locked System (MLS) Laser Therapy on clinical and functional parameters in Carpal Tunnel Syndrome.
Methods: In the study, 60 patients with mild-moderate carpal tunnel syndrome were evaluated retrospectively in 3 groups. Group I; LLLT, Group II; MLS Laser therapy, Group III; It consisted of patients who did not receive any laser application and were given splints, a home exercise program and patient education. Visual Analogue Scale (VAS), Hand Grip Strength measurement and BOSTON Carpal Tunnel Questionnaire measurements were evaluated from the patients' files at baseline, 4th week and 12th week.
Results: Statistically significant improvements were observed in all parameters in Group I and Group II at 4 weeks and 12 weeks compared to baseline. Group III showed no significant differences in grip strength measurements and the BOSTON Functional Status Scale at 4 weeks compared to baseline. The changes between baseline and 4 weeks were statistically significantly better in Group I and Group II compared to Group III for all parameters. No significant difference was found between Group I and Group II in VAS and grip strength improvements, but the improvement in Boston Symptom Severity Scale was significantly more prominent in Group II than in Group I.
Conclusion: Both LLLT and MLS Laser Therapy can be considered as conservative treatment options along with splinting and exercise to control the symptoms of Carpal Tunnel Syndrome. MLS Laser Therapy may be superior to LLLT in reducing symptom severity.

Keywords

Carpal tunnel syndrome, Lasers, Conservative treatment, Physical therapy modalities

Karpal tünel sendromunda düşük yoğunluklu lazer tedavisi ile çoklu dalga kilitli sistem lazer tedavisinin karşılaştırmalı değerlendirilmesi: retrospektif bir çalışma

Abstract

Amaç: Bu çalışmada, Karpal Tünel Sendromunun tedavisinde kullanılan Düşük Yoğunluklu Lazer terapisi (DYLT) ve Çoklu Dalga Kilitli Sistem (ÇDKS) Lazer terapisi uygulamalarının klinik ve fonksiyonel parametreler üzerine olan etkilerinin değerlendirilmesi amaçlandı.
Yöntem: Çalışmada, hafif-orta dereceli karpal tünel sendromlu 60 hasta, 3 grupta retrospektif olarak değerlendirildi. Grup I; DYLT, Grup II; ÇDKS Lazer terapisi, Grup III; herhangi bir lazer uygulaması yapılmayan splint, ev egzersiz programı ve hasta eğitimi verilen hastalardan oluşuyordu. Hastaların dosyalarından başlangıçta, 4. Haftada ve 12. Haftada Vizüel Analog Skala (VAS), El Kavrama Gücü ölçümü ve Boston Karpal Tünel Sorgulama Anketi ölçümleri değerlendirildi.
Bulgular: Grup I ve Grup II’de 4. ve 12. haftada başlangıca göre tüm parametrelerde istatistiksel olarak anlamlı düzeyde iyileşme görüldü. Grup III'te ise el kavrama gücü ölçümlerinde ve Boston-Fonksiyonel Durum ölçeğinde 4. haftada başlangıca göre istatistiksel olarak anlamlı fark bulunamadı. Başlangıç ile 4. hafta arasındaki değişimler tüm parametreler açısından Grup I ve Grup II'de Grup III'e göre istatistiksel olarak anlamlı düzeyde daha iyi bulundu. Grup I ve II arasında ise VAS ve el kavrama gücü iyileşmeleri açısından istatistiksel olarak anlamlı fark bulunamadı ama Boston-Semptom Şiddet Skalasındaki iyileşme Grup II’de Grup I’e göre istatistiksel olarak anlamlı düzeyde daha belirgin bulundu.
Sonuç: Hem DYLT hem de ÇDKS Lazer terapisi karpal tünel sendromunun semptomlarını kontrol altına almak için splintleme ve egzersizle birlikte konservatif tedavi seçeneği olabilir. ÇDKS lazer terapisi semptom şiddetini azaltmada DYLT’e üstün olabilir.

Keywords

Karpal tünel sendromu, Lazer terapi, Konservatif tedavi, Fizik tedavi yöntemleri

References

• Atroshi I, Gummesson C, Johnsson R, et al. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282:153-158.
• Jordan R, Carter T, Cummins C. A systematic review of the utility of electrodiagnostic testing in carpal tunnel syndrome. Br J Gen Pract. 2002;52:670-673.
• Stevens JC. AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve. 1997;20:1477-1486.
• Ibrahim I, Khan WS, Goddard N, et al. Carpal tunnel syndrome: a review of the recent literature. Open Orthop J. 2012;6:69-76.
• Graham B, Peljovich AE, Afra R, et al. The American Academy of Orthopaedic Surgeons Evidence-Based Clinical Practice Guideline on: Management of Carpal Tunnel Syndrome. J Bone Joint Surg Am. 2016;98:1750-1754.
• Mussttaf RA, Jenkins DFL, Jha AN. Assessing the impact of low level laser therapy (LLLT) on biological systems: a review. Int J Radiat Biol. 2019;95:120-143.
• Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci. 2014;5:58-62.
• Huang YC, Tran N, Shumaker PR, et al. Blood flow dynamics after laser therapy of port wine stain birthmarks. Lasers Surg Med. 2009;41:563-571.
• British Orthopaedic Association. Commissioning guide: treatment of carpal tunnel syndrome. London: Royal College of Surgeons; 2017.
• Hopkins JT, McLoda TA, Seegmiller JG, et al. Low-Level Laser Therapy Facilitates Superficial Wound Healing in Humans: A Triple-Blind, Sham-Controlled Study. J Athl Train. 2004;39:223-229.
• Pattapong N, Wongwanna K, Iamlaoor, P, et al. Effectiveness of Multiwave Locked System Laser therapy in treatment of Carpal Tunnel Syndrome Patients. NUJST. 2016;24:24-35.
• Alayat MS, Elsodany AM, AlMatrafi NA, , et al. Effectiveness of multiwave locked system laser on the treatment of patients with idiopathic Bell's palsy: a randomized double-blind placebo controlled trial. Lasers Med Sci. 2022;37:3495-3502.
• Totten PA, Hunter JM. Therapeutic techniques to enhance nerve gliding in thoracic outlet syndrome and carpal tunnel syndrome. Hand Clin. 1991;7: 505–520.
• Shyam Kumar AJ, Parmar V, Ahmed S, Kar S, Harper WM. A study of grip endurance and strengh in different elbow positions. J Orthop Traumatol. 2008;9:209-211.
• Levine DW, Simmons BP, Koris MJ, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75:1585-1592.
• Sezgin M, Incel NA, Serhan S, et al. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire. Disabil Rehabil. 2006;28:1281-1285.
• Wipperman J, Goerl K. Carpal Tunnel Syndrome: Diagnosis and Management. Am Fam Physician. 2016;94:993-999.
• Page MJ, Massy-Westropp N, O'Connor D, et al. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev. 2012;2012:CD010003. doi:10.1002/14651858.CD010003.
• Burke DT, Burke MM, Stewart GW, et al. Splinting for carpal tunnel syndrome: in search of the optimal angle. Arch Phys Med Rehabil. 1994;75:1241-1244.
• Ballestero-Pérez R, Plaza-Manzano G, Urraca-Gesto A, et al. Effectiveness of Nerve Gliding Exercises on Carpal Tunnel Syndrome: A Systematic Review. J Manipulative Physiol Ther. 2017;40:50-59.
• Coderre TJ, Katz J, Vaccarino AL, et al. Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence. Pain. 1993;52:259-285.
• Ekim A, Armagan O, Tascioglu F, et al. Effect of low level laser therapy in rheumatoid arthritis patients with carpal tunnel syndrome. Swiss Med Wkly. 2007;137:347-352.
• Evcik D, Kavuncu V, Cakir T, et al. Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed Laser Surg. 2007;25:34-39.
• Irvine J, Chong SL, Amirjani N, et al. Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome. Muscle Nerve. 2004;30:182-187.
• Pasternak K, Wróbel D, Nowacka O, et al. The effect of MLS laser radiation on cell lipid membrane. Ann Agric Environ Med. 2018;25:108-113.
• Alayat MS, Elsoudany AM, Ali ME. Efficacy of Multiwave Locked System Laser on Pain and Function in Patients with Chronic Neck Pain: A Randomized Placebo-Controlled Trial. Photomed Laser Surg. 2017;35:450-455.