Kronik omuz ağrılı olgularda yüksek yoğunluklu lazer terapinin ağrı, fonksiyonellik ve yaşam kalitesi üzerine etkisi

Year 2021, Volume: 1 Issue: 3, 108 - 114, 30.09.2021

Levent Aydin Devrim Tarakcı Zubeyir Sari Dilara Merve Sarı Candan Algun

Abstract

Amaç: Bu çalışmanın amacı, kronik omuz ağrılı hastalarda geleneksel tedaviye eklenen yüksek yoğunluklu lazer tedavisinin (HILT) ağrı, fonksiyonellik ve yaşam kalitesi üzerine etkilerini araştırmaktır.
Yöntemler: Çalışmaya (18-75 yaşları arasında) kronik omuz ağrısı olan 50 kişi katıldı. Hastalar rastgele iki gruba (CT grubu veya CT+HILT grubu) ayrılarak ve her iki gruba da 3 hafta boyunca, haftada 5 seans olmak üzere geleneksel terapi programı uygulandı ve sadece CT+HILT grubuna (n=25) geleneksel tedaviye ek olarak HILT uygulandı. Üst ekstremite hareket açıklığı, ağrı eşiği, kas kuvveti, engellilik durumu ve yaşam kalitesi tedavi öncesinde ve hemen sonrasında değerlendirildi.
Bulgular: Gruplar arası karşılaştırmalarda Independent-Samples T-test ve grup içi karşılaştırmalarda Paired-Samples T-test; normal dağılıma uymayan verilerin karşılaştırılmasında ise Mann Whitney-U and Wilcoxon testleri kullanıldı. Analizler p<0.05 güven aralığında anlamlı kabul edildi. Her iki grupta da tedavi sonrasında tüm sonuç ölçümlerinde iyileşme olduğu gözlemlendi. Değerlendirilen değerler arasındaki farklar ve yüzdelerdeki artış açısından iki grup arasında omuzun iç rotasyonel kuvveti artış yüzdesi haricinde (p=0,04) anlamlı bir fark yoktu.
Sonuçlar: Her iki grup da tedaviden yararlandı, ancak tedavilerin etkinliği birbirlerinden üstün değildi. Kronik omuz ağrısının tedavisinde HILT'in geleneksel tedaviye eklenebilecek alternatif bir seçenek olabileceği düşünülmektedir.

Keywords

Omuz ağrısı, kronik ağrı, lazer terapi, fizyoterapi

The effect of high-intensity laser therapy on pain, functionality, and quality of life in patients with chronic shoulder pain

Abstract

Purpose: The purpose of this study was to investigate the effects of high-intensity laser therapy (HILT) added to conventional therapy (CT) on pain, functionality, and quality of life in patients with chronic shoulder pain.
Methods: Fifty people with chronic shoulder pain (18-75 years) participated in the study. Participants were randomized into two groups (CT group or CT+HILT group), and both received CT program for 3 weeks, 5 sessions a week and only CT+HILT group (n=25) received HILT in addition to CT. Upper extremity range of motion, pain threshold, muscle strength, disability, and quality of life were assessed before and immediately after the treatment.
Results: For intergroup comparisons Independent-Samples T-test and intra-group comparisons Paired-Samples T-test were used and for the data that did not show normal distribution Mann Whitney-U and Wilcoxon tests were used. Analyzes were considered significant at a confidence interval of p<0.05. After the treatment, improvements in all outcome measures were observed in both groups. There was no significant difference between the two groups in terms of the differences between the outcome measures and increase in the percentages, except shoulder internal rotational strength (p=0.04).
Conclusion: Both groups benefited from the treatment, but the efficacy of the treatments was not superior to each other. In the treatment of chronic shoulder pain, HILT might be an additive option to CT.

Keywords

Shoulder pain, chronic pain, laser therapy, physiotherapy

References

• Angelova, A., Ilieva, E. M. (2016). Effectiveness of high intensity laser therapy for reduction of pain in knee osteoarthritis. Pain Res Manag, 2016.
• Angst, F., Schwyzer, H. K., Aeschlimann, A., et al. (2011). Measures of adult shoulder function: Disabilities of the arm, shoulder, and hand questionnaire (DASH) and its short version (QuickDASH), shoulder pain and disability index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, constant (Murley) score (CS), simple shoulder test (SST), Oxford shoulder score (OSS), shoulder disability questionnaire (SDQ), and Western ontario shoulder instability index (WOSI). Arthritis Care Res, 63, S174.
• Benfica, P., Aguiar, L. T., Brito, S., Bernardino, L. H. N., Teixeira-Salmela, et al. (2018). Reference values for muscle strength: a systematic review with a descriptive meta-analysis. Braz J Phys Ther, 22(5), 355-369.
• Bennell, K., Wee, E., Coburn, S., et al. (2010). Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial. BMJ, 340.
• Brox, J. I., Staff, P. H., Ljunggren, A. E., Brevik, J. I. (1993). Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease (stage II impingement syndrome). BMJ, 307(6909), 899-903.
• Celik, D., Sirmen, B., Demirhan, M. (2011). The relationship of muscle strength and pain in subacromial impingement syndrome. Acta orthopaedica et traumatologica turcica, 45(2), 79-84.
• Choi, H.-W., Lee, J., Lee, S., et al. (2017). Effects of high intensity laser therapy on pain and function of patients with chronic back pain. J Phys TherSci, 29(6), 1079-1081.
• Ciplak, E., Akturk, S., Buyukavci, R., Ersoy, Y. (2018). Efficiency of high intensity laser therapy in patients with knee osteoarthritis. Inter Med J, 7, 724-727.
• Cuesta-Vargas, A. I., González-Sánchez, M., Casuso-Holgado, M. J. (2013). Effect on health-related quality of life of a multimodal physiotherapy program in patients with chronic musculoskeletal disorders. Health Qual Life Outcomes, 11(1), 19.
• Dickens, V. A., Williams, J. L., Bhamra, M. S. (2005). Role of physiotherapy in the treatment of subacromial impingement syndrome: a prospective study. Physiotherapy, 91(3), 159-164.
• Duger, T. i., Yakut, E., Oksuz, C., Yorukan, S., Bilgutay, B. S., et al. (2006). Reliability and validity of the Turkish version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. Turkish Journal of Physiotherapy Rehabilitation, 17(3), 99-107.
• El Mughrabi, M., El Alwani, A., Amein, N. (2016). The effectiveness of exercise on function for adults with shoulder impingement syndrome (sis): a structured literature review. J Pain Manage Ther. 1 (1): 13, 23.
• Faul, F., Erdfelder, E., Lang, A.-G., Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods, 39(2), 175-191. doi:10.3758/bf03193146
• Hanratty, C. E., McVeigh, J. G., Kerr, D. P., Basford, J. R., Finch, M. B., Pendleton, A., et al (2012). The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Semin Arthritis Rheum; 2012: Elsevier.
• Herin, F., Vézina, M., Thaon, I., Soulat, J.-M., & Paris, C. (2012). Predictors of chronic shoulder pain after 5 years in a working population. PAIN®, 153(11), 2253-2259.
• Hoozemans, M., Van Der Beek, A., Frings-Dresen, M., Van der Woude, L., Van Dijk, F. (2002). Pushing and pulling in association with low back and shoulder complaints. Occup Environ Med, 59(10), 696-702.
• Karabulut, M. (2006). Subakromial Sıkışma Sendromu Konservatif Tedavisinde Lazerin Etkinliğinin Araştırılması. TC Sağlık Bakanlığı İstanbul, 70.
• Kim, S. H., Kim, Y. H., Lee, H.-R., Choi, Y. E. (2015). Short-term effects of high-intensity laser therapy on frozen shoulder: a prospective randomized control study. Man Ther, 20(6), 751-757.
• Kocyigit, H. (1999). Kisa Form-36 (KF-36)'nm Turkce versiyonunun guvenilirligi ve gecerliligi. Ilaç ve Tedavi Dergisi, 12, 102-106. Leclerc, A., Chastang, J., Niedhammer, I., Landre, M., & Roquelaure, Y. (2004). Incidence of shoulder pain in repetitive work. Occupl Environ Med, 61(1), 39-44.
• Luime, J. J., Koes, B. W., Miedem, H. S., Verhaar, J. A., Burdorf, A. (2005). High incidence and recurrence of shoulder and neck pain in nursing home employees was demonstrated during a 2-year follow-up. J Clin Epidemiol, 58(4), 407-413.
• Michener, L. A., McClure, P. W., Karduna, A. R. (2003). Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clinl Biomech, 18(5), 369-379.
• Michener, L. A., Walsworth, M. K., Burnet, E. N. (2004). Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther, 17(2), 152-164.
• Neer, C. S. (2005). Anterior acromioplasty for the chronic impingement syndrome in the shoulder. JBJS, 87(6), 1399.
• Ozdincler, A. R. (2005). The effects of TENS and LLL on pain and functional performance of patients with shoulder pain. J Med Sci, 5(4), 328-332.
• Rubin, B. D., & Kibler, W. B. (2002). Fundamental principles of shoulder rehabilitation: conservative to postoperative management. Arthroscopy, 18(9), 29-39.
• Tascioglu, F., Dalkiran, İ., Oner, C. (2003). Parsiyel supraspinatus tendon rüptürü olan subakromiyal sıkışma sendromlu hastalarda düşük doz lazer tedavisinin etkinliği. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 49(6), 18-22.
• Ucurum, S. G., Kaya, D. O., Kayali, Y., Askin, A., Tekindal, M. A. (2018). Comparison of different electrotherapy methods and exercise therapy in shoulder impingement syndrome: A prospective randomized controlled trial. Orthop Traumatol Turc, 52(4), 249-255.
• Van der Windt, D., Koes, B. W., de Jong, B. A., Bouter, L. M. (1995). Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis, 54(12), 959-964.
• Vaughan, B., McLaughlin, P., Gosling, C. (2007). Validity of an electronic pressure algometer. Intern J Osteopathic Med, 10(1), 24-28.
• Vecchio, P., Cave, M., King, V., Adebajo, A., Smith, M., Hazleman, B. (1993). A double-blind study of the effectiveness of low level laser treatment of rotator cuff tendinitis. Rheumatol, 32(8), 740-742.
• Yeldan, I., Cetin, E., Razak Ozdincler, A. (2009). The effectiveness of low-level laser therapy on shoulder function in subacromial impingement syndrome. Disabil Rehabil, 31(11), 935-940.