Investigation of the Effectiveness of Low-Level Laser Therapy for Chronic Low-Back Pain Patients

Yıl 2022, Cilt: 7 Sayı: 2, 319 - 325, 01.06.2022

Zehra Atlı , Elif Yakşi , Mustafa Fatih Yaşar

https://doi.org/10.26453/otjhs.1057015

Öz

Objective: This study aims to investigate the effects of low-level laser therapy (LLLT) on pain, functional status, and quality of life.

Materials and Methods: 40 patients between the ages of 18-65, with low back pain longer than three months, were included in the study. The patients were randomly divided into two groups. The first group (n=20) were treated with LLLT and exercise combination, the second group (n=20) were only given 15 sessions of therapeutic exercise. The patients were evaluated during pre and post-treatment periods. Visual Analogue Scale (VAS), Modified Oswestry Low Back Pain Disability Questionnaire (MOL PDQ), and Short Form-36 (SF-36) were used to assess the pain severity, functional status, and quality of life of the patients respectively.

Results: There is a statistically significant decrease detected in post-treatment VAS and MOL PDQ scores compared to pre-treatment scores for both groups (p<0.05). A statistically significant improvement in post-treatment VAS and MOL PDQ scores were found in favor of LLLT in the comparison between the groups (<0.05).

Conclusion: Although LLLT has been proved to be effective in pain control and functional status of chronic low back pain, it does not effect on quality of life. There is a necessity for comprehensive, randomized controlled trials on this topic.   

Anahtar Kelimeler

Low-level laser, exercise, chronic low-back pain

Kronik Bel Ağrılı Hastalarda Düşük Yoğunluklu Lazer Tedavisinin Etkinliğinin Araştırılması

Öz

Amaç: Bu çalışmanın amacı; kronik bel ağrılı hastalarda düşük yoğunluklu lazer (DYL) tedavisinin ağrı, fonksiyonel durum ve yaşam kalitesi üzerine etkilerini araştırmaktır.

Materyal ve Metot: Çalışmaya, üç aydan uzun süre bel ağrısı şikayeti olan, 18-65 yaş arası 40 hasta dahil edildi. Hastalar randomize olarak iki gruba ayrıldı. Birinci gruptaki hastalara (n=20) DYL+egzersiz tedavisi; ikinci gruptaki hastalara (n=20) yalnızca egzersiz tedavisi 15 seans olacak şekilde uygulandı. Hastalar tedavi öncesi (TÖ) ve tedavi sonrası (TS) dönemde değerlendirildi. Hastaların ağrı şiddeti değerlendirmesi Vizüel Analog Skala (VAS) ile, fonksiyonel durumu Modifiye Oswestry Bel Ağrısı Engellilik Anketi (MOS) ile, yaşam kalitesi ise Short Form-36 (SF-36) ile değerlendirildi.

Bulgular: Her iki grupta VAS ve MOS skorlarında TS’de TÖ’ye oranla istatistiksel olarak anlamlı azalma saptandı (p<0,05). Gruplar arası karşılaştırmada VAS ve MOS değerlerinde TS ’de DYL lehine istatistiksel olarak anlamlı düzelme saptandı (p<0,05).

Sonuç: Kronik bel ağrısında DYL tedavisinin ağrı kontrolü ve fonksiyonel durumda iyileşmede etkili olduğu gösterilmiş olsa da yaşam kalitesi üzerine etkileri saptanamamıştır. Bu konuda daha geniş kapsamlı, randomize kontrollü çalışmalara ihtiyaç vardır. 

Anahtar Kelimeler

Düşük yoğunluklu lazer, egzersiz, kronik bel ağrısı

Kaynakça

• Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Prac Res Clin Rheumatol. 2010;24(6):769-781.
• Weiner SS, Nordin M. Prevention and management of chronic back pain. Best Prac Res Clin Rheumatol. 2010;24(2):267-279.
• Chou R. Low back pain (chronic). BMJ Clin Evid. 2010;2010:1116.
• Chou R, Qaseem A, Snow V, ve ark. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491. doi:10.7326/0003-4819-147-7-200710020-00006
• Poitras S, Brosseau L. Evidence-informed management of chronic low back pain with transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and thermotherapy. Spine J. 2008;8(1):226-233. doi:10.1016/j.spinee.2007.10.022
• Ay S, Doğan SK, Evcik D. Is low-level laser therapy effective in acute or chronic low back pain? Clin Rheumatol. 2010;29(8):905-910. doi:10.1007/s10067-010-1460-0
• Haslerud S, Magnussen LH, Joensen J, Lopes-Martins RA, Bjordal JM. The efficacy of low-level laser therapy for shoulder tendinopathy: a systematic review and meta-analysis of randomized controlled trials. Physiother Res Int. 2015;20(2):108-125. doi:10.1002/pri.1606
• Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci. 2014;5(2):58-62.
• Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med. 2003;32(3):233-238. doi:10.1002/lsm.10134
• Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56.
• Yakut E, Düger T, Öksüz Ç, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine. 2004;29(5):581-585.
• Duruoz M, Ozcan E, Ketenci A, Karan A, Kiralp M. Cross cultural validation of the Revised Oswestry Pain Questionnaire (ROPQ) in a Turkish population. Arthritis & Rheumatism. 1999;42(9):270-2070.
• Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş AK. Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilaç ve Tedavi Dergisi. 1999;12(2):102-106.
• Huang Z, Ma J, Chen J, Shen B, Pei F, Kraus VB. The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther. 2015;17:360. doi:10.1186/s13075-015-0882-0
• Kingsley JD, Demchak T, Mathis R. Low-level laser therapy as a treatment for chronic pain. Front Physiol. 2014;5:306. doi:10.3389/fphys.2014.00306
• Mansouri V, Arjmand B, Rezaei Tavirani M, Razzaghi M, Rostami-Nejad M, Hamdieh M. Evaluation of efficacy of low-level laser therapy. J Lasers Med Sci. 2020;11(4):369-380. doi:10.34172/jlms.2020.60
• Clijsen R, Brunner A, Barbero M, Clarys P, Taeymans J. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2017;53(4):603-610. doi:10.23736/S1973-9087.17.04432-X
• Yeh SW, Hong CH, Shih MC, Tam KW, Huang YH, Kuan YC. Low-Level Laser Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis. Pain Physician. 2019;22(3):241-254.
• Stausholm MB, Naterstad IF, Joensen J, ve ark. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open. 2019;9(10):e031142. doi:10.1136/bmjopen-2019-031142
• Qaseem A, Wilt TJ, McLean RM, ve ark. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
• Vallone F, Benedicenti S, Sorrenti E, Schiavetti I, Angiero F. Effect of diode laser in the treatment of patients with nonspecific chronic low back pain: a randomized controlled trial. Photomed Laser Surg. 2014;32(9):490-494. doi:10.1089/pho.2014.3715
• Djavid GE, Mehrdad R, Ghasemi M, Hasan-Zadeh H, Sotoodeh-Manesh A, Pouryaghoub G. In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial. Aust J Physiother. 2007;53(3):155-160. doi:10.1016/s0004-9514(07)70022-3
• Tantawy SA, Abdelbasset WK, Kamel DM, Alrawaili SM, Alsubaie SF. Laser photobiomodulation is more effective than ultrasound therapy in patients with chronic nonspecific low back pain: a comparative study. Lasers Med Sci. 2019;34(4):793-800. doi: 10.1007/s10103-018-2665-8
• van Middelkoop M, Rubinstein SM, Kuijpers T, ve ark. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J. 2011;20(1):19-39. doi:10.1007/s00586-010-1518-3
• Maher CG. Effective physical treatment for chronic low back pain. Orthop Clin North Am. 2004;35(1):57-64. doi:10.1016/S0030-5898(03)00088-9
• Unde Ayvat P, Aydın ON, Oğurlu M. Algoloji polikliniğine başvuran bel ağrılı hastaların risk faktörleri. Agrı. 2012;24(4):165-170. doi:10.5505/agri.2012.38258
• Koldaş Doğan Ş, Ay S, Evcik D. The effects of two different low level laser therapies in the treatment of patients with chronic low back pain: A double-blinded randomized clinical trial. J Back Musculoskelet Rehabil. 2017;30(2):235-240. doi:10.3233/BMR-160739
• Yousefi-Nooraie R, Schonstein E, Heidari K, ve ark. Low level laser therapy for nonspecific low-back pain. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD005107. doi:10.1002/14651858
• Glazov G, Yelland M, Emery J. Low-level laser therapy for chronic non-specific low back pain: a meta-analysis of randomised controlled trials. Acupunct Med. 2016;34(5):328-341. doi:10.1136/acupmed-2015-011036
• Kholoosy L, Elyaspour D, Akhgari MR, Razzaghi Z, Khodamardi Z, Bayat M. Evaluation of the Therapeutic Effect of Low Level Laser in Controlling Low Back Pain: A Randomized Controlled Trial. J Lasers Med Sci. 2020;11(2):120-125. doi:10.34172/jlms.2020.21