Efficacy of high-intensity laser therapy on arthropathy of the hands in patients with systemic lupus erythematosus: a double-blinded,randomized controlled trial
Restricted accessResearch articleFirst published online October, 2020
Efficacy of high-intensity laser therapy on arthropathy of the hands in patients with systemic lupus erythematosus: a double-blinded,randomized controlled trial
To determine the efficacy of high-intensity laser therapy (HILT) on arthropathy of the hands in patients with systemic lupus erythematosus.
Design:
A double-blinded randomized, controlled study.
Setting:
Outpatient setting
Participants:
Fifty patients, 30–50-years-old, suffering from arthropathy of the hands were randomly assigned either into the experimental group, received HILT plus the routine physical therapy program or the control group, received sham HILT plus the same routine physical therapy program.
Intervention:
All treatment interventions were applied at a frequency of three sessions per week for eight weeks.
Outcome measures:
Handgrip strength, joints swelling counts, joints tenderness counts, visual analog scale (VAS) were measured before and after eight-weeks of interventions.
Results:
There were statistically significant differences in handgrip strength, joint swelling count, joint tenderness count and VAS in favor of the study group (P < 0.05). After eight-weeks of intervention, the mean (SD) for handgrip strength, joint swelling counts, joint tenderness count, and pain score was 28.34 ± 8.3 kg, 4.4 ± 2.18, 5 ± 2.1, and 35.6 ± 13.87 mm in the study group, and 22.96 ± 8.76 kg, 7.36 ± 2.14, 9.08 ± 1.63, and 58.8 ± 10.54 mm in the control group, respectively. The MD (95%CI) for handgrip strength, joint swelling counts, joint tenderness count, and pain score was 5.38(0.53,10.23) kg, −2.96(−4.19, −1.73), −4.08(−5.15, −3.01), and −23.2(−30.2, −16.2) mm between groups, respectively.
Conclusions:
Adding HILT to the routine physical therapy program might be more effective than routine physical therapy program alone in improving handgrip strength, decreasing joint swelling counts, joint tenderness counts, and pain in patients with arthropathy of the hands.
Bağlan YentürSTunaZMeteO, et al. Hand functions in systemic lupus erythematosus: a comparative study with rheumatoid arthritis patients and healthy subjects. Turk J Med Sci2018; 48(4): 840–844.
2.
Malcus JohnssonPSandqvistGNilssonJÅ, et al. Hand function and performance of daily activities in systemic lupus erythematosus: a clinical study. Lupus2015; 24(8): 827–834.
3.
JohnssonPMSandqvistGBengtssonA, et al. Hand function and performance of daily activities in systemic lupus erythematosus. Arthritis Rheum2008; 59(10): 1432–1438.
4.
BoomsmaMMBijlMStegemanCA, et al. Patients’ perceptions of the effects of systemic lupus erythematosus on health, function, income, and interpersonal relationships: a comparison with Wegener’s granulomatosis. Arthritis Rheum2002; 47(2): 196–201.
5.
MeinersPMCoertJHRobinsonPH, et al. Impairment and employment issues after nerve repair in the hand and forearm. Disabil Rehabil2005; 27(11): 617–623.
6.
FeuersteinMHuangGDOrtizJM, et al. Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status. J Occup Environ Med2003; 45(8): 803–812.
7.
GabbaAPigaMVaccaA, et al. Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients. Rheumatology2012; 51(12): 2278–2285.
8.
DescoinsMDanionFBootsmaRJ.Predictive control of grip force when a moving object with an elastic load applied on the arm. Exp Brain Res2006; 172(3): 331–342.
9.
EfratZHagarPZeeviD.Grip and pinch strength in healthy subjects and patients with primary osteoarthritis of the hand: a reproducibility study. Open Orthop J2008; 2: 86–90.
10.
ZatiAValentA.Physical therapy: new technologies in rehabilitation medicine (translated to English). Edizioni Minerva Medica2006; 2006: 162–185.
11.
SongHJSeoHJLeeY, et al. Effectiveness of high-intensity laser therapy in the treatment of musculoskeletal disorders: a systematic review and meta-analysis of randomized controlled trials. Medicine2018; 97(51): e13126.
12.
EnwemekaCSReddyGK.The biological effects of laser therapy and other physical modalities on connective tissue repair processes. Laser Ther2000; 12(1): 22–30.
13.
FarivarSMalekshahabiTShiariR.Biological effects of low level laser therapy. J Lasers Med Sci2014; 5(2): 58–62.
14.
MoniciMCialdaiFFusiF, et al. Effects of pulsed Nd: YAG laser at the molecular and cellular level. A study on the basis of Hilterapia. Energy Health2008; 3: 27–33.
15.
OrdahanBKarahanAYKaydokE.The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: a randomized clinical trial. Lasers Med Sci2018; 33(6): 1363–1369.
16.
SantamatoASolfrizziVPanzaF, et al. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of people with subacromial impingement syndrome: a randomized clinical trial. Phys Ther2009; 89(7): 643–652.
17.
KimGJChoiJLeeS, et al. The effects of high intensity laser therapy on pain and function in patients with knee osteoarthritis. J Phys Ther Sci2016; 28(11): 3197–3199.
18.
AngelovaAIlievaEM.Effectiveness of high intensity laser therapy for reduction of pain in knee osteoarthritis. Pain Res Manag2016; 2016: 9163618.
19.
JacobsJWGeenenREversAW, et al. Short term effects of corticosteroid pulse treatment on disease activity and the wellbeing of patients with active rheumatoid arthritis. Ann Rheum Dis2001; 60(1): 61–64.
20.
Stoffer-MarxMAKlingerMLuschinS, et al. Functional consultation and exercises improve grip strength in osteoarthritis of the hand–a randomised controlled trial. Arthritis Res Ther2018; 20(1): 253.
21.
KeramiotouKAnagnostouCKataxakiE, et al. The impact of upper limb exercise on function, daily activities and quality of life in systemic lupus erythematosus: a pilot randomised controlled trial. RMD Open2020; 6(1): e001141.
22.
FessEE.Grip strength. In: CasanovaJS (ed) Clinical assessment recommendations. 2nd ed.Chicago: The American Society of Hand Therapists, 1992, pp. 41–45.
23.
WeiWLing-LingZJian-HuaX, et al. A multicenter, double-blind, randomized, and controlled phase III clinical trial of chicken type II collagen in rheumatoid arthritis. Arthritis Res Ther2009; 11(6): R180.
24.
HendianiJAWestlundKNLawandN, et al. Mechanical sensation and pain thresholds in patients with chronic arthropathies. J Pain2003; 4(4): 203–211.
25.
GadburyGLCoffeyCSAllisonDB.Modern statistical methods for handling missing repeated measurements in obesity trial data: beyond LOCF. Obes Rev2003; 4(3):175–184.
26.
ChenLLiuDZouL, et al. Efficacy of high intensity laser therapy in treatment of patients with lumbar disc protrusion: a randomized controlled trial. J Back Musculoskelet Rehabil2018; 31(1): 191–196.
27.
DundarUTurkmenUToktasH, et al. Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study. Lasers Med Sci2015; 30(1): 325–332.
28.
DundarUTurkmenUToktasH, et al. Effectiveness of high-intensity laser therapy and splinting in lateral epicondylitis; a prospective, randomized, controlled study. Lasers Med Sci2015; 30(3): 1097–1107.
29.
VilianiTCarabbaCMangoneG, et al. High intensity pulsed Nd: YAG laser in painful knee osteoarthritis: the bio stimulating protocol. Energy Health2012; 9: 18–22.
30.
KnappeVFrankFRohdeE.Principles of lasers and biophotonic effects. Photomed Laser Surg2004; 22: 411–417.
31.
ChowRArmatiPLaaksoEL, et al. Inhibitory effects of laser irradiation on peripheral mammalian nerves and relevance to analgesic effects: a systematic review. Photomed Laser Surg2011; 29(6): 365–381.
32.
KujawaJZavodnikLZavodnikI, et al. Effect of low-intensity (3.75–25 J/cm2) near-infrared (810 nm) laser radiation on red blood cell ATPase activities and membrane structure. J Clin Laser Med Surg2004; 22(2): 111–117.
33.
FiorePPanzaFCassatellaG, et al. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial. Eur J Phys Rehabil Med2011; 47(3): 367–373.
34.
NazariAMoezyANejatiP, et al. Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis: a randomized controlled trial with 12-week follow up. Lasers Med Sci2019; 34(3): 505–516.
35.
NiemzMH.Laser-tissue interactions: fundamentals and applications. 4th ed.Switzerland: Springer international publishing, 2019.
36.
OralAIlievaEKüçükdeveciA, et al. Local soft tissue musculoskeletal disorders and injuries. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med2013; 49(5): 727–742.
37.
Štiglić-RogoznicaNStamenkovićDFrlan-VrgočL, et al. Analgesic effect of high intensity laser therapy in knee osteoarthritis. Coll Antropol2011; 35(2): 183–185.
38.
WyszyńskaJBal-BocheńskaM.Efficacy of high-intensity laser therapy in treating knee osteoarthritis: a first systematic review. Photomed Laser Surg2018; 36(7): 343–353.
39.
GworysKGasztychJPuzderA, et al. Influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis. Ortop Traumatol Rehabil2012; 14(3): 269–277.
40.
HegedusBViharosLGervainM, et al. The effect of low-level laser in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial. Photomed Laser Surg2009; 27(4): 577–584.
41.
KarabegovićAKapidžić-DurakovićSLjucaF.Laser therapy of painful shoulder and shoulder-hand syndrome in treatment of patients after the stroke. Bosn J Basic Med Sci2009; 9(1): 59–65.
42.
TimóteoRPSilvaAFMicheliDC, et al. Increased flexibility, pain reduction and unaltered levels of IL-10 and CD11b+ lymphocytes in patients with systemic lupus erythematosus were associated with kinesiotherapy. Lupus2018; 27(7): 1159–1168.
43.
LambSEWilliamsonEMHeinePJ, et al. Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial. Lancet2015; 385(9966): 421–429.
44.
BuljinaAITaljanovicMSAvdicDM, et al. Physical and exercise therapy for treatment of the rheumatoid hand. Arthritis Rheum2001; 45(4): 392–397.
45.
de CarvalhoMRSatoEITebexreniAS, et al. Effects of supervised cardiovascular training program on exercise tolerance, aerobic capacity, and quality of life in patients with systemic lupus erythematosus. Arthritis Rheum2005; 53(6): 838–844.
46.
BrorssonSHilligesMSollermanC, et al. A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis. J Rehabil Med2009; 41(5): 338–342.
47.
O’DwyerTDurcanLWilsonF.Exercise and physical activity in systemic lupus erythematosus: a systematic review with meta-analyses. Semin Arthritis Rheum2017; 47(2): 204–215.
48.
PetriM.Epidemiology of systemic lupus erythematosus. Best Pract Res Clin Rheumatol2002; 16(5): 847–858.
49.
LahitaRG.The role of sex hormones in systemic lupus erythematosus. Curr Opin Rheumatol1999; 11(5): 352–356.
50.
CooperGSDooleyMATreadwellEL, et al. Hormonal, environmental, and infectious risk factors for developing systemic lupus erythematosus. Arthritis Rheum1998; 41(10): 1714–1724.
51.
PetersonEMurrayWHiebertJM.Effect of gender and exercise type on relative hand grip strength. J Strength Cond Res2010; 24: 1.
