Clinical and functional evaluation of patients with acute low back pain and radiculopathy treated with different energy doses of low level laser therapy.
2012
Background/Aim. The main clinical phenomena in acute low back pain (LBP) with
radiculopathy are pain and neurological disorders. Although some studies show
that low level laser therapy (LLLT) has the ability to modulate inflammatory
processes and relieve acute pain condition, the laser therapy dose protocol
has not been yet completely established. The aim of this study was to
investigate the effects of three different energy doses of LLLT in patients
with acute LBP and radiculopathy. Methods. The study included 66 patients
with acute LBP and radiculopathy who had been randomly divided into three
groups (22 patients each) received three different doses of LLLT. The
patients were treated 5 times weekly, for a total of 10 treatments, with the
following parameters: wave length 904 nm, frequency 3,000 Hz, average diode
power 25 mW; energy dose of 0.1 J per point in the first group, 1 J per point
in the second and 4 J per point in the third group; daily treatment time and
accumulated energy were 16 s and 0.4 J in the first group, 160 s and 4 J in
the second group and 640 s and 16 J in the third group, respectively. The
parameters of assessment before and after the therapy were: lumbar and leg
pain measured by visual analogue scale (VAS), local and general functional
changes (Schober test, manual muscle test, straight leg raise test and the
modified North American Spine Society-Low Back Pain Outcome Instrument-NASS
LBP). Results. Highly significant improvements (p < 0.01) were noted in all
the groups after LLLT with respect to all the investigated parameters. The
VAS scores were significantly lower in all the groups without a difference
between the groups (p > 0,05). Functional improvements were better in the
third group treated with the dose of 4 J per point than in other two groups
(p < 0.05). Conclusions. Three different energy doses of LLLT were equally
effective in alleviating lumbar and leg pain without side effects, but the
dose of 4 J per point seemed to be more effective in improving the activities
of daily living and lumbar mobility.
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