Faculty of Physical Therapy, Cairo, Egypt.
J Surg Res. 2011 Jan;165(1):82-90. doi: 10.1016/j.jss.2010.03.050. Epub 2010 Apr 18.
In post-mastectomy patients, lymphedema has the potential to become a permanent progressive condition and become extremely resistant to treatment. Thus, it can results in function impairment and decrease quality of life. The aim of this study was to evaluate the effect of low level laser therapy (LLLT) on limb volume, shoulder mobility, and hand grip strength.
Fifty women with breast cancer-related lymphedema were enrolled in a double-blind, placebo controlled trial. Patients were randomly assigned to active laser (n = 25) and placebo (n = 25) groups and received irradiation with Ga-As laser device that had wavelength of 904 nm, power of 5 mW, and spot size of 0.2 cm(2) over the axillary and arm areas, three times a week for 12 wk. The total energy applied at each point was 300 mjoules over seven points, giving a dosage of 1.5 joules/cm(2) in the active group. The placebo group received placebo therapy in which the laser had been disabled without affecting its apparent function. Limb circumference, shoulder mobility, and grip strength were measured before treatment and at 4, 8, and 12 wk.
The two groups had similar parameters at baseline. The reduction of limb volume tended to decline in both groups. The trend being more significantly pronounced in active LLLT group than placebo at 8 and 12 wk, respectively (P < 0.05). Goniometric data for shoulder mobility and hand grip strength were statistically significance for LLLT group than for placebo.
Laser treatment was found to be effective in reducing the limb volume, increase shoulder mobility, and hand grip strength in approximately 93% of patients with postmastectomy lymphedema.
在乳腺癌根治术后患者中，淋巴水肿有可能成为一种永久性进行性疾病，并变得极其难以治疗。因此，它可能会导致功能障碍和生活质量下降。本研究的目的是评估低水平激光疗法（LLLT）对肢体体积、肩部活动度和手握力的影响。
50 名患有乳腺癌相关淋巴水肿的女性患者参加了这项双盲、安慰剂对照试验。患者被随机分为主动激光（n = 25）和安慰剂（n = 25）组，并接受 Ga-As 激光设备的照射，该设备的波长为 904nm，功率为 5mW，光斑大小为 0.2cm(2)，照射腋窝和手臂区域，每周 3 次，共 12 周。每个点应用的总能量为 300mjoules，共 7 个点，在主动组中给予 1.5 焦耳/cm(2)的剂量。安慰剂组接受的是激光已被禁用但不影响其明显功能的安慰剂治疗。在治疗前和治疗后 4、8 和 12 周测量肢体周长、肩部活动度和握力。
两组在基线时具有相似的参数。两组的肢体体积均有下降趋势。主动 LLLT 组在 8 和 12 周时分别比安慰剂组更明显（P < 0.05）。在 LLLT 组中，肩部活动度和手握力的角度测量数据具有统计学意义，而在安慰剂组中则没有。
激光治疗被发现对减少乳腺癌根治术后淋巴水肿患者的肢体体积、增加肩部活动度和手握力有效，约 93%的患者有效。
