IV类（10瓦）治疗性激光治疗肱骨外上髁炎的疗效。

The effectiveness of therapeutic class IV (10 W) laser treatment for epicondylitis.

作者信息

Roberts Delia B, Kruse Roger J, Stoll Stephen F

机构信息

Selkirk College, Castlegar, British Columbia, Canada, V1N 4L3.

出版信息

Lasers Surg Med. 2013 Jul;45(5):311-7. doi: 10.1002/lsm.22140. Epub 2013 Jun 3.

DOI:10.1002/lsm.22140

PMID:23733499

Abstract

BACKGROUND AND OBJECTIVE

Photobiomodulation has been shown to modulate cellular protein production and stimulate tendon healing in a dose-dependent manner. Previous studies have used class IIIb lasers with power outputs of less than 0.5 W. Here we evaluate a dual wavelength (980/810 nm) class IV laser with a power output of 10 W for the purpose of determining the efficacy of class IV laser therapy in alleviating the pain and dysfunction associated with chronic epicondylitis.

METHODS

Sixteen subjects volunteered for laser therapy, or an identically appearing sham instrument in a randomized, placebo-controlled, double-blinded clinical trial. Subjects underwent clinical examination (pain, function, strength, and ultrasonic imaging) to confirm chronic tendinopathy of the extensor carpi radialis brevis tendon, followed by eight treatments of 6.6 ± 1.3 J/cm(2) (laser), or sham over 18 days. Safety precautions to protect against retinal exposure to the laser were followed. The exam protocol was repeated at 0, 3, 6 and 12 months post-treatment.

RESULTS

No initial differences were seen between the two groups. In the laser treated group handgrip strength improved by 17 ± 3%, 52 ± 7%, and 66 ± 6% at 3, 6, and 12 months respectively; function improved by 44 ± 1%, 71 ± 3%, and 82 ± 2%, and pain with resistance to extension of the middle finger was reduced by 50 ± 6%, 93 ± 4%, and 100 ± 1% at 3, 6 and 12 months, respectively. In contrast, no changes were seen until 12 months following sham treatment (12 months: strength improved by 13 ± 2%, function improved by 52 ± 3%, pain with resistance to extension of the middle finger reduced by 76 ± 2%). No adverse effects were reported at any time.

CONCLUSIONS

These findings suggest that laser therapy using the 10 W class IV instrument is efficacious for the long-term relief of the symptoms associated with chronic epicondylitis. The potential for a rapidly administered, safe and effective treatment warrants further investigation.

摘要

背景与目的

光生物调节已被证明可调节细胞蛋白质生成，并以剂量依赖方式刺激肌腱愈合。以往研究使用的是功率输出小于0.5W的IIIb类激光。在此，我们评估一种功率输出为10W的双波长（980/810nm）IV类激光，以确定IV类激光疗法在缓解与慢性肱骨外上髁炎相关的疼痛和功能障碍方面的疗效。

方法

16名受试者自愿参加一项随机、安慰剂对照、双盲临床试验，接受激光治疗或外观相同的假仪器治疗。受试者接受临床检查（疼痛、功能、力量和超声成像）以确认桡侧腕短伸肌腱的慢性肌腱病，随后在18天内接受8次6.6±1.3J/cm²（激光）治疗或假治疗。遵循了防止视网膜暴露于激光的安全预防措施。在治疗后0、3、6和12个月重复检查方案。

结果

两组最初无差异。在激光治疗组中，握力在3、6和12个月时分别提高了17±3%、52±7%和66±6%；功能分别提高了44±1%、71±3%和82±2%，中指伸展抵抗疼痛在3、6和12个月时分别降低了50±6%、93±4%和100±1%。相比之下，假治疗组直到12个月才出现变化（12个月时：力量提高了13±2%，功能提高了52±3%，中指伸展抵抗疼痛降低了76±2%）。任何时候均未报告不良反应。