Fusakul Yupadee, Aranyavalai Thanyaporn, Saensri Phongphitch, Thiengwittayaporn Satit
Department of Physical Medicine and Rehabilitation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Lasers Med Sci. 2014 May;29(3):1279-87. doi: 10.1007/s10103-014-1527-2. Epub 2014 Jan 30.
The efficacy of low-level laser therapy (LLLT) was evaluated in a total of 66 patients with mild to moderate carpal tunnel syndrome (CTS) with a double-blinded randomized controlled study. The patients were randomly assigned into two groups. Group I received 15 sessions of a gallium-aluminum-arsenide laser treatment at a dosage of 18 J per session over the carpal tunnel area with neutral wrist splint. Group II received placebo laser therapy with neutral wrist splint. The patients were evaluated with the following parameters: (1) clinical parameters which consisted of visual analog scale, symptom severity scale, functional status scale, and pinch strength and grip strength before the treatment and at 5- and 12-week follow-ups and (2) electroneurophysiological parameters from nerve conduction study which were evaluated before the treatment and at 12-week follow-up. Fifty nine patients (112 hands: unilateral CTS = 6 hands and bilateral CTS = 106 hands) completed the study. Both groups I and II had n = 56 hands. Improvements were significantly more pronounced in the LLLT-treated group than the placebo group especially for grip strength at 5- and 12-week follow-ups. At 12-week follow-up, distal motor latency of the median nerve was significantly improved in the LLLT group than the placebo group (p < 0.05). LLLT therapy, as an alternative for a conservative treatment, is effective for treating mild to moderate CTS patients. It can improve hand grip strength and electroneurophysiological parameter with a carry-over effect up to 3 months after treatment for grip strength of the affected hands.
通过一项双盲随机对照研究,对66例轻至中度腕管综合征(CTS)患者评估了低强度激光疗法(LLLT)的疗效。患者被随机分为两组。第一组在腕管区域接受15次砷化镓铝激光治疗,每次剂量为18焦耳,同时佩戴中立位腕部夹板。第二组接受安慰剂激光治疗并佩戴中立位腕部夹板。通过以下参数对患者进行评估:(1)临床参数,包括视觉模拟量表、症状严重程度量表、功能状态量表,以及治疗前、治疗后5周和12周随访时的捏力和握力;(2)治疗前和治疗后12周随访时通过神经传导研究评估的神经电生理参数。59例患者(112只手:单侧CTS = 6只手,双侧CTS = 106只手)完成了研究。第一组和第二组均有n = 56只手。与安慰剂组相比,LLLT治疗组的改善更为显著,尤其是在治疗后5周和12周随访时的握力方面。在12周随访时,LLLT组正中神经的远端运动潜伏期比安慰剂组有显著改善(p < 0.05)。LLLT疗法作为保守治疗的一种替代方法,对治疗轻至中度CTS患者有效。它可以改善握力和神经电生理参数,对患手握力的治疗效果可持续至治疗后3个月。