El-Shamy Shamekh Mohamed, Abdelaal Ashraf Abdelaal Mohamed
a Department of Physical Therapy for Disturbance of Growth and Development in Children and its Surgery, Faculty of Physical Therapy , Cairo University , Giza , Egypt.
b Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy , Cairo University , Giza , Egypt.
Disabil Rehabil. 2018 Feb;40(4):462-468. doi: 10.1080/09638288.2016.1261416. Epub 2016 Dec 15.
The aim of this study was to evaluate the effects of pulsed high-intensity laser therapy (HILT) on pain, functional capacity, and gait in children with haemophilia.
Thirty children with haemophilia type A with ages ranging from 9 to 13 years were selected for this study. They were assigned randomly, into two equal treatment groups. The laser group received the traditional physical therapy programme plus active laser (total energy of 1500 J through three phases/3 sessions/week), whereas the placebo group received the same physical therapy programme plus placebo laser over three consecutive months. Baseline and post-treatment assessments used the visual analogue scale (VAS) to evaluate pain, a 6-min walk test (6MWT) to evaluate functional capacity, and the GAITRite system to evaluate gait parameters.
Children in the laser group showed significant improvement in pain, functional capacity, and gait parameters compared to those in the placebo group (p < 0.05). Post-treatment functional capacity for the laser and placebo groups were 316.6 ± 35.27 and 288 ± 43.3 m, respectively.
HILT is an effective modality in reducing pain, increasing functional capacity, and improving gait performance in children with haemophilic arthropathy. Implications for Rehabilitation Haemophilic arthropathy due to recurrent joint bleeding leads to physical, psychological, and socioeconomic problems in children with haemophilia and reduces their quality of life. Early physiotherapeutic interventions help to prevent and treat the sequelae of recurrent haemarthrosis. High-intensity laser therapy has been introduced as non-invasive and an effective physiotherapy modality for rapid pain control, with consequent improvement in children's quality of life. High-intensity laser therapy should be used as an adjunct to exercise programme in the rehabilitation of children with haemophilic arthropathy.
本研究旨在评估脉冲高强度激光疗法（HILT）对血友病患儿疼痛、功能能力和步态的影响。
选取30名年龄在9至13岁之间的甲型血友病患儿进行本研究。他们被随机分为两个相等的治疗组。激光组接受传统物理治疗方案加活性激光治疗（通过三个阶段/每周3次治疗，总能量为1500焦耳），而安慰剂组在连续三个月内接受相同的物理治疗方案加安慰剂激光治疗。基线和治疗后评估使用视觉模拟量表（VAS）评估疼痛，6分钟步行试验（6MWT）评估功能能力，以及GAITRite系统评估步态参数。
与安慰剂组相比，激光组患儿在疼痛、功能能力和步态参数方面有显著改善（p < 0.05）。激光组和安慰剂组治疗后的功能能力分别为316.6 ± 35.27米和288 ± 43.3米。
HILT是减轻血友病性关节病患儿疼痛、提高功能能力和改善步态表现的有效方法。康复意义 由于反复关节出血导致的血友病性关节病会给血友病患儿带来身体、心理和社会经济问题，并降低他们的生活质量。早期物理治疗干预有助于预防和治疗反复关节积血的后遗症。高强度激光疗法已被引入作为一种非侵入性且有效的物理治疗方法，用于快速控制疼痛，从而改善患儿的生活质量。在血友病性关节病患儿的康复中，高强度激光疗法应作为运动计划的辅助手段使用。
