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高功率激光缓解髌股关节疼痛综合征患者疼痛及改善功能的疗效:一项单盲随机对照试验

Efficacy of High-Power Laser in Alleviating Pain and Improving Function of Patients With Patellofemoral Pain Syndrome: A Single-Blind Randomized Controlled Trial.

作者信息

Nouri Farshad, Raeissadat Seyed Ahmad, Eliaspour Dariush, Rayegani Seyed Mansoor, Rahimi Maryam Sadat, Movahedi Behnaz

机构信息

Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Clinical Research Development Center of Shahid Modarres Hospital & Physical Medicine and Rehabilitation Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Lasers Med Sci. 2019 Winter;10(1):37-43. doi: 10.15171/jlms.2019.06. Epub 2018 Dec 15.

Abstract

In this study, a single-blind and randomized controlled trial (RCT) for assessing the effectiveness of high-power (up to 12 W) laser therapy (HPLT) on patients with patellofemoral pain syndrome (PFPS) was carried out. Forty-four patients were randomly assigned to two treatment groups by generating random numbers with MATLAB 2014b software, where odd and even numbers were attributed to sham laser group (group A) and actual laser group (group B), respectively. Group B patients underwent HPLT with total dose of 300 J/session for 5 consecutive sessions separated by a 2-day interval. On the other hand, sham laser was applied to group A patients. Both groups had the same exercise therapy programs during the study period (3 months). The exercise therapy program included isometric knee exercise for 3 sets per day and 10 times in each set, with duration of 10 seconds per time and straight leg raise for 15 seconds 10 times a day. The group codes of patients were not revealed to subjects and data analyzer until completion of the study. Kujala, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) questionnaires were chosen as outcome measures. These questionnaires were completed at three points during the study; at the beginning of the study to obtain the pre-therapy conditions and one month and three months after the start of the study to evaluate post-therapy conditions. Two main analyses were conducted: within-group and between-group analyses. Withingroup analyses indicated significant improvements in respect to all measurements where pretherapy and post-therapy comparisons were conducted in both groups ( < 0.05). On the other hand, between-group comparisons did not reveal any statistically significant functional difference between group A and group B regarding the evaluative criteria ( > 0.05) except for pain VAS ( < 0.05). This study indicated that short-term HPLT accompanied by appropriate exercise regimen significantly decreased pain in patients with PFPS. But it was not recommended as an efficient modality in functional improvement. Also, it was observed that, in the short-term period of study, HPLT was a safe modality.

摘要

在本研究中,开展了一项单盲随机对照试验(RCT),以评估高功率(高达12瓦)激光疗法(HPLT)对髌股疼痛综合征(PFPS)患者的疗效。通过使用MATLAB 2014b软件生成随机数,将44例患者随机分为两个治疗组,其中奇数和偶数分别对应假激光组(A组)和实际激光组(B组)。B组患者接受HPLT,总剂量为300 J/次,连续5次,每次间隔2天。另一方面,对A组患者应用假激光。在研究期间(3个月),两组患者接受相同的运动治疗方案。运动治疗方案包括每天进行3组等长膝关节运动,每组10次,每次持续10秒,以及每天进行10次直腿抬高,每次持续15秒。在研究完成之前,患者的分组代码对受试者和数据分析人员保密。选择库贾拉量表、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)以及视觉模拟量表(VAS)问卷作为疗效指标。这些问卷在研究期间的三个时间点完成;在研究开始时以获取治疗前状况,在研究开始后1个月和3个月以评估治疗后状况。进行了两项主要分析:组内分析和组间分析。组内分析表明,在两组中进行治疗前和治疗后比较的所有测量指标方面均有显著改善(<0.05)。另一方面,除疼痛VAS外(<0.05),组间比较未显示A组和B组在评估标准方面存在任何统计学上的显著功能差异(>0.05)。本研究表明,短期HPLT联合适当的运动方案可显著减轻PFPS患者的疼痛。但不建议将其作为改善功能的有效方式。此外,观察到,在短期研究期间,HPLT是一种安全的治疗方式。

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