Postgraduate Program in Biomedical Engineering, Anhembi Morumbi University (UAM), Estrada Dr. Altino Bondensan 500, Distrito de Eugênio de Melo, CEP: 12.247-016, São José dos Campos, SP, Brazil.
Institute of Biomedical Engineering, Anhembi Morumbi University (UAM), Estrada Dr. Altino Bondensan 500, Distrito de Eugênio de Melo, CEP: 12.247-016, São José dos Campos, SP, Brazil.
Lasers Med Sci. 2022 Oct;37(8):3155-3167. doi: 10.1007/s10103-022-03584-2. Epub 2022 Jun 1.
This study aimed to compare shoulder tendinopathy treatment with therapeutic ultrasound combined with LED photobiomodulation therapy using LED-infrared (850 nm) or LED-red (640 nm). The study assessed 75 patients, aged 45 to 70 years, distributed into five experimental groups (15 patients each): therapeutic ultrasound (US), infrared light irradiation (IR), visible red light irradiation (VR), infrared light and ultrasound combined (IR-US), and red light in conjunction with ultrasound (VR-US). The ultrasound parameters are 1 MHz, 0.5 W/cm (SATA), and 100 Hz repetition rate, applied for 4 min each session. LED irradiation protocols were as follows: 3 points, 7.5 J per point, IR-LED 750 mW, 10 s, VR-LED 250 mW, 30 s. LED irradiation is followed by ultrasound in the combined therapies. The efficiency of the five therapies was evaluated assessing 12 parameters: quality of life (Health Assessment Questionnaire, HAQ), pain intensity (Visual Analog Scale, VAS), articular amplitude of shoulder movement (flexion, extension, abduction, adduction, medial rotation, lateral rotation), muscle strength (abduction, lateral rotation), and electromyography (lateral rotation, abduction). Treatments comprised 12 sessions for 4 weeks. Intra-group analysis showed that the five therapies significantly improved the recovery of all parameters after treatment. Regarding the comparison of irradiated therapies and ultrasound, statistical analysis showed that IR-US was a better treatment than US for all 12 parameters. IR treatment exceeded US on 9 items, whereas that VR and VR-US therapies exceeded US in 7 and 10 parameters, respectively (p < 0.05). Because of that, IR-US shows to be the best treatment for rotator cuff tendinopathy. In conclusion, improvements in quality of life, pain intensity relief, shoulder amplitude motion, and muscle strength force obtained with ultrasound therapy are enhanced by adding infrared LED irradiation to ultrasound for patients suffering from rotator cuff tendinopathy. This study was registered with the Brazilian Registry of Clinical Trials (ReBEC) under Universal Trial Number (UTN) U1111-1219-3594 (2018/22/08).
本研究旨在比较超声治疗与 LED 光生物调节治疗(使用 LED 红外光[850nm]或 LED 红光[640nm])联合治疗肩袖肌腱病的效果。该研究纳入了 75 名年龄在 45 至 70 岁之间的患者,将其分为五个实验组(每组 15 名患者):超声治疗组(US)、红外光照射组(IR)、可见红光照射组(VR)、红外光与超声联合治疗组(IR-US)和红光与超声联合治疗组(VR-US)。超声参数为 1MHz、0.5W/cm²(SATA)和 100Hz 重复频率,每次治疗 4 分钟。LED 辐照方案如下:IR-LED 为 750mW,3 个照射点,每个点 7.5J,辐照时间为 10 秒;VR-LED 为 250mW,辐照时间为 30 秒。在联合治疗中,先进行 LED 照射,然后再进行超声治疗。通过评估 12 个参数评估这 5 种疗法的效果:生活质量(健康评估问卷,HAQ)、疼痛强度(视觉模拟量表,VAS)、肩关节运动幅度(前屈、伸展、外展、内收、内旋、外旋)、肌肉力量(外展、外旋)和肌电图(外旋、外展)。治疗包括 4 周内的 12 次治疗。组内分析显示,五种疗法在治疗后均能显著改善所有参数的恢复情况。关于照射疗法与超声疗法的比较,统计分析显示,IR-US 对所有 12 个参数的治疗效果均优于 US。IR 治疗在 9 项指标上优于 US,而 VR 和 VR-US 治疗在 7 项和 10 项指标上优于 US(p<0.05)。因此,IR-US 是治疗肩袖肌腱病的最佳方法。总之,对于患有肩袖肌腱病的患者,在超声治疗的基础上增加红外 LED 照射可以提高生活质量的改善、疼痛强度的缓解、肩关节活动幅度和肌肉力量。本研究已在巴西临床试验注册处(ReBEC)注册,注册号为通用试验编号(UTN)U1111-1219-3594(2018/22/08)。