Notarnicola Angela, Covelli Ilaria, Macchiarola Dario, Bianchi Francesco Paolo, Cassano Giuseppe Danilo, Moretti Biagio
Orthopedics Section, Department of Translational Biomedicine and Neuroscience, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, 70121 Bari, Italy.
Course of Motor and Sports Sciences, Department of Precision and Regenerative Medicine and the Ionian Area, Faculty of Medicine and Surgery, University of Study of Bari, 70121 Bari, Italy.
J Clin Med. 2023 Mar 29;12(7):2583. doi: 10.3390/jcm12072583.
Rotator cuff tendinopathy is a common diagnosis among patients with shoulder pain and dysfunction. Laser therapy is recommended for the treatment of this tendon disease due to the possibility of increasing tissue biostimulation. The aim of this study was to investigate the effects of HELT (high-energy laser therapy) in relation to the wavelengths of 650 nm, 810 nm, 980 nm, and 1064 nm administered.
The study design was prospective and observational. Thirty patients with shoulder tendinopathy were recruited and treated in one of two high-energy laser therapy groups (5 Watt/cm, 450 Joule, super-pulsed mode). Group A received a high-energy laser therapy protocol with a single wavelength (1064 nm); group B received a high-energy laser therapy program with four wavelengths (650 nm, 810 nm, 980 nm, and 1064 nm). Pain (VAS), function (ASES), and disability (DASH) were monitored at the time of recruitment (T0), 1 month later (T1), and 6 months later (T2). Roles and Maudsley scores were also evaluated at T1 and T2.
Both protocols resulted in improvement of pain and in functional and disability recovery at the two times of assessment, without statistically significant differences. In group B, treated with the four wavelengths, a trend emerged, bordering on statistical significance, for a greater reduction in pain.
The high-energy laser proved to be an effective therapy for the treatment of rotator cuff tendinopathy. The possibility of modulating the choice of wavelengths could allow the customization of the protocol in relation to the patient's clinical condition.
肩袖肌腱病是肩部疼痛和功能障碍患者的常见诊断。由于激光疗法有可能增强组织生物刺激作用，因此推荐用于治疗这种肌腱疾病。本研究的目的是调查650纳米、810纳米、980纳米和1064纳米波长的高能激光疗法（HELT）的效果。
本研究设计为前瞻性观察性研究。招募了30例肩部肌腱病患者，并在两个高能激光治疗组（5瓦/平方厘米，450焦耳，超脉冲模式）之一接受治疗。A组接受单一波长（1064纳米）的高能激光治疗方案；B组接受四种波长（650纳米、810纳米、980纳米和1064纳米）的高能激光治疗方案。在招募时（T0）、1个月后（T1）和6个月后（T2）监测疼痛（视觉模拟评分法[VAS]）、功能（美国肩肘外科医师学会[ASES]评分）和残疾程度（上肢功能障碍评分[DASH]）。在T1和T2时还评估了角色和莫兹利评分。
两种方案在两次评估时均导致疼痛改善以及功能和残疾恢复，无统计学显著差异。在接受四种波长治疗的B组中，出现了疼痛减轻幅度更大的趋势，接近统计学显著性。
高能激光被证明是治疗肩袖肌腱病的有效疗法。调节波长选择的可能性可以根据患者的临床状况定制治疗方案。
