High power laser therapy versus ultrasound therapy

Aim

The aim of the study is to evaluate the short-term effectiveness of HILT (High Intensity Laser Therapy) versus ultrasound therapy .

Study type

The study was conducted as a randomized clinical trial in a university hospital.

Patients

The study involved 70 patients with SAIS (Subacromial impingement syndrome) who were randomly assigned to HILT or US therapy treatments.

Study program

Participants received 10 treatment sessions of HILT and ultrasound therapy for a period of two weeks.

Measurement method

The results were determined in Constant Murley Scale (CMS), Visual Analog Scale (VAS) and the Simple Shoulder Test (SST).

In the study group were 42 women and 28 men with the average age of 54.1 years. The baseline value level was 6.4 in the VAS scale. There were no differences between groups at the beginning phase of the study.

After a two-week treatment period HILT group participants showed a significantly greater reduction in pain than participants of the US group.

Study limitations: the study was limited by the small sample size, lack of placebo group and observation period after treatment procedures.

HILT group's treatments were carried out by laser Hiro 1.0. Its high peak power is 1 kW. Treatment parameters were as follows: emitted wavelength -1064nm, maximum energy per single pulse - 150mJ, average power - 6W, energy density - 760mJ/cm2 and duration of a single pulse - less than 150ms. The initial phase of the treatment concerned the manual scanning (sweeping) of the muscular contracture area (100cm2/30s), especially the upper part of the trapezius and deltoid muscles. In this phase, the total administered dose was 1000J. The intermediate phase include application on trigger points to achieve a reduction in pain up to 70-80%. The average energy dose in this case was 50J. The final phase of the treatment consisted of slow manual sweeping (100cm2/60s) of the same area that was subjected to treatment in the initial phase until achieving a total energy dose of 1000J. Energy densities at various stages were respectively 510, 610, 710 mJ/cm2. In this way, the total dose of administered energy was approximately 2.050 J. The time required for the treatment was approximately 10 minutes.

Participants in the ultrasound therapy group were subjected to a treatment with the application of 1 MHz ultrasound head with an intensity of 2W/cm2 and a duty cycle of 100%. The ultrasound head was operated in a slow circular motion in the area of 20cm2.

Evaluation

The initial value of pain sensation in the HILT group was 6.28 determined in VAS scale, after the treatment it decreased to 2.42.

In the US group, the initial value was 6.6. After the above mentioned treatment session it decreased to 4.44.

VAS is an abbreviation of the Visual Analog Scale. This measuring method is related to the assessment of the reported level in relation to two extreme values. They may include the determination of absence of pain and very sharp pain sensation. Respondents specify their sensation level by indicating a position along the scale. Then, the location is measured at a specified point in relation to the length of sections between the determinants. In such a system, the response in the middle of the VAS scale is 5.

The study was also assessed in the Constant-Murley Scale (CMS) and the Simple Shoulder Test (SST), but the descriptions of these measurement methods are beyond the scope of the article.

Conclusions

A study shows that high power laser therapy was twice as efficient as the ultrasound therapy in the treatment of SAIS.

Disadvantages

· Unproven benefit.

· Because ultrasound has the greatest penetration of any other therapeutic modality, tissues can be damaged if ultrasound is used inappropriately - it should only be used in those cases where there has been a full veterinary evaluation.

· Tissue damage can be done before there is a pain response in the patient.

· Should not be used in proximity to open wounds or metal implants, or in cases of cellulitis, infection, unstable fractures or surgical incisions.

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donna@gigaalaser.com