EFFECTS OF HIGH POWER LASER PLUS MANUAL THERAPY VERSUS MANUAL THERAPY ALONE ON MUSCLE ACTIVITY IN PATIENTS WITH CHRONIC CERVICAL RADICULOPATHY

Main Article Content

Siamak Bashardoust Tajali
Hassan Namvar
Gholamreza Olyaie
Hossien Bagheri
Sharareh Saneie Sistani
Mohammad Hosienifar

Keywords

High-Power Laser, Muscle Activity, Flexor Carpi Radialis

Abstract

Background: Muscles activity changes may occur in chronic neck pain, but there are few RCTs on specific changes in muscle activity chronic neck pain and also after using High Power Laser. The aim of this research was to study effects of High Power (H.P.) Laser plus Manual Therapy Versus Manual Therapy alone on Muscle Activity in Chronic Cervical Radiculopathy Patients.


Materials and Methods: Frothy two patients with Chronic Cervical Radiculopathy were recruited for this double blind randomized clinical trial. The patients were randomly divided into Manual therapy plus H.P. Laser group and Manual therapy alone group. The Manual therapy plus H.P. Laser group was treated with High-Power Laser model K-LASER in addition to manual therapy. The Manual therapy alone group received suboccipital muscle release method, ULTT for median and radial nerve, chin tuck exercise, and resistance and stretching exercises. The interventions were conducted three times per week for 6 weeks. The activity of Flexor Carpi Radialis muscle (RMS) was evaluated before and after third and sixth weeks of the interventions by electromyography (EMG) instrument. The evaluations were also repeated two months after treatment accomplishment as follow up of the treatment effectiveness. The pain was assessed using Visual Analog Scale and the disability was assessed using Neck Disability Index questionnaire. Data were analyzed with multiple ANOVA Repeated measure and Bonferroni tests (p<0.05)

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References

1.MacDowall A, Skeppholm M, Lindhagen L, Robinson Y, Olerud C.Effects of preoperative mental distress versus surgical modality, arthroplasty, or fusion on long-term outcome in patients with cervical radiculopathy. Journal of Neurosurgery: Spine, 2018. 29(4): p. 371-379. DOI: 10.3171/2018.2.SPINE171378
2.Liang L, Feng M , Cui X, Zhou S , Yin X, Wang X, Yang M, Liu C, Xie R, Zhu L, Yu J, Wei X. The effect of exercise on cervical radiculopathy: a systematic review and meta-analysis. Medicine, 2019. 98 (45): e17733. doi: 10.1097/MD.0000000000017733.
3.Revel M, Minguet M, Gregoy.P, Viallant.J, Manuel J. Changes in cervicocephalic Kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomizd controlled study. Archives of physical medicine and rehabilitation 1994;75(8):895-9.
4.Oleary S, Vincenzino B, Jull G. A new method of isometric dynamometry for the craniocervical flexor muscles. Phys Ther. 2005; 85:556-64.
5.Strimpakos N. The assessment of the cervical spine.Part 1: range of motion and proprioception. Journal of body work and movement therapies. 2011;15(1):114-24.
6.Falla D, Jull G, Hodges P. Feed forward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Experimental brain research. 2004;157(1):4-80.
7.Mantyselka P, Kautiainen H, Vanhala. Prevalence of neck pain in subjects with metabolic syndrome – a cross-sectional population-based study.BMC Musculoskeletal Disorders. 2010;11(1):171.
8.Revel M, Andre-Deshays C, Minguet M. Cervicocephalic kinesthetic sensibility in patients with cervical pain. Archives of physical medicine and rehabilitation. 1991;72(5):288-91.
9.Escortel-Mayor E, Riesgo-Fuertes R, Garrido-Elustondo S, Asunsolo-Del Barco A, Diaz-Pulido B, Blanco-Diaz M, et al. Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain. Manual therapy. 2011;16(1):66-73.
10.Jull G, Richardson C. Motor control problems in patients with spinal pain: a new direction for therapeutic exercise journal of manipulative and physiological therapeutics. 2000;23(2):115-7.
11.Comerford M, Mottram S. Movement and stability dysfunction-contemporary developments. Manual Therapy. 2001;6(1):15-26.
12.Kang, K.-C., H.S. Lee, and J.-H. Lee, Cervical radiculopathy focus on characteristics and differential diagnosis. Asian Spine Journal, 2020. 14(6): p. 921.
13. Jellad A, Salah B, Boudokhane S, Migaou H, Bahri I, Rejeb N. The value of intermittent cervical traction in recent cervical radiculopathy. Annals of physical and rehabilitation medicine, 2009. 52(9): 638-652. doi: 10.1016/j.rehab.2009.07.035. Epub 2009 Oct 8.
14.Romeo A, Vanti C , Boldrini V , Ruggeri M , Guccione AA , Pillastrini P, Bertozzi L. Cervical radiculopathy: effectiveness of adding traction to physical therapy—a systematic review and meta-analysis of randomized controlled trials. Physical Therapy, 2018. 98(4):231-242. DOI: 10.1093/physth/pzy001.
15. Borrella-Andrés S, Marqués-García I, Lucha-López MO, Fanlo-Mazas P, Hernández-Secorún M, Pérez-Bellmunt A, Tricás-Moreno JM and Hidalgo-García1 C. Manual therapy as a management of cervical radiculopathy: A systematic review. BioMed Research International, 2021: 1-15. https://doi.org/10.1155/2021/9936981.
16. Song HJ, Seo HJ, Lee Y, Kim SK. Effectiveness of high-intensity laser therapy in the treatment of musculoskeletal disorders: A systematic review and meta-analysis of randomized controlled trials. Medicine, 2018. 97)51). doi: 10.1097/MD.0000000000013126.
17.Chow RT, Barnsley l. Systematic review of the literature of low‐level laser therapy (LLLT) in the management of neck pain. Lasers in Surgery and Medicine: The Official Journal of the American Society for Laser Medicine and Surgery, 2005. 37(1):46-52.
18. Gworys K, Gasztych J, Puzder A, Gworys P, Kujawa J. Influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis. Ortopedia, traumatologia, rehabilitacja, 2012. 14(3): p. 269-277. doi: 10.5604/15093492.1002257.
19. Chang WD, Lee CL, Lin HY, Hsu YC, Wang CJ, PhD,5 and Lai PT. A meta-analysis of clinical effects of low-level laser therapy on temporomandibular joint pain. Journal of physical therapy science, 2014. 26(8): p. 1297-1300. doi: 10.1589/jpts.26.1297.
20. Huang, Z, Chen J, Ma J, Shen B, Pei F, Kraus VB. Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis and cartilage, 2015. 23(9): p. 1437-1444.
21. Shady N, Negm AM, Zitun ZMY, Abdelhakiem NM .Multimodal Intervention of High-Intensity Laser with Neurodynamic Mobilization in Cervical Radiculopathy. 2021., 14(4): 1679-85.
22. Roy R, Rajeeva A, Veena J and Jayaram BS. Effectiveness of cold laser therapy with exercises and intermittent cervical traction with exercises in cervical radiculopathy: a comparative study. 2018, 5(1): 230-236.
23. Haładaj R, Pingot M, Topol M. The effectiveness of cervical spondylosis therapy with Saunders traction device and high-intensity laser therapy: a randomized controlled trial. Medical science monitor: international medical journal of experimental and clinical research, 2017. 23:335.
24. Abdallah GA, Mohamed RA, Sharaf MA. Effect of Snags Mulligan Technique Versus Low Level Laser Therapy on Patients with Unilateral Cervical Radiculopathy. Int. J. Physiother. Res, 2017. 5:2240-2248.
25. Konstantinovic LM, Cutovic MR, Milovanovic AN, Jovic SJ, Dragin AS, Letic MD, Miler VM. Low-level laser therapy for acute neck pain with radiculopathy: a double-blind placebo-controlled randomized study. Pain Medicine, 2010. 11(8):1169-1178. doi: 10.1111/j.1526-4637.2010.00907.x.
26. Halvorsen M, Falla D, Gizzi L, Harms-Ringdahl K, Peolsson A, Dedering A. Short-and long-term effects of exercise on neck muscle function in cervical radiculopathy: A randomized clinical trial. Journal of rehabilitation medicine, 2016. 48(8):696-704. doi: 10.2340/16501977-2120.
27. Rubinstein SM, Pool JJM, van Tulder MW, Riphagen II, de Vet HCW. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. European spine journal, 2007. 16(3):307-319.doi : 10.1007/s00586-006-0225-6.
28.Hertling, D. and R.M. Kessler, Management of common musculoskeletal disorders. Physical therapy principles and methods, 1996.3th ed.
29. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine, 2001. 8(12):1153-1157.
30. Mousavi SJ, Parnianpour M, Montazeri A, Mehdian H, Karimi A, Abedi M, Askary AR, Mobini B, Hadian MR. Translation and validation study of the Iranian versions of the Neck Disability Index and the Neck Pain and Disability Scale. Spine, 2007. 32(26): p. E825-E831. doi: 10.1097/BRS.0b013e31815ce6dd.
31.Green LA, McGuire J, Gabriel DA. Flexor carpi radialis surface electromyography electrode placement for evoked and voluntary measures. Muscle & Nerve, 2015. 52(5):818-825.
32.Alshami AM, Bamhair DA. Effect of manual therapy with exercise in patients with chronic cervical radiculopathy: a randomized clinical trial. Trials, 2021. 22(1):1-12.
33.Alayat MSM, Mohamed AA, Helal of, Khaled OA. Efficacy of High-intensity laser therapy in the treatment of chronic neck pain: a randomized double- blind placebo – control trial. lasers med sci 2016; 31: 687 – 694.
34.Basford JR. low intensity laser therapy : still not an established clinical tool. Laser surg med. 1995 ; 16(4) : 331-42.
35.Zati A, Valent A. physical therapy : new technologies in rehabilitation medicine (translated to English). Edizioni Minerva medica. 2006 ; 162-185.
36. Zati A, Valent A. laser therapy in medicine. Torino, Italy, Edizioni Minerva Medica, 2008 ; p : 20-30.
37.Dundar U, Turkmen U, Toktas H, Solak O, Wasli AM. Effect of high- intensity laser therapy in the managment of myofascial pain syndrom of the trapezius: a double – blind, placebo – controlled study. laser med sci. 2015; 30 (1): 325-32.
38.Maeda T . Morphological demonstration of low reactive laser therapeutic pain attenuation effect of the gallium aluminum arsenide diode laser . laser Ther . 1989 ; 1 (1) : 23 -6.
39.Hsieh YL, Hong CZ, Chou LW, Yang SA, Yang CC. Fluence – dependent effects of low – level laser therapy in myofascial trigger spot on modulation of biochemicals associated with pain in a rabbit model. lasers Med sci, 2015; 30 (1): 209 -16.
40.Mendonca F, de tarso comillop. Muscle Fiber conduction velocity and EMG amplitude of the upper trapezius muscle in healthy subjects after low laser irradiation: laser in medical science. 2018; 33 (4): 737-744.