高能量激光疗法治疗常见运动损伤与骨科疾病
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摘要
背景:高能量激光疗法具有更好的穿透性,更高的输出功率,在常见骨科疾病以及常见运动损伤如骨关节退行性疾病、慢性肌肉软组织损伤、脊柱疾病等的治疗方面具有广阔的前景。目前,临床对这种疗法的应用缺少统一标准,适应证、参数、疗程等缺乏循证医学支持,需要更多随机对照研究来验证。目的:为高能激光疗法在治疗常见运动损伤和骨科疾病方面提供理论和方法依据。方法:于2018年5至7月以主题词检索PubMed、中国学术期刊全文数据库和万方数据库收录的文献。中文检索词为"高能量激光疗法"、"运动损伤"、"物理治疗"、"骨关节退行性疾病"、"慢性肌肉软组织损伤"、"脊柱疾病";英文检索词为"high Intensity laser therapy"、"sports injuries"、"Physical therapy"、"Osteoarthritis degenerative disease"、"Chronic muscle soft tissue injury"、"Spinal disease"。检索时限为2010至2018年。结果与结论:①共21篇文献纳入研究、其中包括骨关节退行性疾病、慢性肌肉软组织损伤、脊柱疾病、代谢性疾病和急性肌肉软组织损伤等疾病;②应对相同的疾病时,高能量激光疗法的参数也有不同的选择。疾病的病程、病情的严重程度、体表阻挡组织的厚度等都有可能影响治疗方法的调整;③结果提示高能量激光疗法可减少炎症反应、疼痛物质产生,促进血液循环和淋巴循环,修复受损肌腱,并可治愈局部骨质流失和刺激新骨形成,且对常见运动损伤及骨科疾病的治疗效果是可以预期的。
BACKGROUND: High energy laser therapy has good penetration and high output power, and has broad prospects in the treatment of common orthopedic diseases and common sports injuries, such as degenerative diseases of bone and joints, chronic muscle and soft tissue injuries, and spinal diseases. At present, the clinical application of this therapy lacks a unified standard, and there is a lack of evidence-based medical support in terms of indications, parameters and courses of treatment.Therefore, more randomized controlled studies are needed.OBJECTIVE: To provide theoretical and methodological basis for high-energy laser therapy in the treatment of common sports injuries and orthopedic diseases.METHODS: Databases of PubMed, CNKI, and WanFang were searched from May-July, 2018. The keywords were "high intensity laser therapy, sports injuries, physical therapy, osteoarthritis degenerative disease, chronic muscle soft tissue injury, spinal disease" in English and Chinese, respectively for the articles published from 2010 to 2018.RESULTS AND CONCLUSION:(1) Twenty-one eligible articles were included in the study, including diseases such as osteoarticular degenerative diseases, chronic muscle soft tissue injuries, spinal diseases, metabolic diseases, and acute muscle and soft tissue injuries.(2)When dealing with the same disease, the parameters of high energy laser therapy have different choices. The course of the disease, the severity of the condition, and the thickness of the body's blocking tissue may affect the adjustment of the treatment.(3) High energy laser therapy can reduce inflammation, production of painful substances, promote blood circulation and lymph circulation, and repair damaged tendons. High energy laser therapy can cure local bone loss and stimulate new bone formation. The treatment effect on common sports injuries and orthopedic diseases is expected.
BACKGROUND: High energy laser therapy has good penetration and high output power, and has broad prospects in the treatment of common orthopedic diseases and common sports injuries, such as degenerative diseases of bone and joints, chronic muscle and soft tissue injuries, and spinal diseases. At present, the clinical application of this therapy lacks a unified standard, and there is a lack of evidence-based medical support in terms of indications, parameters and courses of treatment.Therefore, more randomized controlled studies are needed.OBJECTIVE: To provide theoretical and methodological basis for high-energy laser therapy in the treatment of common sports injuries and orthopedic diseases.METHODS: Databases of PubMed, CNKI, and WanFang were searched from May-July, 2018. The keywords were "high intensity laser therapy, sports injuries, physical therapy, osteoarthritis degenerative disease, chronic muscle soft tissue injury, spinal disease" in English and Chinese, respectively for the articles published from 2010 to 2018.RESULTS AND CONCLUSION:(1) Twenty-one eligible articles were included in the study, including diseases such as osteoarticular degenerative diseases, chronic muscle soft tissue injuries, spinal diseases, metabolic diseases, and acute muscle and soft tissue injuries.(2)When dealing with the same disease, the parameters of high energy laser therapy have different choices. The course of the disease, the severity of the condition, and the thickness of the body's blocking tissue may affect the adjustment of the treatment.(3) High energy laser therapy can reduce inflammation, production of painful substances, promote blood circulation and lymph circulation, and repair damaged tendons. High energy laser therapy can cure local bone loss and stimulate new bone formation. The treatment effect on common sports injuries and orthopedic diseases is expected.
引文
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[23]Güner A,Altan L,Kasapo?lu Aksoy M.The effectiveness of the low-power laser and kinesiotaping in the treatment of carpal tunnel syndrome,a pilot study.Rheumatol Int.2018;38(5):895-904.
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[29]Femiano F,Femiano R,Lanza A,et al.Effectiveness on oral pain of 808-nm diode laser used prior to composite restoration for symptomatic non-carious cervical lesions unresponsive to desensitizing agents.Lasers Med Sci.2017;32(1):67-71.
[30]Ji YW,Kim M,Kang DSY,et al.Effect of Lowering Laser Energy on the Surface Roughness of Human Corneal Lenticules in SMILE.J Refract Surg.2017;33(9):617-624.
[31]Barbosa NG,Gonzaga AKG,de Sena Fernandes LL,et al.Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome:a randomized clinical trial.Lasers Med Sci.2018;33(6):1255-1262.
[32]Bickle C,Deighan M,Theis N.The effect of pointe shoe deterioration on foot and ankle kinematics and kinetics in professional ballet dancers.Hum Mov Sci.2018;60:72-77.
[33]Bay C,Vissing AC,Thaysen-Petersen D,et al.Skin reactions after photodynamic therapy are unaffected by 839?nm photobiomodulation therapy:A randomized,double-blind,placebo-controlled,clinical trial.Lasers Surg Med.2017;49(9):810-818.
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[46]Alayat MSM,Abdel-Kafy EM,Thabet AAM,et al.Long-Term Effect of Pulsed Nd-YAG Laser Combined with Exercise on Bone Mineral Density in Men with Osteopenia or Osteoporosis:1 Year of Follow-Up.Photomed Laser Surg.2018;36(2):105-111.
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[2]Dundar U,Turkmen U,Toktas H,et al.Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius:a double-blind,placebo-controlled study.Lasers Med Sci.2015;30(1):325-332.
[3]Dundar U,Turkmen U,Toktas H,et al.Effectiveness of high-intensity laser therapy and splinting in lateral epicondylitis;a prospective,randomized,controlled study.Lasers Med Sci.2015;30(3):1097-1107.
[4]Boyraz I,Yildiz A,Koc B,et al.Comparison of high-intensity laser therapy and ultrasound treatment in the patients with lumbar discopathy.Biomed Res Int.2015;2015:304328.
[5]Alayat MSM,Abdel-Kafy EM,Thabet AAM,et al.Long-Term Effect of Pulsed Nd-YAG Laser Combined with Exercise on Bone Mineral Density in Men with Osteopenia or Osteoporosis:1 Year of Follow-Up.Photomed Laser Surg.2018;36(2):105-111.
[6]dos Reis MC,de Andrade EA,Borges AC,et al.Immediate effects of low-intensity laser(808 nm)on fatigue and strength of spastic muscle.Lasers Med Sci.2015;30(3):1089-1096.
[7]Marini L.SPF-RR sequential photothermal fractional resurfacing and remodeling with the variable pulse Er:YAGlaser and scanner-assisted Nd:YAG laser.J Cosmet Laser Ther.2009;11(4):202-211.
[8]Leal Junior EC,Lopes-Martins RA,Baroni BM,et al.Comparison between single-diode low-level laser therapy(LLLT)and LED multi-diode(cluster)therapy(LEDT)applications before high-intensity exercise.Photomed Laser Surg.2009;27(4):617-623.
[9]Nes AG,Posso MB.Patients with moderate chemotherapyinduced mucositis:pain therapy using low intensity lasers.Int Nurs Rev.2005;52(1):68-72.
[10]Bayram K,Yesil H,Dogan E.Efficacy of extracorporeal shock wave therapy in the treatment of lateral epicondylitis.North Clin Istanb.2014;1(1):33-38.
[11]Ordahan B,Karahan AY,Kaydok E.The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis:a randomized clinical trial.Lasers Med Sci.2018;33(6):1363-1369.
[12]Ebid AA,Ibrahim AR,Omar MT,et al.Long-term effects of pulsed high-intensity laser therapy in the treatment of post-burn pruritus:a double-blind,placebo-controlled,randomized study.Lasers Med Sci.2017;32(3):693-701.
[13]Ebid AA,El-Sodany AM.Long-term effect of pulsed high-intensity laser therapy in the treatment of post-mastectomy pain syndrome:a double blind,placebocontrol,randomized study.Lasers Med Sci.2015;30(6):1747-1755.
[14]Alayat MS,Atya AM,Ali MM,et al.Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain:a randomized blinded placebocontrolled trial.Lasers Med Sci.2014;29(3):1065-1073.
[15]Alayat MS,Elsodany AM,El Fiky AA.Efficacy of high and low level laser therapy in the treatment of Bell's palsy:a randomized double blind placebo-controlled trial.Lasers Med Sci.2014;29(1):335-342.
[16]Euzebio Alves VT,de Andrade AK,Toaliar JM,et al.Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment:a 6-month clinical trial.Clin Oral Investig.2013;17(1):87-95.
[17]Karaca B.Effectiveness of High-Intensity Laser Therapy in Subacromial Impingement Syndrome.Photomed Laser Surg.2016;34(6):223-228.
[18]Aranha AC,Eduardo Cde P.Effects of Er:YAG and Er,Cr:YSGG lasers on dentine hypersensitivity.Short-term clinical evaluation.Lasers Med Sci.2012;27(4):813-818.
[19]Sarilho de Mendon?a F,de Tarso Camillo de Carvalho P,Biasotto-Gonzalez DA,et al.Muscle fiber conduction velocity and EMG amplitude of the upper trapezius muscle in healthy subjects after low-level laser irradiation:a randomized,double-blind,placebo-controlled,crossover study.Lasers Med Sci.2018;33(4):737-744.
[20]Matos VAF,Souza DC,Santos VOA,et al.Acute Effects of High-Intensity Interval and Moderate-Intensity Continuous Exercise on GLP-1,Appetite and Energy Intake in Obese Men:A Crossover Trial.Nutrients.2018;10(7):E889.
[21]Kubot A,Grzegorzewski A,Synder M,et al.Radial Extracorporeal Shockwave Therapy and Ultrasound Therapy in the Treatment of Tennis Elbow Syndrome.Ortop Traumatol Rehabil.2017;19(5):415-426.
[22]De Micheli G,de Andrade AK,Alves VT,et al.Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment:a randomized controlled trial.Lasers Med Sci.2011;26(1):43-48.
[23]Güner A,Altan L,Kasapo?lu Aksoy M.The effectiveness of the low-power laser and kinesiotaping in the treatment of carpal tunnel syndrome,a pilot study.Rheumatol Int.2018;38(5):895-904.
[24]Kheshie AR,Alayat MS,Ali MM.High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis:a randomized controlled trial.Lasers Med Sci.2014;29(4):1371-1376.
[25]Vieira KA,Bastos CM,Vitor MGC,et al.Use of low-level laser therapy on children aged 1 to 5 years with energy-protein malnutrition:A clinical trial.Medicine(Baltimore).2018;97(17):e0538.
[26]Vaghardoost R,Momeni M,Kazemikhoo N,et al.Effect of low-level laser therapy on the healing process of donor site in patients with grade 3 burn ulcer after skin graft surgery(a randomized clinical trial).Lasers Med Sci.2018;33(3):603-607.
[27]Chen L,Liu D,Zou L,et al.Efficacy of high intensity laser therapy in treatment of patients with lumbar disc protrusion:Arandomized controlled trial.J Back Musculoskelet Rehabil.2018;31(1):191-196.
[28]Harris DM,White JM,Goodis H,et al.Selective ablation of surface enamel caries with a pulsed Nd:YAG dental laser.Lasers Surg Med.2002;30(5):342-350.
[29]Femiano F,Femiano R,Lanza A,et al.Effectiveness on oral pain of 808-nm diode laser used prior to composite restoration for symptomatic non-carious cervical lesions unresponsive to desensitizing agents.Lasers Med Sci.2017;32(1):67-71.
[30]Ji YW,Kim M,Kang DSY,et al.Effect of Lowering Laser Energy on the Surface Roughness of Human Corneal Lenticules in SMILE.J Refract Surg.2017;33(9):617-624.
[31]Barbosa NG,Gonzaga AKG,de Sena Fernandes LL,et al.Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome:a randomized clinical trial.Lasers Med Sci.2018;33(6):1255-1262.
[32]Bickle C,Deighan M,Theis N.The effect of pointe shoe deterioration on foot and ankle kinematics and kinetics in professional ballet dancers.Hum Mov Sci.2018;60:72-77.
[33]Bay C,Vissing AC,Thaysen-Petersen D,et al.Skin reactions after photodynamic therapy are unaffected by 839?nm photobiomodulation therapy:A randomized,double-blind,placebo-controlled,clinical trial.Lasers Surg Med.2017;49(9):810-818.
[34]Akkurt E,Kucuksen S,Y?lmaz H,et al.Long term effects of high intensity laser therapy in lateral epicondylitis patients.Lasers Med Sci.2016;31(2):249-253.
[35]Stigli?-Rogoznica N,Stamenkovi?D,Frlan-Vrgoc L,et al.Analgesic effect of high intensity laser therapy in knee osteoarthritis.Coll Antropol.2011;35 Suppl 2:183-185.
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