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Synergic effects of ultrasound and laser on the pain relief in women with hand osteoarthritis

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Abstract

Patients with pain avoid movements, leading to a gradual impairment of their physical condition and functionality. In this context, the use of ultrasound (US) and low-level laser therapy (LLLT) show promising results for nonpharmacological and noninvasive treatment. The aim of this study was evaluated the synergistic effects of the US and the LLLT (new prototype) with or without therapeutic exercises (TE) on pain and grip strength in women with hand osteoarthritis. Forty-five women with hand osteoarthritis, aged 60 to 80 years, were randomly assigned to one of three groups, but 43 women successfully completed the full study. The three groups were as follows: (i) the placebo group which did not perform TE, but the prototype without emitting electromagnetic or mechanical waves was applied (n = 11); (ii) the US + LLLT group which carried out only the prototype (n = 13); and (iii) the TE + US + LLLT group which performed TE before the prototype is applied (n = 13). The parameters of US were frequency 1 MHz; 1.0 W/cm2 intensity, pulsed mode 1:1 (duty cycle 50 %). Regarding laser, the output power of the each laser was fixed at 100 mW leading to an energy value of 18 J per laser. Five points were irradiated per hand, during 3 min per point and 15 min per session. The prototype was applied after therapeutic exercises. The treatments are done once a week for 3 months. Grip strength and pressure pain thresholds (PPT) were measured. Grip strength did not differ significantly for any of the groups (p ≥ 0.05). The average PPT between baseline and 3 months shows significant decrease of the pain sensitivity for both the US + LLLT group (∆ = 30 ± 19 N, p˂0.001) and the TE + US + LLLT group (∆ = 32 ± 13 N, p < 0.001). However, there were no significant differences in average PPT for placebo group (∆ = −0.3 ± 9 N). There was no placebo effect. The new prototype that combines US and LLLT reduced pain in women with hand osteoarthritis.

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Acknowledgments

We would like to thank the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)—grant no. 2013/07276-1 and 2013/14001-9, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)—grant no. 573587/2008.

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Authors and Affiliations

  1. Optics Group from Physics Institute of São Carlos (IFSC), University of São Paulo (USP), Av. Trabalhador Sãocarlense, 400-Centro, CEP 13560-970, São Carlos, SP, Brazil

    Alessandra Rossi Paolillo, Fernanda Rossi Paolillo, Jessica Patrícia João, Herbert Alexandre João & Vanderlei Salvador Bagnato

  2. Department of Occupational Therapy, Federal University of São Carlos (UFSCar), Rodovia Washington Luiz, Km. 235, CEP 13565-905, São Carlos, SP, Brazil

    Alessandra Rossi Paolillo

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  1. Alessandra Rossi Paolillo
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Correspondence to Alessandra Rossi Paolillo.

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Paolillo, A.R., Paolillo, F.R., João, J.P. et al. Synergic effects of ultrasound and laser on the pain relief in women with hand osteoarthritis. Lasers Med Sci 30, 279–286 (2015). https://doi.org/10.1007/s10103-014-1659-4

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