Efficacy of high-power laser therapy combined with exercise on wrist pain, function and joint position sense in female gymnasts with non-specific chronic wrist pain
Abstract
Background: Wrist pain is common and debilitating among gymnasts, presenting a tricky diagnostic and therapeutic challenge resulting in falling down in training sessions and during performance. Objective: To find out the effect of high-power laser treatment, either alone or in combination with exercise, on wrist pain, function and joint position sense in female gymnasts with non-specific chronic wrist pain. Methods: Thirty-six female gymnasts (aged 10 to 16 years) who were diagnosed with non-specific wrist pain were recruited as the participants for the study, and were randomly allocated into three groups. The participants of the laser therapy group received only high power laser therapy, the exercise program group participants received exercises only, and the participants of the combined therapy group received both laser and exercises. Pain, function, and joint position sense were the outcomes measures in the study. Results: In all treatment groups, all measured results improved after therapy. The laser therapy group had the least significant impact, whereas the combined therapy group had the most significant impact. Conclusion: It might be early to say whether solely high-power laser therapy is an effective non-invasive modality for treating female gymnasts with non-specific chronic wrist pain. The addition of associated co-interventions to high power laser treatment can improve the beneficial effects of laser therapy.
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Alayat, M. S. M., Abdel-Kafy, E. M., Elsoudany, A. M., Helal, O. F., & Alshehri, M. A. (2017). Efficacy of high intensity laser therapy in the treatment of male with osteopenia or osteoporosis: a randomized placebo-controlled trial. Journal of Physical Therapy Science, 29(9), 1675-1679. https://doi.org/10.1589/jpts.29.1675
Alayat, M. S. M., Mohamed, A. A., Helal, O. F., & Khaled, O. A. (2016). Efficacy of high-intensity laser therapy in the treatment of chronic neck pain: a randomized double-blind placebo-control trial. Lasers in medical science, 31(4), 687-694. https://doi.org/10.1007/s10103-016-1910-2
Angelova, A., & Ilieva, E. M. (2016). Effectiveness of high intensity laser therapy for reduction of pain in knee osteoarthritis. Pain Research and Management, 2016, 9163618. https://doi.org/10.1155/2016/9163618
Benjamin, H. J., Engel, S. C., & Chudzik, D. (2017). Wrist pain in gymnasts: a review of common overuse wrist pathology in the gymnastics athlete. Current Sports Medicine Reports, 16(5), 322-329. https://doi.org/10.1249/JSR.0000000000000398
Boucher, B., & Smith-Young, B. (2017). Examination and physical therapy management of a young gymnast with bilateral wrist pain: A case report. Physical Therapy in Sport, 27, 38-49. https://doi.org/10.1016/j.ptsp.2017.03.002
Burley, J. P., & Müller, H. J. (1997). Applied Laser Medicine. Interekspert, Moscow, Russia.
Changulani, M., Okonkwo, U., Keswani, T., & Kalairajah, Y. (2008). Outcome evaluation measures for wrist and hand–which one to choose? International Orthopaedics, 32(1), 1-6. https://doi.org/10.1016/j.ptsp.2017.03.002
Chen, L., Liu, D., Zou, L., Huang, J., Chen, J., Zou, Y., ... & Liu, G. (2018). Efficacy of high intensity laser therapy in treatment of patients with lumbar disc protrusion: A randomized controlled trial. Journal of back and musculoskeletal rehabilitation, 31(1), 191-196. https://doi.org/10.3233/BMR-170793
Chow, R., Armati, P., Laakso, E. L., Bjordal, J. M., & Baxter, G. D. (2011). Inhibitory effects of laser irradiation on peripheral mammalian nerves and relevance to analgesic effects: a systematic review. Photomedicine and laser surgery, 29(6), 365-381. https://doi.org/10.1089/pho.2010.2928
Clark, N. C., Röijezon, U., & Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 2: Clinical assessment and intervention. Manual therapy, 20(3), 378-387. https://doi.org/10.1016/j.math.2015.01.009
Co, F. H., Skinner, H. B., & Cannon, W. D. (1993). Effect of reconstruction of the anterior cruciate ligament on proprioception of the knee and the heel strike transient. Journal of Orthopaedic Research, 11(5), 696-704. https://doi.org/10.1002/jor.1100110512
Cooney, W. P. (1993). Evaluation of chronic wrist pain by arthrography, arthroscopy, and arthrotomy. The Journal of hand surgery, 18(5), 815-822. https://doi.org/10.1016/0363-5023(93)90047-7
Cornwall, R. (2010). The painful wrist in the pediatric athlete. Journal of Pediatric Orthopaedics, 30, S13-S16. https://doi.org/10.1097/BPO.0b013e3181d131f9
Earp, B. E., Waters, P. M., & Wyzykowski, R. J. (2006). Arthroscopic treatment of partial scapholunate ligament tears in children with chronic wrist pain. JBJS, 88(11), 2448-2455. https://doi.org/10.2106/JBJS.D.02778
Elangovan, N., Herrmann, A., & Konczak, J. (2014). Assessing proprioceptive function: evaluating joint position matching methods against psychophysical thresholds. Physical therapy, 94(4), 553-561. https://doi.org/10.2522/ptj.20130103
El-Shamy, S. M., & Abdelaal, A. A. M. (2018). Efficacy of pulsed high-intensity laser therapy on pain, functional capacity, and gait in children with haemophilic arthropathy. Disability and rehabilitation, 40(4), 462-468. https://doi.org/10.1080/09638288.2016.1261416
El-Shamy, S. M., Alayat, M. S. M., Abdelgalil, A. A., & Alshehri, M. A. (2018). Long-term effect of pulsed Nd: YAG laser in the treatment of children with juvenile rheumatoid arthritis: a randomized controlled trial. Photomedicine and Laser Surgery, 36(8), 445-451. https://doi.org/10.1089/pho.2018.4444
Ezzati, K., Laakso, E. L., Salari, A., Hasannejad, A., Fekrazad, R., & Aris, A. (2020). The beneficial effects of high-intensity laser therapy and co-interventions on musculoskeletal pain management: a systematic review. Journal of lasers in medical sciences, 11(1), 81. https://doi.org/10.15171/jlms.2020.14
Ferguson, R., Riley, N. D., Wijendra, A., Thurley, N., & Carr, A. J. (2019). Wrist pain: a systematic review of prevalence and risk factors–what is the role of occupation and activity? BMC musculoskeletal disorders, 20(1), 1-13. https://doi.org/10.1186/s12891-019-2902-8
Fyhr, C., Gustavsson, L., Wassinger, C., & Sole, G. (2015). The effects of shoulder injury on kinaesthesia: a systematic review and meta-analysis. Manual Therapy, 20(1), 28-37. https://doi.org/10.1016/j.math.2014.08.006
Fiore, P., Panza, F., Cassatella, G., Russo, A., Frisardi, V., Solfrizzi, V., ... & Santamato, A. (2011). Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of low back pain: a randomized controlled trial. European Journal of Physical and Rehabilitation Medicine, 47(3), 367-73.
Gay, A., Harbst, K., Kaufman, K. R., Hansen, D. K., Laskowski, E. R., & Berger, R. A. (2010). New method of measuring wrist joint position sense avoiding cutaneous and visual inputs. Journal of Neuroengineering and Rehabilitation, 7(1), 1-7. https://doi.org/10.1186/1743-0003-7-5
Goble, D. J. (2010). Proprioceptive acuity assessment via joint position matching: from basic science to general practice. Physical therapy, 90(8), 1176-1184. https://doi.org/10.2522/ptj.20090399
Hagert, E. (2010). Proprioception of the wrist joint: a review of current concepts and possible implications on the rehabilitation of the wrist. Journal of Hand Therapy, 23(1), 2-17. https://doi.org/10.1016/j.jht.2009.09.008
Hagiwara, S., Iwasaka, H., Hasegawa, A., & Noguchi, T. (2008). Pre-irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Anesthesia & Analgesia, 107(3), 1058-1063. https://doi.org/10.1213/ane.0b013e31817ee43e
Hincapie, O. L., Elkins, J. S., & Vasquez-Welsh, L. (2016). Proprioception retraining for a patient with chronic wrist pain secondary to ligament injury with no structural instability. Journal of Hand Therapy, 29(2), 183-190. https://doi.org/10.1016/j.jht.2016.03.008
Hsieh, Y. L., Hong, C. Z., Chou, L. W., Yang, S. A., & Yang, C. C. (2015). Fluence-dependent effects of low-level laser therapy in myofascial trigger spots on modulation of biochemicals associated with pain in a rabbit model. Lasers in medical science, 30(1), 209-216. https://doi.org/10.1007/s10103-014-1654-9
Johnstone, D. J., Thorogood, S., Smith, W. H., & Scott, T. D. (1997). A comparison of magnetic resonance imaging and arthroscopy in the investigation of chronic wrist pain. The Journal of Hand Surgery: British & European Volume, 22(6), 714-718. https://doi.org/10.1016/s0266-7681(97)80431-7
Kasdan, M. L., & Millender, L. H. (1996). Occupational soft-tissue and tendon disorders. The Orthopedic clinics of North America, 27(4), 795-803.
King, C. E., Clelland, J. A., Knowles, C. J., & Jackson, J. R. (1990). Effect of helium-neon laser auriculotherapy on experimental pain threshold. Physical therapy, 70(1), 24-30. https://doi.org/10.1093/ptj/70.1.24
MacDermid, J. C. (2007). The patient-rated wrist evaluation (PRWE)© user manual. Hamilton: McMaster University.
MacDermid, J. C., Richards, R. S., Donner, A., Bellamy, N., & Roth, J. H. (2000). Responsiveness of the short form-36, disability of the arm, shoulder, and hand questionnaire, patient-rated wrist evaluation, and physical impairment measurements in evaluating recovery after a distal radius fracture. The Journal of hand surgery, 25(2), 330-340. https://doi.org/10.1053/jhsu.2000.jhsu25a0330
Maeda, T. (1989). Morphological demonstration of low reactive laser therapeutic pain attenuation effect of the gallium aluminium arsenide diode laser. Laser Therapy, 1(1), 23-26. https://doi.org/10.5978/islsm.89-OR-02
McKeon, J. M. M., & McKeon, P. O. (2012). Evaluation of joint position recognition measurement variables associated with chronic ankle instability: a meta-analysis. Journal of athletic training, 47(4), 444-456. https://doi.org/10.4085/1062-6050-47.4.15
Mehta, S. P., MacDermid, J. C., Richardson, J., MacIntyre, N. J., & Grewal, R. (2015). A systematic review of the measurement properties of the patient-rated wrist evaluation. Journal of orthopaedic & sports physical therapy, 45(4), 289-298. https://doi.org/10.2519/jospt.2015.5236
Mohamadi, A., Claessen, F. M., Ozkan, S., Kolovich, G. P., Ring, D., & Chen, N. C. (2017). Diagnostic wrist arthroscopy for nonspecific wrist pain. Hand, 12(2), 193-196. https://doi.org/10.1177/1558944716661993
Moskvin, S. V., & Achilov, A. A. (2008). Basics of laser therapy. Moscow–Tver: Triada.
Niemz, M. (2007). Laser-Tissue Interactions-Fundamentals and Applications. 3rd. Berlin, Germany: Springer.
Ordahan, B., Karahan, A. Y., & Kaydok, E. (2018). The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: a randomized clinical trial. Lasers in medical science, 33(6), 1363-1369. https://doi.org/10.1007/s10103-018-2497-6
Pekyavas, N. O., & Baltaci, G. (2016). Short-term effects of high-intensity laser therapy, manual therapy, and Kinesio taping in patients with subacromial impingement syndrome. Lasers in medical science, 31(6), 1133-1141. https://doi.org/10.1007/s10103-016-1963-2
Pilbeam, C., & Hood-Moore, V. (2018). Test–retest reliability of wrist joint position sense in healthy adults in a clinical setting. Hand Therapy, 23(3), 100-109. https://doi.org/10.1177/1758998318770227
Postle, K., Pak, D., & Smith, T. O. (2012). Effectiveness of proprioceptive exercises for ankle ligament injury in adults: a systematic literature and meta-analysis. Manual therapy, 17(4), 285-291. https://doi.org/10.1016/j.math.2012.02.016
Röijezon, U., Clark, N. C., & Treleaven, J. (2015). Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Manual therapy, 20(3), 368-377. https://doi.org/10.1016/j.math.2015.01.008
Santamato, A., Solfrizzi, V., Panza, F., Tondi, G., Frisardi, V., Leggin, B. G., ... & Fiore, P. (2009). Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of people with subacromial impingement syndrome: a randomized clinical trial. Physical Therapy, 89(7), 643-652. https://doi.org/10.2522/ptj.20080139
Schiftan, G. S., Ross, L. A., & Hahne, A. J. (2015). The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: a systematic review and meta-analysis. Journal of science and medicine in sport, 18(3), 238-244. https://doi.org/10.1016/j.jsams.2014.04.005
Smith, T. O., King, J. J., & Hing, C. B. (2012). The effectiveness of proprioceptive-based exercise for osteoarthritis of the knee: a systematic review and meta-analysis. Rheumatology international, 32(11), 3339-3351. https://doi.org/10.1007/s00296-012-2480-7
Song, H. J., Seo, H. J., Lee, Y., & Kim, S. K. (2018). Effectiveness of high-intensity laser therapy in the treatment of musculoskeletal disorders: A systematic review and meta-analysis of randomized controlled trials. Medicine, 97(51), 131-146. https://doi.org/10.1097/MD.0000000000013126
Valdes, K., Naughton, N., & Algar, L. (2014). Sensorimotor interventions and assessments for the hand and wrist: a scoping review. Journal of Hand Therapy, 27(4), 272-286. https://doi.org/10.1016/j.jht.2014.07.002
Van Vugt, R. M., Bijlsma, J. W. J., & Van Vugt AC. (1999). Chronic wrist pain: diagnosis and management. Development and use of a new algorithm. Annals of the Rheumatic Diseases, 58, 665-674. https://doi.org/10.1136/ard.58.11.665
Wagner, J., Ipaktchi, K., Livermore, M., & Banegas R (2014). Current indications for and the technique of wrist arthroscopy. Orthopedics, 37(4), 251-256. https://doi.org/10.3928/01477447-20140401-07
Walker‐Bone, K., Palmer, K. T., Reading, I., Coggon, D., & Cooper, C. (2004). Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Care & Research, 51(4), 642-651. https://doi.org/10.1002/art.20535
Westermann, R. W., Giblin, M., Vaske, A., Grosso, K., & Wolf, B. R. (2015). Evaluation of men’s and women’s gymnastics injuries: a 10-year observational study. Sports health, 7(2), 161-165. https://doi.org/10.1002/art.20535
Zati, A., & Valent, A. (2006). Physical therapy: new technologies in rehabilitation medicine. Edizioni Minerva Medica.
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