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Lasers in Medical Science

, Volume 29, Issue 3, pp 1065–1073 | Cite as

Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial

  • Mohamed Salaheldien Mohamed AlayatEmail author
  • Azza Mohamed Atya
  • Mohamed Mohamed Ebrahim Ali
  • Tamer Mohamed Shosha
Original Article

Abstract

The aim of this study was to compare the effect of high-intensity laser therapy (HILT), alone or combined with exercise, in the treatment of chronic low back pain (CLBP). A total of 72 male patients participated in this study, with a mean (SD) age of 32.81 (4.48) years. Patients were randomly assigned into three groups and treated with HILT plus exercise (HILT + EX), placebo laser plus exercise (PL + EX), and HILT alone in groups 1, 2, and 3, respectively. The outcomes measured were lumbar range of motion (ROM), pain level by visual analog scale (VAS), and functional disability by both the Roland Disability Questionnaire (RDQ) and the Modified Oswestry Disability Questionnaire (MODQ). Statistical analyses were performed to compare the differences between baseline and post-treatment measurements. The level of statistical significance was set as P < 0.05. ROM significantly increased after 4 weeks of treatment in all groups, then significantly decreased after 12 weeks of follow-up, but was still significantly more than the baseline value in groups 1 and 2. VAS, RDQ, and MODQ results showed significant decrease post-treatment in all groups, although the RDQ and MODQ results were not significantly different between groups 2 and 3. HILT combined with exercise appears to be more effective in patients with CLBP than either HLLT alone or placebo laser with exercise.

Keywords

CLBP HILT Exercise Pain Functional disability 

Notes

Acknowledgements

The authors express their appreciation to all subjects who participated in this study with all content and cooperation, and give special thanks to their colleagues at the Department of Physical Therapy, Faculty of Applied Medical Science, Umm AL-Qura University, Saudi Arabia. They also thank Dr. Hesham Gad Alrab, assistant professor, Faculty of Education, Mansura University, Egypt, for technical support and statistical analysis.

Conflict of interest

There is no financial and personal relationship with other people or organizations that could inappropriately influence this work.

References

  1. 1.
    Andersson GB (1999) Epidemiological features of chronic low back pain. Lancet 354:581–585PubMedCrossRefGoogle Scholar
  2. 2.
    Palmer KT, Walsh K, Bendall H, Cooper C, Coggan D (2000) Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years. BMJ 320:1577–1578PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Abdulbari B, Omer F, Abdulrahim S, Mohammed S, Ferenc T, Gyorgy L (2004) Epidemiology of low back pain in the United Arab Emirates. J APLAR Rheumatol 7:189–195CrossRefGoogle Scholar
  4. 4.
    Shehab D, Al-Jarallah K, Al-Ghareeb F, Sanaseeri S, Al-Fadhli M, Habeeb S (2004) Is low-back pain prevalent among Kuwaiti children and adolescents? J Med Princ Pract 13:142–6CrossRefGoogle Scholar
  5. 5.
    Al-Arfaj AS, Al-Saleh SS, Alballa SR, Al-Dalaan AN, Bahabri SA, Al-Sekeit MA, Mousa MA (2003) How common is back pain in Al-Qaseem region. Saudi Med J 24(2):170–173PubMedGoogle Scholar
  6. 6.
    Abalkhail BA, Bahnassy AA, Ghabrah TM (1998) Low back pain among Saudi school workers in Jeddah 19(4):491–495Google Scholar
  7. 7.
    Manchikanti L (2000) Epidemiology of low back pain. Pain Physician 3:167–192PubMedGoogle Scholar
  8. 8.
    Grabois M (2005) Management of chronic low back pain. Am J Phys Med Rehabil 84(3):S29–41PubMedGoogle Scholar
  9. 9.
    Van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, van Tulder MW (2011) A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J 20(1):19–39PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Brown AW, Weber DC (2000) Physical agent modalities. In: Braddom RL (ed) Physical medicine and rehabilitation. WB Saunders, Harcourt Health Sciences Company, London, pp 440–458Google Scholar
  11. 11.
    Ozdemir F, Birtane M, Kokino S (2001) The clinical efficacy of low power laser therapy on pain and function in cervical osteoarthritis. Clin Rheumatol 20:181–184PubMedCrossRefGoogle Scholar
  12. 12.
    Gur A, Karakoc M, Nas K (2002) Efficacy of low power laser therapy in fibromyalgia: a single-blind, placebo-controlled trial. Lasers Med Sci 17:57–61PubMedCrossRefGoogle Scholar
  13. 13.
    Peplow PV, Chung T, Baxter GD (2010) Application of low level laser technologies for pain relief and wound healing overview of scientific bases. Physical Therapy Reviews 15(4):253–285CrossRefGoogle Scholar
  14. 14.
    Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M (2003) Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med 32(3):233–8PubMedCrossRefGoogle Scholar
  15. 15.
    Zati A, Valent A (2006) Physical therapy: new technologies in rehabilitation medicine (translated to English). Edizioni Minerva Medica 2006:162–185Google Scholar
  16. 16.
    Santamato A, Solfrizzi V, Panza F, Tondi G, Frisardi V, Leggin BG, Ranieri M, 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. Phys Ther 89(7):643–52PubMedCrossRefGoogle Scholar
  17. 17.
    Viliani T, Ricci E, Mangone G, Graziani C, Pasquetti P (2009) Effects of Hilterapia vs. Viscosupplementation in knee osteoarthritis patients: a randomized controlled clinical trial. Energy for Health; International journal of information and scientific culture (3): 14–17.Google Scholar
  18. 18.
    Saggini R, Bellomo RG, Cancelli F (2009) Hilterapia and chronic ankle pain syndromes. Abstract from Energy for Health; International journal of information and scientific culture. 3 (3):22–25: 38.Google Scholar
  19. 19.
    Djavid GE, Mehrdad R, Ghasemi M, Hasan-Zadeh H, Sotoodeh-Manesh A, Pouryaghoub G (2007) In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomized trial. Aust J Physiother 53(3):155–60PubMedCrossRefGoogle Scholar
  20. 20.
    Welkowitz J, Ewen RB, Cohen J (1982) Introductory statistics for the behavioral sciences, 3rd edn. Harcourt Brace Jovanovich, San Diego, CAGoogle Scholar
  21. 21.
    Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–36PubMedCrossRefGoogle Scholar
  22. 22.
    Roland AI, Morris R (1983) A study of the natural history of back pain: Part I. Development of a reliable and sensitive measure of disability in low-back pain. Spine 8:141–144PubMedCrossRefGoogle Scholar
  23. 23.
    Fairbank JC, Couper J, Davies JB, O'Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273PubMedGoogle Scholar
  24. 24.
    Firtz JM, Irrgang JJ (2001) A comparison of a modified Oswestry low back pain disability questionnaire and the Quebec back pain disability scale. Phys Ther 81:776–778Google Scholar
  25. 25.
    Kachingwe AF, Phillips BJ (2005) Inter- and intrarater reliability of a back range of motion instrument. Arch Phys Med Rehabil 86(12):2347–53PubMedCrossRefGoogle Scholar
  26. 26.
    Tousignanta M, Morissetteb J, Murphy M (2002) Criterion validity study of lumbar goniometers BROM II and EDI-320 for range of motion of lumbar flexion of low back pain patients. J Back Musculoskelet Rehabil 1 16(4):159–67Google Scholar
  27. 27.
    Fiore P, Panza F, Cassatella G, Russo A, Frisardi V, Solfrizzi V, Ranieri M, Di Teo L, 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. Eur J Phys Rehabil Med 47(3):367–73PubMedGoogle Scholar
  28. 28.
    Hadi M, Ali SV, Isa MZ, Zeidi BM (2009) Low level laser therapy (LLLT) for chronic low back pain (LBP). European Journal of Scientific Research 29(1):76–81Google Scholar
  29. 29.
    Jovicić M, Konstantinović L, Lazović M, Jovicić V (2012) Clinical and functional evaluation of patients with acute low back pain and radiculopathy treated with different energy doses of low level laser therapy. Vojnosanit Pregl 69(8):656–62PubMedCrossRefGoogle Scholar
  30. 30.
    Ebid AA, Thabet AA, Helal OF (2011) Effect of pulsed high intensity Nd:YAG laser in treatment of chronic diabetic foot ulcer. Energy for Health; International journal of information and scientific culture 7:25–30Google Scholar
  31. 31.
    Zati A, Fortuna D, Benedetti E, Zaghini I, Bigotta TW (2006) HILT Therapy in the treatment of knee osteoarthritis: the first clinical cases and protocol for a multicenter double-blind randomized trial. Proceedings of 1st National conference dominate energy, scientific report HILT therapy.Google Scholar
  32. 32.
    Stiglić-Rogoznica N, Stamenković D, Frlan-Vrgoc L, Avancini-Dobrović V, Vrbanić TS (2011) Analgesic effect of high intensity laser therapy in knee osteoarthritis. Coll Antropol 35(2):183–5PubMedGoogle Scholar
  33. 33.
    Basford JR (1995) Low intensity laser therapy: still not an established clinical tool. Lasers Surg Med 16(4):331–42PubMedCrossRefGoogle Scholar
  34. 34.
    Stadler I, Lanzafame R, Oskoui P, Zhang R, Coleman J, Whittaker M (2004) Alteration of skin temperature during low level laser irradiation at 830nm in a mouse model. Photomedicine and Laser Surgery 22(3):227–231PubMedCrossRefGoogle Scholar
  35. 35.
    Monici M, Cialdai F, Fusi F, Romano G, Pratesi R (2009) Effects of pulsed Nd:YAG laser at molecular and cellular level. A study on the basis of Hilterapia. Energy for Health; International journal of information and scientific culture 3:(3).Google Scholar
  36. 36.
    Chow R, Armati P, Laakso EL, Bjordal JM, Baxter GD (2011) Inhibitory effects of laser irradiation on peripheral mammalian nerves and relevance to analgesic effects: a systematic review. Photomed Laser Surg 29(6):365–81PubMedCrossRefGoogle Scholar
  37. 37.
    Kujawa J, Zavodnik L, Zavodnik I, Buko V, Lapshyna A, Bryszewska M (2004) Effect of low-intensity (3.75–25 J/cm2) near-infrared (810 nm) laser radiation on red blood cell ATPase activities and membrane structure. J Clin Laser Med Surg 22(2):111–7PubMedCrossRefGoogle Scholar
  38. 38.
    Tilburt JC, Emanuel EJ, Kaptchuk TJ, Curlin FA, Miller FG (2008) Prescribing "placebo treatments": results of national survey of US internists and rheumatologists. BMJ 337:a1938PubMedCentralPubMedCrossRefGoogle Scholar
  39. 39.
    Miller FG, Colloca L (2009) The legitimacy of placebo treatments in clinical practice: evidence and ethics. Am J Bioethics 9:39–47CrossRefGoogle Scholar
  40. 40.
    Puhl AA, Reinhart CJ, Rok ER, Injeyan HS (2011) An examination of the observed placebo effect associated with the treatment of low back pain — a systematic review. Pain Res Manag 16(1):45–52PubMedCentralPubMedGoogle Scholar
  41. 41.
    Akindele MO (2007) Comparison of functional disability with physical activity in patients with low back pain. Nigerian Medical Practitioner 52(4):97–99Google Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Mohamed Salaheldien Mohamed Alayat
    • 1
    Email author
  • Azza Mohamed Atya
    • 1
  • Mohamed Mohamed Ebrahim Ali
    • 2
    • 3
  • Tamer Mohamed Shosha
    • 3
  1. 1.Basic Science Department, Faculty of Physical TherapyCairo UniversityCairoEgypt
  2. 2.Department of Physical Therapy for Musculoskeletal Disorders, Faculty of Physical TherapyCairo UniversityCairoEgypt
  3. 3.Department of Physical Therapy, Faculty of Applied Medical SciencesUmm Al-Qura UniversityMeccaSaudi Arabia

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