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Lasers in Medical Science

, Volume 32, Issue 5, pp 1097–1103 | Cite as

Laser acupuncture versus reflexology therapy in elderly with rheumatoid arthritis

  • Afnan Sedky Adly
  • Aya Sedky AdlyEmail author
  • Mahmoud Sedky Adly
  • Zahra M. H. Serry
Original Article

Abstract

The purposes of this study are to determine and compare efficacy of laser acupuncture versus reflexology in elderly with rheumatoid arthritis. Thirty elderly patients with rheumatoid arthritis aged between 60 and 70 years were classified into two groups, 15 patients each. Group A received laser acupuncture therapy (904 nm, beam area of 1cm2, power 100 mW, power density 100 mW/cm2, energy dosage 4 J, energy density 4 J/cm2, irradiation time 40 s, and frequency 100,000 Hz). The acupuncture points that were exposed to laser radiation are LR3, ST25, ST36, SI3, SI4, LI4, LI11, SP6, SP9, GB25, GB34, and HT7. While group B received reflexology therapy, both offered 12 sessions over 4 weeks. The changes in RAQoL, HAQ, IL-6, MDA, ATP, and ROM at wrist and ankle joints were measured at the beginning and end of treatment. There was significant decrease in RAQoL, HAQ, IL-6, and MDA pre/posttreatment for both groups (p < 0.05); significant increase in ATP pre/posttreatment for both groups (p < 0.05); significant increase in ankle dorsi-flexion, plantar-flexion, wrist flexion, extension, and ulnar deviation ROM pre/posttreatment in group A (p < 0.05); and significant increase in ankle dorsi-flexion and ankle plantar-flexion ROM pre/posttreatment in group B (p < 0.05). Comparison between both groups showed a statistical significant decrease in MDA and a statistical significant increase in ATP in group A than group B. Percent of changes in MDA was 41.82%↓ in group A versus 21.68%↓ in group B; changes in ATP was 226.97%↑ in group A versus 67.02%↑ in group B. Moreover, there was a statistical significant increase in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation in group A than group B. Laser therapy is associated with significant improvement in MDA and ATP greater than reflexology. In addition, it is associated with significant improvement in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation greater than reflexology in elderly patients with rheumatoid arthritis.

Keywords

Laser acupuncture Reflexology Rheumatoid arthritis Elderly 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No funding was received.

Ethical approval

All procedures performed were in accordance with the ethical standards of Faculty of Physical Therapy research ethics committee, Cairo University and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Steward K, Land M (2009) Perceptions of patients and professionals on rheumatoid arthritis care. A consultancy report by the King’s Fund for the Rheumatology Futures Group London: The King’s FundGoogle Scholar
  2. 2.
    Yathish G, Balakrishnan C, Mangat G, Parikshit S (2015) Immunomodulators in managing geriatric rheumatoid arthritis. Internet J Rheumatol Clin Immunol 3 (S1)Google Scholar
  3. 3.
    Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, Liang MH, Kremers HM, Mayes MD, Merkel PA (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part I. Arthritis Rheum 58(1):15–25CrossRefPubMedGoogle Scholar
  4. 4.
    McInnes IB, O’Dell JR (2010) State-of-the-art: rheumatoid arthritis. Ann Rheum Dis 69(11):1898–1906CrossRefPubMedGoogle Scholar
  5. 5.
    Shea B, Swinden MV, Tanjong Ghogomu E, Ortiz Z, Katchamart W, Rader T, Bombardier C, Wells GA, Tugwell P (2013) Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev 5Google Scholar
  6. 6.
    Ernst E, Fugh-Berman A (2002) Complementary and alternative medicine: what is it all about? Occup Environ Med 59(2):140–144CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Pagán JA, Pauly MV (2005) Access to conventional medical care and the use of complementary and alternative medicine. Health Aff 24(1):255–262CrossRefGoogle Scholar
  8. 8.
    Hu W-L, Chang C-H, Hung Y-C, Tseng Y-J, Hung I-L, Hsu S-F (2014) Laser acupuncture therapy in patients with treatment-resistant temporomandibular disorders. PLoS One 9(10):e110528CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Vargas JT (2005) Low level laser acupuncture. Medical Acupuncture 16(2):38–41Google Scholar
  10. 10.
    Choi W, Tak S, Yim J, Lee S (2015) Feasibility Study of Laser Acupuncture on Static Balance in Healthy Elderly Women: Pilot StudyGoogle Scholar
  11. 11.
    Brosseau L, Welch V, Wells G, Tugwell P, De Bie R, Gam A, Harman K, Shea B, Morin M (2000) Low level laser therapy for osteoarthritis and rheumatoid arthritis: a metaanalysis. J Rheumatol 27(8):1961–1969PubMedGoogle Scholar
  12. 12.
    Brosseau L, Welch V, Wells GA, de Bie R, Gam A, Harman K, Morin M, Shea B, Tugwell P (2005) Low level laser therapy (Classes I, II and III) for treating rheumatoid arthritis. The Cochrane LibraryGoogle Scholar
  13. 13.
    Alves ACA, de Carvalho PTC, Parente M, Xavier M, Frigo L, Aimbire F, ECPL J, Albertini R (2013) Low-level laser therapy in different stages of rheumatoid arthritis: a histological study. Lasers Med Sci 28(2):529–536CrossRefPubMedGoogle Scholar
  14. 14.
    Attia AM, Ibrahim FA, Abd El-Latif NA, Aziz SW, Elwan AM, Aziz A, Aziz A, Elgendy A, Elgengehy FT (2016) Therapeutic antioxidant and anti-inflammatory effects of laser acupuncture on patients with rheumatoid arthritis. Lasers in surgery and medicineGoogle Scholar
  15. 15.
    Kunz K, Kunz B (1993) The complete guide to foot reflexology (revised) Albuquerque. New Mexico: Kevin and Barbara KunzGoogle Scholar
  16. 16.
    Pitman V, MacKenzie K (2002) Reflexology: a practical approach. Nelson ThornesGoogle Scholar
  17. 17.
    Oleson T (2002) Auriculotherapy stimulation for neuro-rehabilitation. NeuroRehabilitation 17(1):49–62PubMedGoogle Scholar
  18. 18.
    Gozuyesil E, Baser M (2016) The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life. Complement Ther Clin Pract 24:78–85CrossRefPubMedGoogle Scholar
  19. 19.
    Adly AS (2016) Monitoring Laser Therapy Improvement in Range of Motion in Subjects with Tendinopathy Using a Novel Computer Vision System. Cairo UniversityGoogle Scholar
  20. 20.
    Hecker H-U, Steveling A (2011) Color atlas of acupuncture: body points-ear points-trigger points. ThiemeGoogle Scholar
  21. 21.
    Focks C (2008) Atlas of acupuncture. Elsevier Health SciencesGoogle Scholar
  22. 22.
    Mc Vicar A, Greenwood C, Fewell F, D’arcy V, Chandrasekharan S, Alldridge LC (2007) Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: a pilot study in healthy individuals. Complement Ther Clin Pract 13(3):137–145CrossRefGoogle Scholar
  23. 23.
    David J, Townsend S, Sathanathan R, Kriss S, Dore C (1999) The effect of acupuncture on patients with rheumatoid arthritis: a randomized, placebo-controlled cross-over study. Rheumatology 38(9):864–869CrossRefPubMedGoogle Scholar
  24. 24.
    Silman AJ (2002) The changing face of rheumatoid arthritis: why the decline in incidence? Arthritis Rheum 46(3):579–581CrossRefPubMedGoogle Scholar
  25. 25.
    Alamanos Y, Drosos AA (2005) Epidemiology of adult rheumatoid arthritis. Autoimmun Rev 4(3):130–136CrossRefPubMedGoogle Scholar
  26. 26.
    Emery P (2006) Treatment of rheumatoid arthritis. Br Med J 7534:152CrossRefGoogle Scholar
  27. 27.
    Sommer OJ, Kladosek A, Weiler V, Czembirek H, Boeck M, Stiskal M (2005) Rheumatoid arthritis: a practical guide to state-of-the-art imaging, image interpretation, and clinical implications 1. Radiographics 25(2):381–398CrossRefPubMedGoogle Scholar
  28. 28.
    WALT (2010) Recommended anti-inflammatory dosage for low level laser therapy. World Association for Laser Therapy. http://waltza.co.za/documentation-links/recommendations/dosage-recommendations/. Accessed 2014
  29. 29.
    AMAC (2012) Australian Medical Acupuncture College. http://www.chiro.org/acupuncture/FULL/Position_Statement_on_Laser_Acupuncture.shtml. Accessed 2014
  30. 30.
    Araki H, Imaoka A, Kuboyama N, Abiko Y (2011) Reduction of interleukin-6 expression in human synoviocytes and rheumatoid arthritis rat joints by linear polarized near infrared light (Superlizer) irradiation. Laser therapy 20(4):293CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Carteron NL (2000) Cytokines in rheumatoid arthritis: trials and tribulations. Mol Med Today 6(8):315–323CrossRefPubMedGoogle Scholar
  32. 32.
    Jazayeri JA, Carroll GJ, Vernallis AB (2010) Interleukin-6 subfamily cytokines and rheumatoid arthritis: role of antagonists. Int Immunopharmacol 10(1):1–8CrossRefPubMedGoogle Scholar
  33. 33.
    Green VL, Alexandropoulou A, Walker MB, Walker AA, Sharp DM, Walker LG, Greenman J (2010) Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage. Exp Ther Med 1(1):97–108PubMedPubMedCentralGoogle Scholar
  34. 34.
    van Amelsfort JM, Jacobs KM, Bijlsma JW, Lafeber FP, Taams LS (2004) CD4+ CD25+ regulatory T cells in rheumatoid arthritis: differences in the presence, phenotype, and function between peripheral blood and synovial fluid. Arthritis Rheum 50(9):2775–2785CrossRefPubMedGoogle Scholar
  35. 35.
    Kumagai S, Jikimoto T, Saegusa J (2003) Pathological roles of oxidative stress in autoimmune diseases. Rinsho Byori Jpn J Clin Path 51(2):126–132Google Scholar
  36. 36.
    Wattanathorn J, Sutalangka C (2014) Laser acupuncture at HT7 acupoint improves cognitive deficit, neuronal loss, oxidative stress, and functions of cholinergic and dopaminergic systems in animal model of Parkinson’s disease. Evidence-Based Complementary and Alternative Medicine 2014Google Scholar
  37. 37.
    Kunz K, Kunz B (1999) Medical Applications of Reflexology: Findings in Research about Safety, Efficacy, Mechanism of Action and Cost-effectiveness of Reflexology. RRP PressGoogle Scholar
  38. 38.
    Huang Y-Y, Sharma SK, Carroll J, Hamblin MR (2011) Biphasic dose response in low level light therapy–an update. Dose-Response 9 (4):dose-response. 11–009. HamblinGoogle Scholar
  39. 39.
    Evans DH, Abrahamse H 2008 Effect of laser irradiation on mitochondrial responses of stressed keratinocytes. In: International Conference of the World Association of Laser Therapy, Sun City, North West Province, South Africa. Retrieved from http://www.biolase.com/Medical/Documents/Effect-of-Laser-Irradiation-on-Mitochondrial.pdf
  40. 40.
    Wang L, Sikora J, Hu L, Shen X, Grygorczyk R, Schwarz W (2013) ATP release from mast cells by physical stimulation: a putative early step in activation of acupuncture points. Evidence-Based Complementary and Alternative Medicine 2013Google Scholar
  41. 41.
    Zhang D, Spielmann A, Wang L, Ding G, Huang F, Gu Q, Schwarz W (2012) Mast-cell degranulation induced by physical stimuli involves the activation of transient-receptor-potential channel TRPV2. Physiol Res 61(1):113–124PubMedGoogle Scholar
  42. 42.
    Ingham ED, Byers DC (1984) The Original Works of Eunice D. Ingham: Stories the Feet Can Tell Thru Reflexology: Stories the Feet Have Told Thru Reflexology. Ingham PubGoogle Scholar
  43. 43.
    Sudmeier I, Bodner G, Egger I, Mur E, Ulmer H, Herold M (1999) Changes of renal blood flow during organ-associated foot reflexology measured by color Doppler sonography. Forschende Komplementarmedizin 6(3):129–134CrossRefPubMedGoogle Scholar
  44. 44.
    Jones J, Thomson P, Lauder W, Howie K, Leslie SJ (2012) Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: a double-blind randomised controlled trial. Complement Ther Clin Pract 18(4):204–211CrossRefPubMedGoogle Scholar
  45. 45.
    Chow RT, David MA, Armati PJ (2007) 830 nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: implications for the analgesic effects of 830 nm laser. J Peripher Nerv Syst 12(1):28–39CrossRefPubMedGoogle Scholar
  46. 46.
    Poole H, Glenn S, Murphy P (2007) A randomised controlled study of reflexology for the management of chronic low back pain. Eur J Pain 11(8):878–887CrossRefPubMedGoogle Scholar
  47. 47.
    Tiran D (2010) Reflexology in pregnancy and childbirth. Elsevier Health SciencesGoogle Scholar
  48. 48.
    Khan S, Otter S, Springett K (2006) The effects of reflexology on foot pain and quality of life in a patient with rheumatoid arthritis: a case report. Foot 16(2):112–116CrossRefGoogle Scholar
  49. 49.
    McCullough J, Liddle S, Sinclair M, Close C, Hughes C (2014) The physiological and biochemical outcomes associated with a reflexology treatment: a systematic review. Evidence-Based Complementary and Alternative Medicine 2014Google Scholar
  50. 50.
    De Jong Z, van der Heijde D, McKenna S, Whalley D (1997) The reliability and construct validity of the RAQoL: a rheumatoid arthritis-specific quality of life instrument. Rheumatology 36(8):878–883CrossRefGoogle Scholar
  51. 51.
    McDowell I (2006) Measuring health: a guide to rating scales and questionnaires. Oxford university pressGoogle Scholar

Copyright information

© Springer-Verlag London 2017

Authors and Affiliations

  • Afnan Sedky Adly
    • 1
  • Aya Sedky Adly
    • 2
    Email author
  • Mahmoud Sedky Adly
    • 3
  • Zahra M. H. Serry
    • 4
  1. 1.Medical Applications of Laser in Physical Medicine, Physical Therapy for Cardiovascular-Respiratory Disorders and GeriatricsCairo University Kasr El Aini Medical SchoolCairoEgypt
  2. 2.Computer Science, Biomedical InformaticsHelwan University Faculty of Computers and InformationCairoEgypt
  3. 3.Orthodontics and Dentofacial Orthopedics, Medical Applications of LaserCairo University Faculty of Oral and Dental MedicineCairoEgypt
  4. 4.Physical Therapy for Cardiovascular-Respiratory Disorders and GeriatricsCairo University Faculty of Physical TherapyCairoEgypt

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