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Low intensity laser and LED therapies associated with lateral decubitus position and flexion exercises of the lower limbs in patients with lumbar disk herniation: clinical randomized trial

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Abstract

The objective of this study is to evaluate the effectiveness of laser and LED therapies, associated with lateral decubitus position and flexion exercises of the lower limbs in patients with lumbar disk herniation (LDH). It is a randomized blinded clinical trial. Fifty-four subjects with LDH L4-L5 and L5-S1 were selected and randomly allocated into groups: laser 904 nm, placebo, and LED 945 nm. The numbers of subjects for each group that completed the treatment were 18, 13, and 18, respectively. Twelve points over the lumbar spine region (L2 to S1) and eight points on the injured thigh in the path of the lumbar roots L5 and S1 were irradiated. Irradiation parameters for each point were as follows: laser wavelength 904 ± 10 nm, average power 0.038 ± 20 % W, irradiated area 0.16 cm2, energy per point 4 J, and treatment time per point 104 s; LED wavelength 945 ± 15 nm, power 0.1 W, irradiated area 1.0cm2, energy per point 4 J, and treatment time per point 40 s. Lateral decubitus opposite to the side of the radicular was the standard position for all patients. After phototherapy and laser placebo sessions, the subjects performed sequences of flexion exercises of the lower limbs (ten per session) for 15 daily sessions. Variables studied: pain intensity assessed by visual analog scale (VAS), degree of flexion of the affected hip measured by the universal goniometer and functional capacity assessed by the Oswestry Disability Index. The three groups had statistically significant improvement in lumbar and radicular pain, in hip mobility, and in the functional disability index (p ≤ 0.001). There was a statistically significant difference (p = 0.024) in radicular pain between the groups, gait claudication and Oswestry Disability Index. We can conclude that in the treatment of L4-L5 and L5-S1 LDH with radiculopathy, LED, associated with lateral decubitus position and flexion exercises of the lower limbs, showed better therapeutic performance for radicular pain, gait claudication, and functional disability.

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Acknowledgments

Maria E.I.M. Carvalho thanks the University Camilo Castelo Branco, State University of Piauí, and Getúlio Vargas Hospital for making the development of this work possible.

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Authors and Affiliations

  1. Biomedical Engineering Institute, University Camilo Castelo Branco, Dr. Altino Bondesan Road, 500 District of Eugênio de Melo, 12247-004, São José dos Campos, São Paulo, Brazil

    Maria Ester I. Mendes de Carvalho, Osmar Pinto Neto, Antonio Balbin Villaverde & Carlos José de Lima

  2. Department of Physical Therapy, State University of Piauí, Teresina, Piauí, Brazil

    Maria Ester I. Mendes de Carvalho

  3. Department of Physical Therapy, Getulio Vargas Hospital, Teresina, Piaui, Brazil

    Maria Ester I. Mendes de Carvalho

  4. Specialized Medicine Department—Neurology, Federal University of Piauí, Teresina, Piaui, Brazil

    Reynaldo Mendes de Carvalho Jr & Antonio César Almeida de Oliveira

  5. Department of Neurosurgery, Getulio Vargas Hospital, Teresina, Piaui, Brazil

    Reynaldo Mendes de Carvalho Jr

  6. Department of Rehabilitation, University of São Paulo USP, São Paulo, São Paulo, Brazil

    Amélia Pasqual Marques

  7. Department of Anesthesiology, Getulio Vargas Hospital, Teresina, Piaui, Brazil

    Lorena Mendes de Carvalho Lucio

  8. Cité Center of Innovation, Technology, and Education, São José dos Campos, São Paulo, Brazil

    Antonio Balbin Villaverde & Carlos José de Lima

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  1. Maria Ester I. Mendes de Carvalho
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Corresponding author

Correspondence to Antonio Balbin Villaverde.

Ethics declarations

The research involved patients of physiotherapy services in a public hospital and a private clinic and was approved by the research and ethics committee of the State University of Piauí/Brazil platform (CAAE no. 03231112.0.0000.5209) under no. 54123 on 12/06/2012 and recorded in “The Universal Trial Number (UTN)” under no. U1111-1147-7846. International Clinical Trials Registry Platform (ICTRP). Registry U URL (register number): RBR-8v5s6s. All patients signed a consent form of their own free will.

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de Carvalho, M.E.I.M., de Carvalho, R.M., Marques, A.P. et al. Low intensity laser and LED therapies associated with lateral decubitus position and flexion exercises of the lower limbs in patients with lumbar disk herniation: clinical randomized trial. Lasers Med Sci 31, 1455–1463 (2016). https://doi.org/10.1007/s10103-016-2009-5

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  • DOI: https://doi.org/10.1007/s10103-016-2009-5

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