TREATMENT OF ACHILLES TENDINITIS WITH
CLASS IV INFRARED (980 NM) THERAPEUTIC LASER
https://www.aspenlaseru.com/wp-content/uploads/2016/07/Achilles-Tendinitis.pdf
OBJECTIVE:
To describe the clinical management of Achilles tendinitis by using a “high-power” Class IV therapeutic laser.
CLINICAL FEATURES:
This is a case of a fifty-eight year old woman, 5’4”, 155 lbs., presenting with bilateral Achilles tendon pain, the left foot for two years, the right for one year. She did not respond to physical therapy or steroid injections. Rest relieved the pain, weight bearing activity increased the pain. There was pain on palpation over her Achilles tendons. She showed decreased ankle dorsiflexion, and displayed genu valgum and foot pronation. Resisted neutral position isometric dorsiflexion and active eccentric dorsiflexion exacerbated the pain. Passive eccentric dorsiflexion did not exacerbate the pain. The patient filled out a VAS describing her “worst” pain, “best” pain, and pain “now.” This was filled out on each visit. The patient was accepted for laser therapy.
INTERVENTION AND OUTCOME:
The laser used was the class IV infrared laser, model AVI HP-7 5, continuous wave (nonpulsing). The laser emits a visible red beam at 635 nm wavelengths, and an infrared laser beam at 980 nm wavelength. The power used was 7.5 watts; the dose was 2250 joules; the area was 15 cm; the energy density was .5 w/cm2; the treatment time was 5 minutes per side and the treatment distance was 2 cm. Treatment distance was ensured by securing the laser wand stylus to maintain the treatment distance.
The stylus was kept in light contact with the patient. A swatch of cotton fabric was placed over the tendon with a 3×5 cm hole cut from it to allow for consistent laser treatment area. One open end was placed over
the Achilles insertion, and extending proximally. The patient showed significant reduction in pain as indicated by the VAS scores, and significant increase in dorsiflexion flexibility as measured after four sessions with a goniometer.
CONCLUSION:
This case demonstrates the potential benefit of conservative management for Achilles tendinitis with the utilization of “high-power” Class IV therapeutic laser technology to decrease the symptoms associated with Achilles tendinitis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319951/
Abstract
Background:
Although high-intensity laser therapy (HILT) has been used for the management of musculoskeletal disorders (MSD), studies examining the effectiveness of HILT have been limited. We investigated the effectiveness of HILT in MSD using a systematic review and meta-analysis.
Methods:
We searched the ovid MEDLINE, ovid Embase, Cochrane CENTRAL library, and Web of Science until January, 2018. Relevant studies concerning the effectiveness of HILT in patients with MSD were included. Both placebo and active controls were considered as comparators and only randomized controlled trial (RCT) design studies were included. Risk of bias (ROB) was used for the quality assessment of the RCT. For continuous variables, a meta-analysis was conducted using an inverse variance random effects model. The mean difference (MD) for visual analog scale pain and standardized mean difference (SMD) for disability were applied.
Results:
Twelve studies were selected for this systematic review. In 11 studies, comprising 736 patients, pain was significantly improved by HILT compared with a control group (MD: −1.01; 95% confidence interval [CI]: −1.28 to −0.74). From the analysis of 688 patients from 10 studies, the pooled standardized mean difference (SMD) of HILT showed a significant improvement in disability scores compared with those in the control group (SMD, −1.09; 95% CI −1.77, −0.41). In subgroup analysis by treatment regions, the mean difference (MD) in neck pain was the highest at −1.02 (95% CI: −1.45, −0.58) than in controls, followed by back pain (MD, −0.91; 95% CI: −1.24, −0.59).
Conclusions:
The results of this study show that HILT treatment for back and neck pain significantly improved pain and disability scores compared with controls. The ROB of the included studies was moderate; however, significant heterogeneity existed. Thus, additional well-designed studies involving larger samples with long-term follow-up are needed to further assess each laser application, treatment region, and comparator.
https://www.iomcworld.org/open-access/effects-of-class-iv-laser-in-knee-osteoarthritis-a-randomized-controltrial.pdf
Abstract
Background: Knee osteoarthritis (KOA) is characterized by a gradual wearing away of the cartilage in the joint through strain
originating from weight bearing, repeated injury, and/or damage and is one of the most associated causes of knee pain. Current options for pain management include medication or surgery. Consequently patients are alternatively seeking a non-invasive approach
that can help manage their pain. Recently, Class IV laser has gained popularity due to its clinical efficacy in pain management and non-invasive application.
Objective: The aim of this randomized control trial was to evaluate the effects of a 30W powered Class IV laser with 1064 nmwavelength on knee pain in the treatment of patients with KOA.
Methods: Patients were randomly assigned into two groups. Each patient underwent 7 treatment sessions every other day.
Group-I (Laser group): 30 patients were treated with a semi conductive Class IV Laser with Scanning System applicator (BTL Industries Ltd.) With a maximal power of 30 W and 1064 nm wavelength. Group-II (Control group): 30 patients were treated with the
same device without emission from the laser diode, and only a visible navigation beam to act as a placebo. All patients perception
of pain was evaluated prior to beginning treatment (baseline), following the first session, after the 7 therapies, and 1 month following
the last treatment using the Visual Analogue Scale (VAS).
Results: The Man-Whitney test revealed there was a significant (P=0.01) reduction in pain according to the VAS results for
the laser group (44.24% improvement), whereas the control group displayed no significant difference (3.93% improvement) in pain
perception following the treatment(s).
Conclusion: Class IV laser treatment was found to be an effective modality in reducing knee pain in KOA patients
https://pubmed.ncbi.nlm.nih.gov/27119270/
Abstract
Importance: Although cutaneous warts are common lesions, full remission is not always achieved with conventional therapies. Laser modalities including carbon dioxide (CO2), erbium:yttrium-aluminum-garnet (Er:YAG), pulsed dye (PDL), and Nd:YAG have been investigated as alternative treatments for warts.
Objective: To review the use and efficacy of lasers for treating nongenital cutaneous warts.
Evidence review: Published randomized clinical trials (RCTs), cohort studies, case series, and case reports involving laser treatment of nongenital warts were retrieved by searching PubMed with no date limits. Quality ratings of studies were based on a modified version of the Oxford Centre for Evidence-Based Medicine scheme for rating individual studies. A higher emphasis was placed on RCTs and prospective cohort studies with large sample sizes and detailed methodology.
Findings: There were 35 studies published between 1989 and 2015 that comprised an aggregate of 2149 patients. Simple and recalcitrant nongenital warts treated with lasers show variable response rates (CO2 laser, 50%-100%; Er:YAG laser, 72%-100%; PDL, 47%-100%; and Nd:YAG laser, 46%-100%). Current RCTs suggest that PDL is equivalent to conventional therapies such as cryotherapy and cantharidin. Combination therapies with lasers and other agents including bleomycin, salicylic acid, and light-emitting diode have shown some success.
Conclusions and relevance: Lasers can be an effective treatment option for both simple and recalcitrant warts. The lasers most studied for this purpose are CO2, PDL, and Nd:YAG, and of these, PDL has the fewest adverse effects. Currently, use of lasers for wart treatment is limited by lack of established treatment guidelines. Future studies are needed to compare laser modalities with each other and with non-laser treatment options, and to establish optimal treatment protocols.
