Onur Armagan, Merih Ozgen, Funda Berkan, Burcu Ortanca, Setenay Oner

De-Quervain’s Tenosinovitli Hastalarda Düşük Düzeyli Laser Tedavisinin Etkisi

Bu çalışmanın amacı de Quervain tenosinoviti olan hastalarda başparmak destekli el bilek ateli ile birlikte düşük düzeyli laser tedavisinin (DDLT) etkinliğini değerlendirmek ve DDLT ile kombine edilen başparmak destekli el bilek atelinin tek başına atelden üstün olup olmadığını araştırmaktı. Pozitif Finkelstein testi ve radyal stiloid hassasiyeti olan 34 kadın hasta çalışmaya dahil edildi. Hastalar 2 gruba ayrıldı. Grup 1(n = 18) deki hastalara DDLT ile birlikte başparmak destekli el bilek splinti uygulandı. Grup 2 (n = 17) deki hastalar sadece başparmak destekli el bilek splinti giydi. Hastalara 3 haftalık bir süre boyunca tam bir splint kullanma talimatı verildi. DDLT, haftada beş kez, toplam 15 seans uygulandı. Değerlendirmeler için görsel analog skala (VAS), kavrama gücü ve hastanın sözel olarak ifade ettiği global iyileşme skoru (VSGI) kullanılmıştır. Klinik değerlendirmeler başlangıçta ve tedavi sonunda yapıldı. Tedaviden önce klinik parametreler tedavi grupları arasında benzerdi. Tedavi sonrası VAS, her iki grupta da tedavi öncesi değerlere göre anlamlı olarak iyileşti (grup 1; p

Effect of Low-Level Laser Treatment in de Quervain’s De-Quervain’s Tenosinovitli Has

The aim of the present study was to assess the efficacy of low level laser therapy (LLLT) combined with thumb support wirstsplint in patients with de Quervain’s tenosynovitis and to investigate whether the thumb support wirst splint combined with LLLT is superiorto splint-alone. Thirty-five female patients with a positive Finkelstein test and radial styloid tenderness were included in this study. Patientswere divided two group. Patients in group 1(n=18) were applied LLLT combined thumb support wirst splint and patients in group 2 (n=17)wore thumb support wirst splint-only. Patients were instructed to use one splint full time for a period of 3 weeks. LLLT was applied fivetimes a week, for a total of 15 sessions. Visual analog scale (VAS), grip-strength, and global improvement as reported on a verbal scale(VSGI) were used for evaluations. Clinical evaluations were performed at baseline and at the end of the treatment. Before the treatment,clinical parameters were similar between the treatment groups. Posttreatment VAS significantly improved in both groups compared to thepretreatment values (group 1; p

PDF

___

1. Walker-Bone K, Palmer KT, Reading I, and et al. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum. 2004;51:642-51.
2. Huisstede BM, Gladdines S, Randsdorp MS, and et al. Effectiveness of conservative, surgical, and postsurgical interventions for trigger finger, dupuytren disease, and de Quervain disease: A Systematic Review. Arch Phys Med Rehabil. 2018;99:1635-49.
3. Moore, J.S. De Quervain's tenosynovitis. Stenosing tenosynovitis of the first dorsal compartment. J Occup Environ Med. 1997;39:990–1002.
4. Avci, S., Yilmaz, C., and Sayli, U. Comparison of nonsurgical treatment measures for De Quervain's disease of pregnancy and lactation. J Hand Surg Am. 2002;27:322–4
5. Peters-Veluthamaningal C., Winters J., Groenier K., and et al. Randomized controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice. BMC Musculoskeletal Disord. 2009;10:131.
6. Backstrom, KM. Mobilization with movement as an adjunct intervention in a patient with complicated de Quervain's tenosynovitis: a case report. J Orthop Sports Phys Ther. 2002;32:86-94.
7. Adams JE, Habbu R. Tendinopathies of the hand and wrist. J Am Acad Orthop Surg. 2015; 23:741-50.
8. Richie CA, Briner WW Jr. Corticosteroid injection for treatment of de Quervain’s tenosinovitis: a pooled quantitative literature evaluation. J Am Board Fam Pract. 2003;16:102-6.
9. Weiss AP, Akelman E, Tabatabai M. Treatment of de Quervain’s disease. J Hand Surg 1994;19:595- 8.
10. Bjordal JM, Bensadoun RJ, Tunèr J, and et al. A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer.2011;19:1069-77.
11. Baltzer WA, Stosch D, Seidel F, and et al. Low level laser therapy: A narrative literature review on the efficacy in the treatment of rheumatic orthopaedic conditions. Z Rheumatol. 2017;76:806-12.
12. Gur A, Sarac AJ, Cevik R, and et al. Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial. Lasers Surg Med. 2004;35:229-35.
13. Gur A, Karakoc M, Cevik R, and et al. M. Efficacy of low power laser theraphy and exercise on pain and functions in chronic low back pain. Lasers Surg Med. 2003;32:233-8.
14. Nogueira AC Jr, Júnior Mde J. The effects of laser treatment in tendinopathy: a systematic review.Acta Ortop Bras. 2015; 23:47-9.
15. Lane LB, Boretz RS, Stuchin SA. Treatment of de Quervain's disease:role of conservative management. J Hand Surg Br. 2001; 26:258-60.
16. Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001;38:633-8.
17. Heymann RE, Helfenstein M, Feldman D. A double-blind, randomized, controlled study of amitriptyline, nortriptyline and placebo in patients with fibromyalgia. An analysis of outcome measures. Clin Exp Rheumatol. 2001;19:697-702.
18. Mardani-Kivi M, Karimi Mobarakeh M, Bahrami F, and et al. Corticosteroid injection with or without thumb spica cast for de Quervain tenosynovitis. J Hand Surg. 2014;39:37–41.
19. Mehdinasab SA, Alemohammad SA. Methylprednisolone acetate injection plus casting versus casting alone for the treatment of de Quervain’s tenosynovitis. Arch Iran Med 2010;13:270–4.
20. Tumilty S, Munn J, McDonough S, Hurley DA, Basford JR, Baxter GD. Low level laser treatment of tendinopathy: a systematic review with metaanalysis. Photomed Laser Surg. 2010;28:3-16. doi: 10.1089/pho.2008.2470.
21. Sharma R, Thukral A, Kumar S, and et al. Effect of Low Level Lasers in de Quervains Tenosynovitis: Prospective study with ultrasonographic assessment. Physiotheraphy 2002;88:730-4.
22. Sharma R, Aggarwal AN, Bhatt S, and et al. Outcome of low level lasers versus ultrasonic therapy in de Quervain's tenosynovitis. Indian J Orthop. 2015;49:542-8.
23. Walker J. Relief from chronic pain by low power laser irradiation. Neurosci Lett 1983;43:339–44
24. Bjordal JM, Lopes-Martins RA, Iversen VV. A randomized, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations. Br J Sports Med 2006;40:76–80.
25. Jarvis D, MacIver B, Tanelian DL. Electrophysiologic recording and thermodynamic modeling demonstrate that helium-neon laser irradiation does not affect peripheral Aδ- or Cfiber nociceptors. Pain 1990;43:235–42.
26. Rochkind S, Drory V, Alon M, Nissan M, Ouaknine GE.) Laser phototherapy (780 nm), a new modality in treatment of long-term incomplete peripheral nerve injury: a randomized double-blind placebo-controlled study. Photomed Laser Surg 2007;25:436–42.
27. de Andrade AL, Bossini PS, Parizotto NA. Use of low level laser therapy to control neuropathic pain: A systematic review. J Photochem Photobiol B. 2016;164:36-42.