Comparação da eficácia clínica da terapia a laser Classe IV e do ultrassom terapêutico em pacientes com dor cervical crônica: um estudo controlado e randomizado

Autores

DOI:

https://doi.org/10.17267/2238-2704rpf.2024.e5538

Palavras-chave:

Terapia a Laser, Cervicalgia, Atividades Cotidianas, Terapia por Ultrassom

Resumo

A dor cervical crônica (DCC) é um problema musculoesquelético comum que afeta uma grande proporção da população e dura mais de três meses. Ela tem um alto custo em termos de vida, incapacidade e assistência médica. Várias modalidades têm proporcionado alívio imediato e de longo prazo para a dor cervical crônica; entretanto, a eficácia clínica comparativa dessas modalidades é limitada. OBJETIVOS: O objetivo do estudo foi determinar a eficácia clínica da terapia a laser de classe IV e do ultrassom terapêutico (UST) em pacientes com DCC. MÉTODOS E MATERIAIS: Quarenta e quatro pacientes com DCC de ambos os sexos, em uma faixa etária de 20 a 45 anos, foram recrutados do Departamento de fisioterapia musculoesquelética do Instituto de Fisioterapia Maharishi Markandeshwar, MM (DU), Ambala, Índia. Eles foram divididos em dois grupos de forma aleatória: o grupo LASER A (n = 22) e o grupo UST B (n = 22). A duração da intervenção foi de 2 semanas com 6 sessões de tratamento. As medidas de resultado pré e pós-tratamento foram avaliadas com os questionários  Escala Visual Analógica (EVA), Algometer, Goniometer e Índice de Incapacidade do Pescoço (IIP) na linha de base e após 2 semanas de intervenção. O grupo LASER recebeu dose alvo de 10 joules por cm2 na potência de 10 watts, com frequência de dosagem contínua. O grupo UST foi submetido a ultrassom em modo contínuo (3 MHz, 1 W/cm2) por 6 minutos. O teste de Shapiro-Wilk foi utilizado para avaliar a normalidade dos dados. Para análise dos dados paramétricos e não paramétricos dentro do grupo, foram utilizados o teste t pareado e o posto sinalizado de Wilcoxon. O teste t independente e o teste Mann-U Whitney foram utilizados para comparação de grupos para dados paramétricos e não paramétricos, respectivamente. RESULTADOS: Em ambos os grupos, houve uma melhora significativa em todas as medidas de resultado (p<0,001). Houve uma diferença estatisticamente significativa entre as duas intervenções na EVA, Limiar de pressão de dor (PPT) e IIP (p<0,05). CONCLUSÕES: A terapia a laser de classe IV é clinicamente mais eficaz do que o ultrassom terapêutico no tratamento de pacientes com dor cervical crônica.

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Referências

(1) Alayat MSM, Mohamed AA, Helal OF, Khaled OA. Efficacy of high-intensity laser therapy in the treatment of chronic neck pain: a randomized double-blind placebo-control trial. Lasers Med Sci. 2016;31(4):687-94. https://doi.org/10.1007/s10103-016-1910-2 DOI: https://doi.org/10.1007/s10103-016-1910-2

(2) Dundar U, Turkmen U, Toktas H, Solak O, Ulasli AM. Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study. Lasers Med Sci. 2015;30(1):325-32. https://doi.org/10.1007/s10103-014-1671-8 DOI: https://doi.org/10.1007/s10103-014-1671-8

(3) Buttagat V, Muenpan K, Wiriyasakunphan W, Pomsuwan S, Kluayhomthong S, Areeudomwong P. A comparative study of Thai massage and muscle energy technique for chronic neck pain: A single-blinded randomized clinical trial. J Bodyw Mov Ther. 2021;27:647-53. https://doi.org/10.1016/j.jbmt.2021.05.007 DOI: https://doi.org/10.1016/j.jbmt.2021.05.007

(4) Khare D, Pathak R. Effectiveness of elastic resistance band exercises versus conventional exercises on cases of trapezitis: A comparative study. Int J Orthop Sci. 2018;4(1):174-8. https://doi.org/10.22271/ortho.2018.v4.i1c.27 DOI: https://doi.org/10.22271/ortho.2018.v4.i1c.27

(5) Seo BK, Lee JH, Kim PK, Baek YH, Jo DJ, Lee S. Bee venom acupuncture, NSAIDs or combined treatment for chronic neck pain: study protocol for a randomized, assessor-blind trial. Trials. 2014;15:132. https://doi.org/10.1186/1745-6215-15-132 DOI: https://doi.org/10.1186/1745-6215-15-132

(6) Ortiz HAB, Cangas SA, Herrera AC, García FO, Velásquez SV. Efficacy of class IV LASER in the management of musculoskeletal pain: a systematic review. Physiother Quart. 2021;29(2):1-11. https://doi.org/10.5114/pq.2021.105882 DOI: https://doi.org/10.5114/pq.2021.105882

(7) Kheshie AR, Alayat MSM, Ali MME. High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers Med Sci. 2014;29(4):1371-6. https://doi.org/10.1007/s10103-014-1529-0 DOI: https://doi.org/10.1007/s10103-014-1529-0

(8) Qing W, Shi X, Zhang Q, Peng L, He C, Wei Q. Effect of Therapeutic Ultrasound for Neck Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2021;102(11):2219-30. https://doi.org/10.1016/j.apmr.2021.02.009 DOI: https://doi.org/10.1016/j.apmr.2021.02.009

(9) Kenareh R, Mirmohammadi SJ, Khatibi A, Shamsi F, Mehrparvar AH. The Comparison of The Efficacy of Photobiomodulation and Ultrasound in the Treatment of Chronic Non-specific Neck Pain: A Randomized Single-Blind Controlled Trial. J Lasers Med Sci. 2021;12:e20. https://doi.org/10.34172/jlms.2021.20 DOI: https://doi.org/10.34172/jlms.2021.20

(10) Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165-9. https://doi.org/10.1097/MRR.0b013e3282fc0f93 DOI: https://doi.org/10.1097/MRR.0b013e3282fc0f93

(11) Young IA PT, Dunning J, Butts R, Mourad F, Cleland JA. Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiother Theory Pract. 2019;35(12):1328-35. https://doi.org/10.1080/09593985.2018.1471763 DOI: https://doi.org/10.1080/09593985.2018.1471763

(12) Oliveira AK, Dibai-Filho AV, Soleira G, Machado ACF, Guirro RRJ. Reliability of pressure pain threshold on myofascial trigger points in the trapezius muscle of women with chronic neck pain. Rev Assoc Med Bras. 2021;67(5):708-12. https://doi.org/10.1590/1806-9282.20201149 DOI: https://doi.org/10.1590/1806-9282.20201149

(13) Farooq MN, Mohseni Bandpei MA, Ali M, Khan GA. Reliability of the universal goniometer for assessing active cervical range of motion in asymptomatic healthy persons. Pak J Med Sci. 2016;32(2):457-61. https://doi.org/10.12669/pjms.322.8747 DOI: https://doi.org/10.12669/pjms.322.8747

(14) Ilter L, Dilek B, Batmaz I, Ulu MA, Sariyildiz MA, Nas K, et al. Efficacy of Pulsed and Continuous Therapeutic Ultrasound in Myofascial Pain Syndrome: A Randomized Controlled Study. Am J Phys Med Rehabil. 2015;94(7):547-54. https://doi.org/10.1097/PHM.0000000000000210 DOI: https://doi.org/10.1097/PHM.0000000000000210

(15) Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem Med. 2021;31(1):010502. https://doi.org/10.11613/BM.2021.010502 DOI: https://doi.org/10.11613/BM.2021.010502

(16) Ortiz HA, Liebano RE, Vera MAV, Cancino JO. Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis. Adv Rehab. 2022;36(3):35-48. https://doi.org/10.5114/areh.2022.119498 DOI: https://doi.org/10.5114/areh.2022.119498

(17) Ezzati K, Laakso EL, Salari A, Hasannejad A, Fekrazad R, Aris A. The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review. J Lasers Med Sci. 2020;11(1):81-90. https://doi.org/10.15171/jlms.2020.14 DOI: https://doi.org/10.15171/jlms.2020.14

(18) Best N, Loppar A, Derlien S, Ullrich S, Smolenski U. The effectiveness of ultrasound applications in comparison to high-intensity laser regarding to the outcome measure of pain intensity at patients with disorders of the lumbar spine or the shoulder. Phys Med Rehab Kuror. 2012;22(3):154-61. https://doi.org/10.1055/s-0032-1309024 DOI: https://doi.org/10.1055/s-0032-1309024

(19) Fiore P, Panza F, Cassatella G, Russo A, Frisardi V, Solfrizzi V, et al. 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. 2011;47(3):367-73. Cited: PMID: 21654616.

(20) Kolu E, Buyukavci R, Akturk S, Eren F, Ersoy Y. Comparison of high-intensity laser therapy and combination of transcutaneous nerve stimulation and ultrasound treatment in patients with chronic lumbar radiculopathy: A randomized single-blind study. Pak J Med Sci. 2018;34(3):530-4. https://doi.org/10.12669/pjms.343.14345 DOI: https://doi.org/10.12669/pjms.343.14345

(21) Mokmeli S, Vetrici M. Low level laser therapy as a modality to attenuate cytokine storm at multiple levels, enhance recovery, and reduce the use of ventilators in COVID-19. Can J Respir Ther. 2020;56:25-31. https://doi.org/10.29390/cjrt-2020-015 DOI: https://doi.org/10.29390/cjrt-2020-015

(22) Maeda T. Morphological demonstration of low reactive laser therapeutic pain attenuation effect of the gallium aluminium arsenide diode laser. Laser Ther. 1989;1(1):23-6. https://doi.org/10.5978/islsm.89-or-02 DOI: https://doi.org/10.5978/islsm.89-OR-02

(23) King CE, Clelland JA, Knowles CJ, Jackson JR. Effect of helium-neon laser auriculotherapy on experimental pain threshold. Phys Ther. 1990;70(1):24-30. https://doi.org/10.1093/ptj/70.1.24 DOI: https://doi.org/10.1093/ptj/70.1.24

(24) Zati A, Valent A. Physical therapy: new technologies in rehabilitation medicine. Torino: Edizioni Minerva Medica; 2006.

(25) Chow R, Armati P, Laakso EL, Bjordal JM, Baxter GD. Inhibitory effects of laser irradiation on peripheral mammalian nerves and relevance to analgesic effects: a systematic review. Photomed Laser Surg. 2011;29(6):365-81. https://doi.org/10.1089/pho.2010.2928 DOI: https://doi.org/10.1089/pho.2010.2928

(26) Hagiwara S, Iwasaka H, Hasegawa A, Noguchi T. Pre-Irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg. 2008;107(3):1058-63. https://doi.org/10.1213/ane.0b013e31817ee43e DOI: https://doi.org/10.1213/ane.0b013e31817ee43e

(27) Moriyama Y, Nguyen J, Akens M, Moriyama EH, Lilge L. In vivo effects of low level laser therapy on inducible nitric oxide synthase. Lasers Surg Med. 2009;41(3):227-31. https://doi.org/10.1002/lsm.20745 DOI: https://doi.org/10.1002/lsm.20745

(28) Tam G. Low power laser therapy and analgesic action. J Clin Laser Med Surg. 1999;17(1):29-33. https://doi.org/10.1089/clm.1999.17.29 DOI: https://doi.org/10.1089/clm.1999.17.29

Publicado

03.06.2024

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1.
Shrestha D, Sharma S. Comparação da eficácia clínica da terapia a laser Classe IV e do ultrassom terapêutico em pacientes com dor cervical crônica: um estudo controlado e randomizado. Rev Pesq Fisio [Internet]. 3º de junho de 2024 [citado 19º de novembro de 2024];14:e5538. Disponível em: https://www5.bahiana.edu.br/index.php/fisioterapia/article/view/5538

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