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THU0562 Low-Level Laser Therapy with Wrist Splint in the Treatment of Carpal Tunnel Syndrome: A Double-Blinded Randomized Controlled Trial
  1. Y. Fusakul1,
  2. T. Aranyavalai1,
  3. P. Saensri1,
  4. S. Thiengwittayaporn2
  1. 1Department of Physical Medicine and Rehabilitation
  2. 2Department of Orthopeadic Surgery, Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis, Bangkok, Thailand

Abstract

Background Low-level laser therapy (LLLT) has been found to have beneficial effects in treatment of entrapment neuropathy and various musculoskeletal conditions.

Objectives The aim of the study was to evaluate the efficacy of LLLT in patients with mild to moderate carpal tunnel syndrome (CTS) with double-blinded randomized controlled study.

Methods A total of 66 patients were randomly assigned into two groups. Group I received 15 sessions of laser therapy using Galium-Aluminium-Arsenide (Ga-Al-As) laserat a dosage of 18Joules per sessionover carpal tunnel area with wrist splint. Group II received placebo lasertherapy with wrist splint. The patients were evaluated with the following parameters (1) clinical parameters which consisted of visual analogue scale (VAS), symptom severity scale (SSS), functional status scale (FSS), pinch strength and grip strength at baseline, 5-week follow-up and 12-week follow-up (2) electroneurophysiological parameters from nerve conduction study (NCS) which were evaluated at baseline and at 12-week follow-up.

Results 59 patients (112 hands: unilateral CTS = 6 hands and bilateral CTS = 106 hands) completed the study. Improvements were significantly more pronounced in laser group than placebo group. At 5-week follow-up, there were improvements in VAS, SSS, FSS and grip strength in laser group when compared with baseline but only VAS, SSS and FSS improved in placebo in group. At 12-week follow-up, all clinical parameters in laser group improved when compared with baseline whereas grip strength in placebo group did not improve significantly. A comparison between groups showed significant improvement in SSS at 5-week follow-up while SSS at baseline did not show any statistical difference between groups. The electroneurophysiological parameters were statistically different in distal motor latency (DML) of median nerve between at baseline and at 12-week follow-up only in laser group. Side effects from laser treatment were reported in 4 hands: wrist pain of mild degree in 2 hands and discomfort in 2 hands during treatment.

Conclusions Laser therapy as a new conservative treatment is effective and safe in treating mild to moderate CTS patients. It can improve symptoms, hand grip and pinch strengths, and electroneurophysiological parameters for these patients with carry-over effect up to 3 months post-treatment especially for grip strength of the affected hands.

References

  1. Yagci I, Elmas O, Akcan E, Ustun I, Gunduz OH, Guven Z. Comparison of splinting and splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome. ClinRheumato 2009; 28: 1059-65.

  2. Shooshtari SM, Badiee V, Taghizadeh SH, Nematollahi AH, Armanollahi AH, Grami MT. The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome. ElectromyogrClinNeurophysiol 2008; 48(5): 229-31.

Disclosure of Interest None Declared

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